technetium-tc-99m-medronate and Osteoarthritis--Hip

Topics: Diagnosis, Differential; Hip Joint; Humans; Joint Diseases; Male; Middle Aged; Osteoarthritis, Hip; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate; Tuberculosis, Osteoarticular

To establish the time-course of bone scans after bipolar hip arthroplasty (BHA) bone scanning was performed before and after surgery in 22 hips. The influence of migration of the outer head into the acetabulum on the time-course of bone scans was examined by analyzing the relationship between the uptake of radioisotope and the magnitude of migration. The bone scans were quantitatively analyzed by single photon emission computed tomography (SPECT) on the basis of the ratio of radioactivity at the acetabulum to that in the anterior superior iliac spine (ASIS). The increased radionuclide activity decreased exponentially to a baseline with time after surgery. The postoperative uptake ratio could be expressed as a function of the preoperative uptake ratio and the postoperative length of time. The regression slope representing the decreasing rate of uptake showed no significant differences between two groups divided by the magnitude of migration of the outer head. Migration of the outer head was considered not to influence the time-course of the bone scans.

Topics: Adult; Aged; Aged, 80 and over; Evaluation Studies as Topic; Female; Foreign-Body Migration; Hip Prosthesis; Humans; Male; Middle Aged; Osteoarthritis, Hip; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

During the past 4 years, three-phase bone scintigraphy using 99mTc-MDP has been studied in 68 patients suffering from hemi-lateral hip-joint disorders. We were impressed on abnormal uptake of the shaft of femur on the involved side. 99mTc-MDP uptake in the shaft of femur is compared with between involved leg and normal leg of 68 cases with hemi-lateral hip-joint disorders (76 examinations). We excluded cases of osteomyelitis, cases of malignant tumor, and post-operative cases. In early images, the 99mTc-MDP uptake is not always increased in involved side. But in delayed images, there are no patients whose normal side's 99mTc-MDP uptake is increased. The 99mTc-MDP uptake in early image is not related only with blood flow of the thigh but with the amount of soft tissue of the thigh. And the 99mTc-MDP uptake in delayed image is related with disuse osteoporosis.

Topics: Adult; Aged; Child; Female; Femur; Hip Dislocation; Hip Fractures; Humans; Legg-Calve-Perthes Disease; Male; Middle Aged; Osteoarthritis, Hip; Osteonecrosis; Radionuclide Imaging; Technetium Tc 99m Medronate

We evaluated the monoclonal antibody MAb, BW 250/183, which is easy to label with Tc-99m, with respect to its clinical application for the detection of inflammatory processes in bone and joint diseases. This monoclonal antibody is a murine immunoglobulin (IgG1 isotype), directed against NCA 95 (nonspecific cross-reacting antigen), which is also present on the surface of neutrophil granulocytes. We investigated patients with acute (n = 9) and chronic (n = 3) osteomyelitis, with coxitis (n = 3) and coxarthrosis (n = 2), with septic hip prosthesis (n = 8) and loosening hip prosthesis (n = 14), with low back pain (n = 4), with spondylitis (n = 5) and with postoperative spondylodiscitis (n = 9). With reference to the total number of patients examined in this study we found 29 true positive results, 22 true negative results, 4 false negative results and 2 false positive results. This gives a sensitivity of 88% and a specificity of 92%. The lesions were already visualized within 4 to 6 hours, but 24 hour pictures are desirable. SPECT pictures are mandatory in patients with diseases of the hip or of the spine because sensitivity is considerably improved thereby.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal; Arthritis, Infectious; Bone Diseases; Discitis; Female; Humans; Inflammation; Joint Diseases; Male; Middle Aged; Osteoarthritis, Hip; Osteomyelitis; Prosthesis Failure; Radionuclide Imaging; Spondylitis; Technetium Tc 99m Medronate

Factor analysis was applied to dynamic study of Tc-99m MDP for the evaluation of hip joint disorders. Fifteen patients were examined; eight were normal, six were osteoarthritis in which one accompanied synovitis was included, and one was aseptic necrosis on the head of the femur. In normals, according to the Tc-99m MDP kinetics, three factor images and time-activity curves were obtained which were named as blood vessel, soft tissue, and bone factor images and curves. In the patient with osteoarthritis, increased accumulation of the hip joint was shown in bone factor image only. But in one patient, who took osteoarthritis with synovitis, marked accumulations of the Tc-99m MDP appeared not only on the bone factor image but also on the soft tissue. Operation revealed thickening synovial tissue around the hip joint, caused by inflammatory process. In follow-up studies of the patient with aseptic necrosis on the head of the left femur, excessive accumulations, which were seemed in his left hip joint on both bone and soft tissue factor images at first, were decreased respondently to the treatment of this lesion. In conclusion, the factor analysis was useful for differencial diagnosis of the hip joint disorders and observation of the clinical course of the hip joint disorders.

Topics: Adult; Diagnosis, Differential; Factor Analysis, Statistical; Female; Femur Head Necrosis; Hip Joint; Humans; Male; Osteoarthritis, Hip; Radionuclide Imaging; Technetium Tc 99m Medronate

The accumulation rate and velocity of 99mTc-hydroxymethylene diphosphonate (99mTc-HMDP) in hip joints were determined within four minutes after a bolus of injection of 99mTc-HMDP in the patients with hip joint disorders. There exist a significant relationship between accumulation velocity of 99mTc-HMDP in the affected joint and serum osteocalcin in the patients with eight cases of degenerative osteoarthropathy and six cases of femoral necrosis. This result indicates that the accumulation velocity of 99mTc-HMDP in the affected joint is likely to become a marker of bone turnover in hip joint disorder.

Topics: Adult; Aged; Calcium-Binding Proteins; Female; Femur Head Necrosis; Hip Joint; Humans; Male; Middle Aged; Osteoarthritis, Hip; Osteocalcin; Radionuclide Imaging; Technetium Tc 99m Medronate