Skip to main content

Advertisement

SpringerLink
Log in

Role of technetium-99m planar bone scanning in the evaluation of low back pain

  • Articles
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

The records of 1018 patients with low back pain in a tertiary spine referral practice were reviewed. One hundred thirty-nine out of 1018 (13.6%) underwent technetium-99m planar bone scanning as part of their investigation. Seventy-three out of 139 scans (52%) showed increased uptake in some area, but only 27 out of 139 (19.4%) showed increased uptake specifically in the low back. Scans consistently yielded no findings with reference to the back when the prescan diagnosis was spinal stenosis, lumbar pain syndrome, herniated nucleus pulposus, or postlaminectomy syndrome. Some scans gave positive findings in patients with a diagnosis of degenerative disc disease, pseudarthrosis, spondylolisthesis, fracture, infection, metabolic disorder, or tumor. Positive scans were generally obtained early after presentation (within 3 months) and negative scans obtained later (after 6 months), suggesting that clinical suspicion is still the main indication for early scanning. Planar bone scanning was helpful in both diagnosis and therapeutic decisionmaking in many conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bahar RH, Al-Suhali AR, Mouse AM, Nawaz MK, Kaddah N, Abdel-Dayem HM (1988) Brucellosis: appearance on skeletal imaging. Clin Nucl Med 13:102

    Google Scholar 

  2. Barraclough D, Russell AS, Percy JS (1977) A clinical, radiological and scintiscan survey. J Rheumatol 4:282

    Google Scholar 

  3. Bodner RJ, Heyman S, Drummond DS, Gregg JR (1988) The use of single photon emission computed tomography (SPECT) in the diagnosis of low-back pain in young patients. Spine 13:1155

    Google Scholar 

  4. Chalmers IM, Lentle BC, Percy JS, Russell AS (1979) Sacroilitis detected by bone scintiscanning. A clinical, radiological, and scintigraphic follow-up study. Am Rheum Dis 38:112

    Google Scholar 

  5. Collier BD, Johnson RP, Carrera GF, Meyer GA, Schwab JP, Flatley TJ, Isitman AT, Hellman RS, Zielonka JS, Knobel J (1985) Painful spondylolysis or sponylolisthesis studied by radiography and single-photon emission computed tomography. Radiology 154:207

    Google Scholar 

  6. David P, Thomson ABR, Lentle BC (1978) Quantitative sacroiliac scintigraphy in patients with Crohn's disease. Arthritis Rheumatol 21:234

    Google Scholar 

  7. Fidler MW, Hoefnagel CA (1984) Lateral and computerized transverse 99m-Tc-MDP bone scintigrams to supplement the anteroposterior bone scintigram for spinal hot spot localization. Report of a case. Spine 9:655

    Google Scholar 

  8. Garty I, Tanzman M, Reiner S (1985) Accumulation of technetium-99m MDP in distended ureter. A potential error in diagnosing osteoblastic bone activity. Clin Nucl Med 10:667

    Google Scholar 

  9. Gelfand MJ, Strife JL, Kereiakes JG (1981) Radionuclide bone imaging in spondylolysis of the lumbar spine in children. Radiology 140:191

    Google Scholar 

  10. Goeithe HS, Lemmons AJ, Goedhard G, Lokkerbol H, Rahmy A, Steven MM, Vander Linden SM, Cats A (1985) Radiologic and scintigraphic findings in patients with a clinical history of chronic inflammatory back pain. Skeletal Radiol 14:243

    Google Scholar 

  11. Goh AS, Sundram FX, Kumar P (1986) Radionuclide bone imaging in patients with low back pain presenting to the orthopaedic surgeon. Ann Acad Med Singapore 15:529

    Google Scholar 

  12. Goldberg RP, Genant HK, Shimshak R, Shame (1978) Applications and limitations of quantitative sacro-iliac joint scintigraphy. Radiology 128:683

    Google Scholar 

  13. Gupta SM, Tung M, Spencer RP, Maturlo S, Davies T, Herrera NE (1988) Nuclear medicine studies of aging VI. Dual photon absorptiometry and bone scans in “at risk” women with back pain. Int J Rad Appl Instrum (B) 15:629

    Google Scholar 

  14. Ham HR, Verelst J, Vandevivere J (1982) Caudal view on bone scan to visualize coccygeal and public lesions. Clin Nucl Med 7:41

    Google Scholar 

  15. Hellman RS, Nowak D, Collier BD, Isitman A, Eisner R (1986) Evaluation of distance-weight SPECT reconstruction for skeletal scintigraphy. Radiology 159:473

