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Title: Role of nuclear medicine bone scans in evaluating pain in athletic injuries

Abstract

The utilization of nuclear medicine bone scanning examinations early in the diagnostic process allows physicians to render prompt and correct treatment in urgent or difficult athletic cases. Bone scanning should be performed for athletic injuries whenever (1) x-rays are normal but bone or joint pain persists; (2) x-rays are positive but it cannot be determined if the findings are acute or chronic; (3) soft-tissue injuries present and x-rays are not useful; and (4) bone pain or joint impairment present without a history of trauma.89 references.

Authors:
Publication Date:
Research Org.:
Union Memorial Hospital, Baltimore, MD (USA)
OSTI Identifier:
6255327
Alternate Identifier(s):
OSTI ID: 6255327
Resource Type:
Journal Article
Resource Relation:
Journal Name: Clin. Sports Med.; (United States); Journal Volume: 6:4
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; SKELETAL DISEASES; DIAGNOSIS; SKELETON; RADIOISOTOPE SCANNING; PAIN; REVIEWS; TECHNETIUM ISOTOPES; X RADIATION; BODY; COUNTING TECHNIQUES; DISEASES; DOCUMENT TYPES; ELECTROMAGNETIC RADIATION; IONIZING RADIATIONS; ISOTOPES; ORGANS; RADIATIONS; SYMPTOMS 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics

Citation Formats

Martire, J.R.. Role of nuclear medicine bone scans in evaluating pain in athletic injuries. United States: N. p., 1987. Web.
Martire, J.R.. Role of nuclear medicine bone scans in evaluating pain in athletic injuries. United States.
Martire, J.R.. Thu . "Role of nuclear medicine bone scans in evaluating pain in athletic injuries". United States. doi:.
@article{osti_6255327,
title = {Role of nuclear medicine bone scans in evaluating pain in athletic injuries},
author = {Martire, J.R.},
abstractNote = {The utilization of nuclear medicine bone scanning examinations early in the diagnostic process allows physicians to render prompt and correct treatment in urgent or difficult athletic cases. Bone scanning should be performed for athletic injuries whenever (1) x-rays are normal but bone or joint pain persists; (2) x-rays are positive but it cannot be determined if the findings are acute or chronic; (3) soft-tissue injuries present and x-rays are not useful; and (4) bone pain or joint impairment present without a history of trauma.89 references.},
doi = {},
journal = {Clin. Sports Med.; (United States)},
number = ,
volume = 6:4,
place = {United States},
year = {Thu Oct 01 00:00:00 EDT 1987},
month = {Thu Oct 01 00:00:00 EDT 1987}
}
  • Increased participation in sports by the general public has led to an increase in sports-induced injuries, including stress fractures, shin splints, arthritis, and a host of musculotendinous maladies. Bone scintigraphy with Tc-99m MDP has been used with increasing frequency in detecting stress fractures, but this study can miss certain important conditions and detect other lesions of lesser clinical significance. This paper demonstrates the spectrum of findings on bone scanning in nonacute sports trauma and offers suggestions for the optimal use of Tc-99m MDP for detecting the causes of lower extremity pain in athletes.
  • In the patient with cardiac trauma, radionuclide imaging may provide important information about cardiac mechanical function, vascular anatomy and integrity, myocardial perfusion, and myocardial metabolism. Studies require only minimal patient cooperation, can be performed relatively rapidly and often at the bedside, and may be repeated at frequent intervals for serial evaluations. These studies provide valuable adjunctive knowledge when selected and interpreted with knowledge of the mechanism of injury, timing of the examination relative to the time of injury, and most likely differential diagnoses.
  • The objective of this study is to correlate the presence of bone and liver metastases in patients with breast cancer with respect to the results of bone and liver scans, axillary nodal status, and serum alkaline phosphatase levels. One hundred ninety-seven patients with breast cancer treated by modified radical mastectomy between the years 1978 and 1981 were studied. Fifty-nine (30%) of the total group had distant metastases during the course of observation of 60 to 96 months; of 35 patients in whom bone metastases developed, 30 had normal preoperative bone scan results. Of 21 patients who had liver metastases, 19more » had normal preoperative liver scans. Nineteen (70%) of the 27 patients with abnormal bone scans had normal alkaline phosphatase levels. Seven (63%) of the 11 patients who had abnormal liver scans had a normal alkaline phosphatase. The study supports the concept that preoperative bone and liver scans are ineffective indicators of metastatic involvement. Selection of patients for screening by bone and liver scans according to alkaline phosphatase determinations was not supported by this study. The appropriate use of bone scans for screening in patients with breast carcinoma is suggested as a follow-up device in patients with positive lymph nodes.« less
  • Osteoid osteoma is a benign bone tumor which is most often seen in young males. Several imaging techniques have been used for the detection of osteoid osteoma lesions. Conventional x-ray was found to detect only two-thirds of lesions. Computerized tomography has been used to determine the extent of the osteoid osteoma's progress, particularly the soft tissue involvement. In this study, the radionuclide three-phase bone scan was positive in all six patients with surgically proven osteoid osteoma. In addition, nuclear medicine scans of bone specimens may be used to predict whether all of the tumor has been removed. Incomplete excision willmore » likely result in recurrence. Since /sup 99m/Tc-MDP (methylene diphosphonate) is blood borne, it reflects blood flow to the tumor site. It also adsorbs onto the hydroxyapatite crystal. Its concentration is proportional to osteoblastic activity. A study was undertaken to evaluate the use of the three-phase bone scan in patient's referred with possible osteoid osteoma. In addition, scans of bone samples were used during the surgical procedures to evaluate complete tumor renewal.« less
  • The records of 100 patients with localized prostatic cancer were examined retrospectively in an effort to determine the usefulness of routine 99mtechnetium bone scans following definitive therapy with 125iodine implantation or external beam irradiation. With a mean followup of 47 months per patient 19 per cent of these patients had positive scans and an additional 15 per cent had scans that were considered equivocal. Of the 100 patients none had a positive scan in the absence of either an elevated serum acid phosphatase or bone pain. In our series the low incidence of positive scans as the sole evidence ofmore » disease progression does not support its routine use after definitive therapy for localized carcinoma of the prostate.« less