technetium-tc-99m-medronate and Intervertebral-Disc-Displacement

Schmorl's node (SN) is a common entity characterized by protrusion of intervertebral disc material through a break in the subchondral end plate of a vertebral body. They can show increased 99mTC methylene diphosphonate uptake on bone scintigraphy mimicking metastasis and can be symptomatic. Differentiation of SN from metastasis is essential for appropriate patient management. Here, we present a case where increased 99mTC methylene diphosphonate uptake in a dorsal vertebra was found to be because of SN by using single-photon emission computed tomography-computed tomography.

Topics: Adult; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Intervertebral Disc Degeneration; Intervertebral Disc Displacement; Magnetic Resonance Imaging; Neoplasm Metastasis; Spinal Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The authors present the case of a 17-year-old girl, with pain over lumbar spine area, treated by paediatricians and rehabilitation specialists, discussing diagnostic imaging and laboratory examinations together with clinical observations. Spondylodiscitis was diagnosed after bone scintigraphy with 99mTc-MDP, the course of disease was monitored by immunoscintigraphy amongst other techniques.

Topics: Adolescent; Back Pain; Bone and Bones; Discitis; Female; Humans; Inflammation; Intervertebral Disc; Intervertebral Disc Displacement; Lumbar Vertebrae; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Adult; Female; Humans; Intervertebral Disc Displacement; Low Back Pain; Lumbar Vertebrae; Lumbosacral Region; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Sacrum; Technetium Tc 99m Medronate

Topics: Abscess; Aged; Aged, 80 and over; Humans; Intervertebral Disc Displacement; Leukocytes; Male; Middle Aged; Osteomyelitis; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Exametazime; Technetium Tc 99m Medronate; Thoracic Vertebrae

Topics: Aged; Aged, 80 and over; Female; Gated Blood-Pool Imaging; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Regional Blood Flow; Technetium Tc 99m Medronate

In patients with chronic low back pain, bone scintigraphy with single photon emission computed tomography (SPECT) of the lumbar spine allows identification of lesions not seen with planar imaging. In this study, findings from radiography, computed tomography (CT), and bone scintigraphy with SPECT in 34 patients with chronic back pain were examined to determine the nature and clinical relevance of the lesions. Twenty-seven patients had lesions at SPECT, of whom 24 (89%) had abnormalities at CT and 18 (67%) had abnormalities at radiography. SPECT allowed identification of 54 lesions, of which only 20 (37%) were detected with planar imaging. Forty-three (80%) SPECT lesions were located at the site of an abnormality also seen at CT and 20 (37%) at the site of an abnormality also seen at radiography. It was concluded that bone SPECT provides diagnostic information in chronic low back pain that is not available with radiography or planar imaging. The majority of lesions seen at SPECT corresponded to identifiable disease at CT.

Topics: Adult; Back Pain; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Osteoarthritis; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

This study looks retrospectively at 113 patients with low back pain referred by orthopaedic surgeons for bone scanning. 79 scans (70%) were reported normal and 34 scans (30%) abnormal. 61 out of the 79 patients with normal scans were diagnosed and managed as "chronic back strain". Negative bone scans were also encountered in 3 patients with degenerative disease, 3 with prolapsed intervertebral disc and one with spondylolysis. In those patients with positive scans, a varied range of diagnoses was encountered, the main ones being bone metastases, previous trauma, osteomyelitis and degenerative disease. The scan was shown to be helpful in deciding on the presence or absence of pathology, and in identifying the sites of involvement, but not the nature of the disease. A higher likelihood of positivity is seen in the more elderly patients as well as those below 20 years of age. In interpreting the scan, the clinical context is important e.g. a history of trauma, previous surgery or of malignant disease. The bone scan may be normal in disc prolapse and in degenerative disease of the spine.

Topics: Adolescent; Adult; Aged; Back Pain; Child; Female; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Male; Middle Aged; Radionuclide Imaging; Spinal Diseases; Spondylolysis; Technetium Tc 99m Medronate

99m technetium methylene diphosphate was used for whole body scanning and linear multiplane tomoscanning in 10 patients with typical clinical symptoms of prolapsed disc, in order to investigate whether there would be an increased focal accumulation corresponding to the bone structures adjacent to the affected disc. The diagnosis of a prolapsed disc was confined by amipaque myelography, carried out in 9 patients, and finally verified at operation. In none of the 10 cases could accumulation of radioactivity in the bony structures of the affected lumar segment be demonstrated. Consequently this method has not been adopted for the diagnosis of prolapsed lumbar discs. However it was demonstrated that 99m technetium methylene diphosphate scintillography is useful in the differential diagnosis of anchylosing spondylitis and discitis.

Topics: Adult; Diagnosis, Differential; Diphosphonates; Female; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Male; Myelography; Radionuclide Imaging; Spondylitis; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Medronate