Abstract
In this prospective study, the radiological features characteristic of osteoarthritis of the hand were compared with the radionuclide bone scan images. A total of 32 patients was assessed at 6-monthly intervals for 18 months. Microfocal radiographs were taken at each visit. The high magnification and resolution of this technique permitted direct measurement of joint space width, subchondral sclerosis, osteophyte number and area and juxta-articular radiolucency area for each joint in the hand. Four-hour technetium 99m methylene diphosphonate bone scans were taken at 0 and 12 months and the activity of tracer uptake at each joint scored. The latter was compared with each X-radiographic feature at every visit and the changes between visits analysed. The scan scores did not correlate with any of the X-radiographic features other than osteophyte size. During the study the size of growing and remodelling osteophytes increased significantly at joints with raised or increased isotope uptake.
Similar content being viewed by others
References
Altman RD, Fries JF, Bloch DA, Carstens J, Cooke TD, Genant H, Gofton P, Groth H, McShane DJ, Murphy WA, Sharp JT, Spitz P, Williams CA, Wolfe F (1987) Radiographic assessment of progression in osteoarthritis. Arthritis Rheum 30:1214–1225
Buckland-Wright JC (1983) X-ray assessment of activity in rheumatoid arthritis. Br J Rheumatol 22:3–10
Buckland-Wright JC (1989) A new high definition microfocal X-ray unit. Br J Radiol 62:201–207
Buckland-Wright JC, Bradshaw CR (1989) Clinical applications of high definition microfocal radiography. Br J Radiol 62:208–217
Buckland-Wright JC, Walker SR (1987) Incidence and size of erosions in the wrist and hand of rheumatoid patients: a quantitative microfocal radiographic study. Ann Rheum Dis 46:463–467
Buckland-Wright JC, Carmichael I, Walker SR (1986) Quantitative microfocal radiography accurately detects joint changes in rheumatoid arthritis. Ann Rheum Dis 45:379–383
Buckland-Wright JC, Clarke GS, Walker SR (1989) Erosion number and area progression in the wrist and hands of rheumatoid patients: a quantitative microfocal radiographic study. Ann Rheum Dis 48:25–29
Buckland-Wright JC, Macfarlane DG, Lynch JA, Clark B (1990) Quantitative microfocal radiographic assessment of progression in osteoarthritis of the hand. Arthritis Rheum 33: 57–65
Christensen SB (1983) Localization of bone-seeking agents in developing experimentally induced osteoarthritis in the knee joint of the rabbit. Scand J Rheum 12:343–349
Christensen SB (1985) Osteoarthrosis. Changes of the bone, cartilage and synovial membrane in relation to bone scintigraphy. Acta Orthop Scand 56 (Suppl 214):1–43
Christensen SB, Arnoldi CC (1980) Distribution of 99mTc-phosphate compounds in osteoarthritic femoral heads. J Bone Joint Surg [Am] 62:90–96
Christensen SB, Krogogaard OW (1981) Localization of Tc-99m MDP in epiphyseal growth plates of rats. J Nucl Med 22:237–245
Danielson LG (1964) Incidence and prognosis of coxarthrosis. Thesis. Acta Orthop Scand (Suppl) 66:21–24
Grieff J, Lanng S, Høilund-Carlsen PF, Karle AK, Uhrenholdt A (1980) Early detection by 99mTc-Sn-pyrophosphate scintigraphy of femoral head necrosis following medial femoral neck fractures. Acta Orthop Scand 51:119–125
Guillement A, Le Pape A, Galy G, Besnard J-C (1980) Bone kinetics of calcium-45 and pyrophosphate labelled with technetium-96: an autoradiographic evaluation. J Nucl Med 21:466–470
Hernborg J, Nilson BE (1973) The relationship between osteophytes in the knee joint, osteoarthritis and aging. Acta Orthop Scand 44:69–74
Hutton CW, Higgs ER, Jackson RC, Watt I, Dieppe PA (1986a) 99mTc-HMDP bone scanning in generalised osteoarthritis I: comparison of the standard radiographs and four hour bone scan image of the hand. Ann Rheum Dis 45:617–621
Hutton CW, Higgs ER, Jackson RC, Watt I, Dieppe PA (1986b) 99mTc-HMDP bone scanning in generalised osteoarthritis II: the four hour scan image predicts radiographic changes. Ann Rheum Dis 45:622–626
Macfarlane DG, Buckland-Wright JC, Emery P, Clark B, Lynch JA (1988) Comparison of clinical, radionuclide and radiographic features of osteoarthritis (OA) of the hands. Br J Rheumatol 27 [Suppl 2]:103
McCrae F, Shouls J, Dieppe P, Watt I (1987) Heterogeneity of osteoarthritis of the knee. Br J Rheumatol 26 (Suppl):45
Moskowitz RW, Goldberg VM (1987) Osteophyte evolution: studies in an experimental partial meniscectomy model. J Rheumatol (Suppl 14)14:116–119
Norussis MJ (1986) SPSS/PC+ for the IBM PC/XT/AT. SPSS Inc Chicago
Radin EL, Paul IL, Rose RM (1972) Role of mechanical factors in pathogenesis of primary osteoarthritis. Lancet 1: 519–522
Rohlin M, Lavason A, Hammarstrom L (1978) In vitro interaction between 99mTc-labelled pyrophosphate, 32P-labelled pyrophosphate and rat tissue. Eur J Nucl Med 3:249–255
Veraguth PC (1955) La téte femorale du veillard, études de ses transformations seniles et de leurs rapport avec la coxarthrose. Rev Chir Orthop 41 (Suppl 1):39–111
Author information
Authors and Affiliations
Additional information
Offprint requests to: J.C. Buckland-Wright, Department of Anatomy, Guy's Hospital Medical School, London Bridge, London SE1, 9RT, UK
Rights and permissions
About this article
Cite this article
Buckland-Wright, J.C., Macfarlane, D.G., Fogelman, I. et al. Techetium 99m methylene diphosphonate bone scanning in osteoarthritic hands. Eur J Nucl Med 18, 12–16 (1991). https://doi.org/10.1007/BF00177678
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00177678