Summary
We report a retrospective study of eighteen patients with pain in the knee or ankle, eleven of whom had osteochondritis dissecans. In these patients the bone-flow time-activity curves were observed after an intravenous injection of a bolus of 99mTc MDP. The curves varied according to the severity of the clinical signs and symptoms. The diagnosis rate was 29% with static scintigraphy and this improved to 57% when dynamic flow studies were used. A positive pattern in the dynamic study together with radiographs and static scintigraphs raised the diagnosis rate to 100%; the sensitivity was 90%. These preliminary results show that dynamic bone scintigraphy holds promise as a technique for identification and management of this condition.
Résumé
Etude rétrospective de dix-huit malades présentant des douleurs du genou ou de la cheville, dont onze étaient porteurs d'une ostéochondrite disséquante. Chez ces malades on a établi, après injection intra-veineuse d'un bolus de Tc99m, des courbes d'activité du flux sanguin en fonction du temps. Celles-ci varient selon l'importance de la symptomatologie. Le taux de diagnostic était de 29% avec la scintigraphie statique et il a atteint 57% lorsqu'on a eu recours à l'étude dynamique. Une réponse positive à l'épreuve dynamique associée à des arguments radiologiques et scintigraphiques statiques élève à 100% le taux de diagnostic; la sensibilité est de 90%. Ces résultats préliminaires permettent de penser que la scintigraphie dynamique est une technique valable pour le diagnostic et le traitement de l'ostéochondrite.
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McCullough, R.W., Gandsman, E.J., Litchman, H.E. et al. Dynamic bone scintigraphy in osteochondritis dissecans. International Orthopaedics 12, 317–322 (1988). https://doi.org/10.1007/BF00317831
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DOI: https://doi.org/10.1007/BF00317831