technetium-tc-99m-pyrophosphate and Arthritis--Rheumatoid

Radionuclide scintigraphy with osteotropic radiopharmaceuticals labelled 99Tc proved highly sensitive in assessment of local inflammation. Osteoscintigraphy allows detection of preclinical and pre-x-ray lesions in the joints in RA and assessment of the treatment efficacy. Characteristic signs of the radionuclide distribution and accumulation can serve as a prompt in differential diagnosis of RA, DOA, reactive and gouty arthritis.

Topics: Adult; Ankle Joint; Arthritis, Rheumatoid; Diagnosis, Differential; Female; Gamma Cameras; Humans; Knee Joint; Radionuclide Imaging; Technetium Tc 99m Pyrophosphate; Wrist Joint

Scintigraphic examination of the joints and spine was performed in 42 children with Bekhterev's disease and rheumatoid arthritis to establish different accumulation of 99mTc-pyrophosphate. In Bekhterev's disease, elevated concentration of the radio-indicator was detected was detected in the joints of the lower limbs, including hip joints, in the sacroiliac parts of the spine and in heels. In rheumatoid arthritis, it was mainly detectable in the joints of the upper limbs and sometimes in the cervical part of the spine. Scintigraphy of the joints may be helpful in differential diagnosis of the above-indicated disease entities.

Topics: Adolescent; Arthritis, Rheumatoid; Child; Diagnosis, Differential; Diphosphates; Female; Humans; Male; Radionuclide Imaging; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Pyrophosphate

The proposed method of sequential scintigraphy of the kidneys and joints in a single administration of 99mTc-pyrophosphate permits obtaining objective information on function and topography of the kidneys and pyodestructive processes in the joints. Dynamic scintigraphy helps to assess visually renal hemodynamics and the antomotopographic position of the kidney and to obtain exhaustive information on accumulative-evacuatory function of each kidney individually. Scintigraphy also helps to investigate all the joints and to detect pyoinflammatory changes in them. The proposed method considerably reduces the time of investigation and lessens radiation exposure of patients, permitting repeated investigations to assess and correct the treatment of patients with rheumatic arthritis.

Topics: Adult; Arthritis, Rheumatoid; Diphosphates; Evaluation Studies as Topic; Female; Humans; Joint Diseases; Joints; Kidney; Kidney Diseases; Male; Middle Aged; Radionuclide Imaging; Suppuration; Technetium; Technetium Tc 99m Pyrophosphate

Application of a complex of clinical, thermography and radionuclide methods in 79 patients with rheumatoid arthritis has demonstrated high sensitivity of scintigraphy with the use of osteotropic radiopharmaceuticals (99mTc-pyrophosphate, 99mTc-phosphone) as well as a possibility of diagnosing preclinical injuries to the joints. The thermography and scintigraphic parameters depended on the degree of inflammation, permitting an objective evaluation of the treatment effect.

Topics: Adult; Arthritis, Rheumatoid; Chronic Disease; Combined Modality Therapy; Diphosphates; Female; Follow-Up Studies; Humans; Joints; Male; Middle Aged; Prognosis; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thermography

Nearly three-quarters of patients on long-term treatment with non-steroidal anti-inflammatory drugs (NSAIDs) have small-intestinal inflammation, the consequences of which are largely unknown. Two potentially important complications, blood and protein loss from the small intestine, have been studied. 49 patients on NSAIDs underwent study with an indium-111 labelled leucocyte technique which localises and measures intestinal inflammation. 32 patients underwent simultaneous study with technetium-99m labelled red blood cells (RBC), which showed identical sites of localisation to 111In-leucocytes in 19. Intestinal blood loss was measured in 8 patients by use of chromium-51 labelled RBC, and a significant correlation between blood loss and intestinal inflammation was found. Intestinal protein loss was assessed in 9 patients with 51Cr-labelled proteins; patients with NSAID-induced small-intestinal inflammation were found to have a protein-losing enteropathy. These studies show that small intestinal inflammation caused by NSAIDs is associated with blood and protein loss, both of which may contribute to the general ill-health of rheumatic patients.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Chromium Radioisotopes; Enteritis; Erythrocytes; Feces; Gastrointestinal Hemorrhage; Humans; Indium Radioisotopes; Intestine, Small; Leukocytes; Proteins; Technetium; Technetium Tc 99m Pyrophosphate; Tin Polyphosphates

Diagnostic potentialities of investigation of the kidneys using 99mTc-pyrophosphate were studied in 34 patients with rheumatoid arthritis (RA) for articular scintigraphy. The results obtained were compared with those of radionuclide renography with 131I-hippuran and excretory urography. A possibility of investigation of the kidneys with 99mTc-pyrophosphate for the assessment of parenchyma function and kidney urodynamics was shown. Taking into account a high prevalence of nephropathy in RA patients, dynamic renal scintigraphy and clearance registration were recommended at the first stage of articular scintigraphy with 99mTc-pyrophosphate in order to obtain information on the anatomotopographic site and accumulation-evacuatory function of the kidneys.

