Steroid osteopathy

Conference · Sun Jan 01 00:00:00 EST 1984 · J. Nucl. Med.; (United States)

OSTI ID:6861497

Conway, J J; Weiss, S C

Patients receiving steroids or having disease processes which increase natural steroid production often demonstrate ''the classic x-ray changes'' of avascular necrosis of bone. Bone scintigraphy in these patients most frequently demonstrates an increased radionuclide localization. The literature suggests that the increased activity is related to healing of the avascular process. In a recent study of Legg-Calve-Perthes Disease (LCPD), 37 of the children had multiple studies and increased activity within the epiphysis during revascularization was extremely rare. Not only are the scintigraphic findings in steroid osteopathy dissimilar to that in healing LCPD, but the time interval for healing is much to short for that of a vascular necrosis and no patients demonstrated an avascular phase on bone scintigraphy. Of 15 children with renal transplants on steroid therapy, 9 demonstrated x-ray and clinical findings of osteopathy. In 8 of 9 instances, bone scintigraphy showed increased localization of radionuclide in the affected bone. Improvement or a return to normal occurred in those patients in whom steroids were discontinued. The following is a proposed mechanism for steroid osteopathy. Steroids affect the osteoblastic and osteoclastic activity of bone and weaken its internal structure. Ordinary stress produces microtrabecular fractures. Fractures characteristically stimulate reactive hyperemia and increase bone metabolism. The result is increased bone radiopharmaceutical localization. The importance of recognizing this concept is that steroid osteopathy is preventable by reducing the administered steroid dose. As opposed to avascular necrosis, bone changes are reversible.

• Research Organization: The Children's Memorial Hospital, Chicago, IL
• OSTI ID: 6861497
• Report Number(s): CONF-840619-
• Journal Information: J. Nucl. Med.; (United States), Vol. 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
59 BASIC BIOLOGICAL SCIENCES
BONE TISSUES
PATHOLOGICAL CHANGES
STEROIDS
BIOLOGICAL EFFECTS
SCINTISCANNING
CHILDREN
ENDOCRINE DISEASES
HEALING
KIDNEYS
RADIOPHARMACEUTICALS
RADIOTHERAPY
THERAPY
TISSUE DISTRIBUTION
TRANSPLANTS
AGE GROUPS
ANIMAL TISSUES
BIOLOGICAL RECOVERY
BODY
CONNECTIVE TISSUE
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DISEASES
DISTRIBUTION
DRUGS
LABELLED COMPOUNDS
MEDICINE
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
RADIOISOTOPE SCANNING
RADIOLOGY
RECOVERY
TISSUES
550601* - Medicine- Unsealed Radionuclides in Diagnostics
550901 - Pathology- Tracer Techniques