technetium-tc-99m-pyrophosphate and Spondylitis--Ankylosing

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

In 576 patients quantitative scintigraphy of the sacroiliac joints and the spinal cord with 99mTc-Pyrophosphate was performed. 328 were patients with proven ankylosing spondylitis according to the New-York criteria. 120 were patients with a clinically and roentgenologically suspected ankylosing spondylitis and 128 persons formed a healthy control group. The count rate in small regions of interest (ROI) in the sacroiliac joints, the spinal cord and the os sacrum were compared on the basis of indexes. The scintigraphic data of patients with ankylosing spondylitis were compared with healthy control group and with the radiographic findings and radiologic staging of the disease: In a longitudinal follow-up study during 1 to 6 years these investigations were continued together with clinical and roentgenological checks. Quantitative bone scintigraphy provides characteristic indexes for ankylosing spondylitis, indicating the increased mineral metabolism of the sacroiliac joints and the spinal chord. Skeletal scintigraphy is recommended for early detection and monitoring of ankylosing spondylitis.

Topics: Diphosphates; Humans; Radiography; Radionuclide Imaging; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Pyrophosphate

A patient with AA amyloidosis secondary to ankylosing spondylitis showed intense liver uptake of Tc-99m MDP on bone imaging. The biopsy showed hepatic amyloid deposition. A repeat bone scan with Tc-99m MDP 1 year later was negative, although the clinical signs and liver function tests of the patient had not changed. A mechanism might exist, other than the affinity of amyloid to calcium, which would explain the extraosseous uptake of pyrophosphates and diphosphonates in organs and soft tissues affected by systemic amyloidosis.

Topics: Amyloidosis; Diphosphates; Humans; Liver; Liver Diseases; Male; Middle Aged; Radiography; Radionuclide Imaging; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Topics: Diphosphates; Humans; Radionuclide Imaging; Sacroiliac Joint; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Pyrophosphate

Thirteen patients with systemic lupus erythematosus, 8 patients with polymyositis, and 6 patients with spondylitis ankylopoetica (Bechterew's disease) underwent clinical cardiologic examination and scintigraphy of the myocardium (99mTc-pyrophosphate), ECG, echocardiography, polygraphy, and their blood pressure was taken. The aim of the study was to ascertain how such a combination of non-invasive examinations can help in recognizing a cardiac involvement. In systemic lupus erythematosus cases one or more positive findings were revealed in 9 patients (69%), in 4 patients all examinations were negative (31%). Four patients (50%) with polymyositis had positive findings. In patients with spondylitis ankylopoetica positive findings occurred in 2 cases (33%). The study has shown that a combination of non-invasive cardiologic methods increases the probability of detecting cardiac involvement in systemic connective tissue diseases.

Topics: Cardiomyopathies; Connective Tissue Diseases; Diphosphates; Electrocardiography; Humans; Lupus Erythematosus, Systemic; Myositis; Radionuclide Imaging; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Adult; Bone and Bones; Diagnosis, Differential; Diphosphates; Female; Humans; Radiography; Radionuclide Imaging; Spine; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Pyrophosphate; Tuberculosis, Spinal

Topics: Bone and Bones; Diphosphates; Humans; Radionuclide Imaging; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Pyrophosphate

Radionuclide joint imaging with the technetium-99m-labeled phosphates is a sensitive technique for the detection of inflammatory articular disease, although it is nonspecific as to the cause of the increased uptake and offers poor resolution in comparison to conventional radiography. There does not appear to be any place for the routine use of joint imaging of the peripheral joints, as there is little evidence that it benefits patient management. Scintigraphy is of benefit in the detection of osteomyelitis, Legg-Perthes' disease, and osteonecrosis, where changes may antedate roentgenologic abnormalities. Technetium-99m-phosphates may have an increasing role in the evaluation of knee and hip prosthetic joint loosening and infection, especially regarding the femoral components. Scintigraphy may be useful in excluding synovitis and allaying concern in selected patients with chronic articular pain in whom a conventional diagnostic evaluation is unrewarding. Attempts have been made to use radionuclide joint imaging to quantitate the degree of synovitis present in individual joints, particularly the sacroiliac joints. To date, reliable methods that distinguish normal from abnormal joints have not been established, although this remains an area of potential usefulness and active research. Scintigraphy with 99mTc-phosphates is useful in the detection of spinal fracture and pseudoarthrosis in individuals with ankylosing spondylitis.