Topics: Adult; Aged; Arthritis, Rheumatoid; Diphosphates; Female; Humans; Iodohippuric Acid; Joints; Kidney; Kidney Failure, Chronic; Male; Middle Aged; Radioisotope Renography; Technetium; Technetium Tc 99m Pyrophosphate; Time Factors; Tomography, Emission-Computed

99mTc-polyphosphate joint imaging of the hand has been performed in 18 patients, with evidence of inflammatory joint disease, but without any significant radiographic lesions, which might be related to rheumatoid arthritis. The hand scans were compared to clinical and radiographic data. An year after, the same subjects were re-examined, with both the radionuclide imaging and radiography. Scintigraphy has been shown to be significantly more sensitive for detecting inflammatory joint disease than x-ray, especially in the early stage of rheumatoid arthritis. Although radionuclide imaging is non specific (activity is increased also in osteoarthritis, trauma, metabolic bone disease, infarction, etc.). Radiography is highly specific but relatively non sensitive.

Topics: Adult; Aged; Arthritis, Rheumatoid; Diagnosis, Differential; Diphosphates; Diphosphonates; Female; Hand; Humans; Male; Middle Aged; Polyphosphates; Radiography; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Technetium Compounds; Technetium Tc 99m Pyrophosphate

The retention of 99mTc-labeled pyrophosphate (PPi) at 24 h was measured in 235 patients, 119 of whom had a normal bone metabolism. The mean retention in the group of normal subjects is 52% of the injected dose. Reproducibility of the measurement in a given person is 5.5% coefficient of variation (CV). The value depends strongly on sex (higher in males) and age (higher with increasing age, especially in cortical bone). Retention increases slowly with the decrease in glomerular filtration rate (GFR) between 50 and 120 ml/min; it rises very rapidly with values below 50 ml/min. The slowing down of the GFR with age does not account for the increase in PPi retention with age. When expressed as a percentage of the expected value for sex and age, retention is frequently low in osteoporosis (P less than .001), more so when urinary hydroxyproline is low; it is normal or high in osteomalacia, and in some cases rises after vitamin D treatment is started; it is high in hyperparathyroidism (P less than .01). The PPi retention is correlated with bone calcium accretion rate, alkaline phosphatase level, and above all, the urinary hydroxyproline level. The lower the bone mineralization (Ca/hydroxyproline ratio in biopsy), the higher the retention value. We conclude that the PPi retention is an index of bone metabolism when GFR is higher than 50 ml/min. It allows for classification of metabolic bone diseases according to the bone turnover rate. It has the advantage over the usual biologic examinations in that it affords better observation of highly localized bone disorders and can be used in combination with a morphologic record, the bone scintigraphy.

Topics: Adolescent; Adult; Aged; Aging; Arthritis, Rheumatoid; Bone and Bones; Bone Diseases; Child; Child, Preschool; Diphosphates; Female; Glomerular Filtration Rate; Humans; Hydroxyproline; Male; Middle Aged; Technetium; Technetium Tc 99m Pyrophosphate

Serum enzymes and articular radionuclide tests have a restricted application in solving the current diagnostic and differential-diagnostic problems of present-day rheumatology. The enzyme tests became positive in case of a high activity of rheumatoid arthritis, not objectivizing the articular degeneration. Their correlation with radionuclide tests of the patients with osteoarthrosis and the patients with rheumatoid arthritis is not elucidated. A juxtaposition was made of the serum enzymes with the articular radionuclide quantitative indices in 88 patients with rheumatoid arthritis with various clinical-laboratory activity, 88 patients with osteoarthrosis in various X-ray stages and 22 healthy controls. A correlation dependence was established between LDH, CPK, acid phosphatase, clearance effectiveness of articular cavity and the deposition of 99mTc-pyrophosphate in knee joints of the patients with osteoarthritis and between gamm-GT, alkaline phosphatase, acid phosphatase and radionuclide articular indices of the patients with rheumatoid arthritis. Those characteristics enabled the earlier overcoming of the diagnostic difficulties in those two basic rheumatic diseases.

Topics: Adult; Arthritis, Rheumatoid; Clinical Enzyme Tests; Diphosphates; Enzyme Activation; Humans; Knee Joint; Middle Aged; Osteoarthritis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Pyrophosphate; Xenon Radioisotopes

Topics: Arthritis, Rheumatoid; Diphosphates; Humans; Joints; Radioactivity; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Arthritis, Reactive; Arthritis, Rheumatoid; HLA Antigens; Humans; Prognosis; Radionuclide Imaging; Sacroiliac Joint; Sacrum; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Pyrophosphate; Tin Polyphosphates