    Google Scholar 

  16. Ho G, Sadovnikoff N, Malhotra CM, Claunch B (1979) Quantitative sacroiliac joint scintigraphy: a clinical assessment. Arthritis Rheumatol 22:837

    Google Scholar 

  17. Humphreys RP, Gilday DL, Ash JM, Hendrick EB, Hoffman HJ (1979) Radiopharmaceutical bone scanning in pediatric neurosurgery. Child's Brain 5:249

    Google Scholar 

  18. Jackson DW, Wiltse LL, Dingman RD, Hayes M (1981) Stress reaction involving the pars inter-articularis in young athletes. Am J Sports Med 9:304

    Google Scholar 

  19. Karl JM, Howard WH, Bunker SR (1985) Scintigraphic appearance of the piriformis muscle syndrome. Clin Nucl Med 10:361

    Google Scholar 

  20. Lentle BC, Russell AS, Percy JS, Jackson FI (1977) The scintigraphic investigation of sacroiliac disease. J Nucl Med Allied Sci 18:529

    Google Scholar 

  21. Lowe J, Schachner E, Hirschberg E, Shapiro Y, Libson E (1984) Significance of bone scintigraphy in symptomatic spondylolysis. Spine 9:653

    Google Scholar 

  22. Lugon M, Torode AS, Travers RL, Amaral H, Laven JP, Hughes GRV (1979) Sacro-iliac joint scanning with technetium-99 diphosphonate. Rheumatol Rehabil 18:131

    Google Scholar 

  23. Lusins JD, Danielski EF, Goldsmith SJ (1989) Bone SPECT in patients with persistent back pain after lumbar spine surgery. J Nucl Med 30:490

    Google Scholar 

  24. Makaiova I, Hupka S, Makai F, Vivodova M, Kausitz J, Rajniakova L, Pipa V, Kutarra A, Huraj E (1981) Experience with bone scanning in differential diagnosis of local bone lesions. Czech Med 4:153

    Google Scholar 

  25. Namey TC, McIntrye J, Buse M, LeRoy EC (1977) Nucleographic studies of axial sponarthritides. Arthritis Rheum 20:1058

    Google Scholar 

  26. Palestro CJ, Malat J, Collica CJ, Richman AH (1986) Incidental diagnosis of pregnancy on bone and gallium scintigraphy. J Nucl Med 27:370

    Google Scholar 

  27. Papanicolaou N, Wilkinson RH, Emans JB, Treves S, Micheli LJ (1985) Bone scintigraphy and radiography in young athletes with low back pain. AJR 145:1039

    Google Scholar 

  28. Pfannenstiel P, Semmler V, Adam W, Halbsgath A, Bandillo R, Berg D (1980) Comparative study of quantitating 99m-Tc-EHDP uptake in sacroiliac scintigraphy. Eur J Nucl Med 5:49

    Google Scholar 

  29. Raymond J, Dumas JM, Lisbona R (1984) Nuclear imaging as a screening test for patients referred for intra-articular facet block. J Can Assoc Radiol 35:291

    Google Scholar 

  30. Rothwell RS, Davis P, Lentle BC (1981) Radionuclide bone scanning in females with chronic low back pain. Ann Rheum Dis 40:79

    Google Scholar 

  31. Schutte HE, Park WM (1983) The diagnostic value of bone scintigraphy in patients with low back pain. Skeletal Radiol 10:1

    Google Scholar 

  32. Smith FW, Gilday DL (1980) Scintigraphic appearances of osteoid osteoma. Radiology 137:191

    Google Scholar 

  33. Snaith ML, Galvin SEJ, Short MD (1982) The value of quantitative radio-isotope scanning in the differential diagnosis of low back pain and sacroiliac disease. J Rheumatol 9:435

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Texas Health Science Center at San Antonio, Texas, USA

    Daniel C. Valdez M.D. & Robert G. Johnson M.D.

  2. St. Luke's Lutheran Hospital, San Antonio, Texas, USA

    Daniel C. Valdez M.D. & Robert G. Johnson M.D.

Authors
  1. Daniel C. Valdez M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert G. Johnson M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Valdez, D.C., Johnson, R.G. Role of technetium-99m planar bone scanning in the evaluation of low back pain. Skeletal Radiol. 23, 91–97 (1994). https://doi.org/10.1007/BF00563199

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00563199

Key words

Search

Navigation