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Title: Simultaneous Tc-99m skeletal and In-111 hip arthrographic scintimaging complementing contrast radiography

Conference · · J. Nucl. Med.; (United States)
OSTI ID:6780924

Prosthetic hip replacement has become a frequent procedure with femoral component (FC) loosening occurring frequently at a rate of 24% at 7 yrs post arthroplasty. Pain may occur from a variety of causes and identification of loosening as the cause is critical. Experience with radiographic contrast arthrography (XA) alone has often resulted in equivocal studies because of confusion caused by the radio-opaque glue-bone interface and adjacent radiolucency of the FC. Radionuclide arthrography (RA) with Tc-99m Sulfur Colloid (SC) has been previously shown to improve the efficiency of FC loosening determination. However, with extravasation or other confusing patterns of tracer distribution more precise localization relative to skeletal structure is required with RA. Simultaneous use of RA using In-111 (IN) chloride (0.2 mCi) injected with contrast at XA superimposed on prior injected TC-99m MDP (20 mCi) skeletal imaging (SI) has considerably improved interpretation and complemented XA, correlated with surgery. Fifty RA and XA patients have been studied: 18 with SC alone, 7 with SC and IN in the joint space simultaneously and 25 with IN RA and SI. Simultaneous joint injection RA with IN and SC demonstrated exactly the same pattern with no translocation of IN. Thirty patients had surgery with 20 loose FC verified; all loose by RA but only 16 by XA plus 2 false positives. Also simultaneous SI has shown unreliable criteria for FC loosening. Thus, addition of simultaneous RA and SI for FC evaluation is a valuable adjunct in 20% of patients in the performance of arthrography.

Research Organization:
Indiana Univ. School of Medicine, Indianapolis, IN
OSTI ID:
6780924
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

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