Topics: Adult; Arthritis; Bone Neoplasms; Child; Diphosphates; Diphosphonates; Female; Gallium Radioisotopes; Humans; Joint Diseases; Legg-Calve-Perthes Disease; Male; Middle Aged; Osteoarthritis; Osteomyelitis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Spondylitis, Ankylosing; Synovitis; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Topics: Diphosphates; Humans; Radionuclide Imaging; Sacroiliac Joint; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Pyrophosphate

Since ankylosing spondylitis (S.a.) tends to be milder and less progressive in women than in men, there are great difficulties in diagnosing S.a. in female patients. The role of scintiscanning for investigation of S.a. in women is discussed by few examiners only, especially there are no investigations of quantitative sacroiliac scintigraphy in large groups of female patients. Quantitative sacroiliac scintigraphy was performed in 19 female patients with S.a. and in 30 control subjects. The sacroiliac/sacrum ratio (Index ISG/sacrum) was calculated. Significantly increased uptakes were found in the patient group compared with the controls. Especially in the early periods of S.a. the activity index was highest. When history and physical examination lead to a suspicion of S.a. and there is no verification by roentgenographic studies, sacroiliac joint scintigraphy is indicated. If clinical and laboratory findings are respected in each patient, quantitative sacroiliac scintigraphy is useful for the early diagnosis of S.a. in female patients.

Topics: Adult; Diphosphates; Diphosphonates; Female; Humans; Middle Aged; Radiography; Radionuclide Imaging; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Quantitative sacroiliac scintigraphy was performed in 41 patients with ankylosing spondylitis (Sp.a.) and in 90 control subjects. The sacroiliac/sacrum ratio (Index ISG/sacrum) was calculated. We examined the correlation between activity ratio on the one hand and age, subjective complaints, erythrocyte sedimentation rate, and antiinflammatory therapy on the other. Significantly increased uptakes were found in the patient group as a whole compared with the controls. The activity index was highest in the early periods of the disease, so we conclude that scintigraphy is useful in the early diagnosis of Sp.a.

Topics: Adult; Age Factors; Aged; Humans; Middle Aged; Radionuclide Imaging; Sacroiliac Joint; Sacrum; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Pyrophosphate; Tin Polyphosphates

Four cases of ankylosing spondylitis are presented in which radionuclide bone studies indicated focal abnormalities of the spine. In three patients, the area of abnormal nuclide uptake corresponded to a site of pseudarthrosis, and in the fourth an acute fracture was present. As such focal lesions on bone scans are unusual in cases of chronic ankylosing spondylitis in which a complication is not apparent, their presence can be a useful finding.

Topics: Aged; Diphosphates; Diphosphonates; Fractures, Bone; Humans; Male; Middle Aged; Pseudarthrosis; Radiography; Radionuclide Imaging; Spinal Injuries; Spine; Spondylitis, Ankylosing; Technetium; Technetium Compounds; Technetium Tc 99m Pyrophosphate

Bone scintigraphy of the sacroiliac joints and the lumbar spine was performed in 35 patients with ankylosing spondylitis and 30 control subjects. The scans were evaluated by qualitative and quantitative assessment. The sacroiliac/sacrum ratio (index ISG/sacrum), the sacroiliac/lumbar spine ratio (index ISG/LWS), and the left sacroiliac joint/right sacroiliac joint ratio (index li. ISG/re. ISG) were calculated. The visual interpretation of colour scans proved to be unreliable. The index ISG/sacrum was more sensitive than the index ISG/LWS. The index li. ISG/re ISG was helpful as an additional criterion. When digital sacroiliac joint scintigraphy is well standardized it can be considered as a useful technique in early diagnosis of ankylosing spondylitis.

Topics: Adult; Diphosphates; Diphosphonates; Humans; Radionuclide Imaging; Sacroiliac Joint; Spondylitis, Ankylosing; Technetium; Technetium Compounds; 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