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The usefulness of Tc-99m-MDP bone scintigraphy in detection of articular involvement of Behçet’s disease

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Abstract

Articular involvement was reported to be present in approximately 5-76% of Behçet patients. Therefore, we need a useful non-invasive method to detect articular involvement early in Behçet patients with nonspecific complaints. We aimed to evaluate the usefulness of99mTc-methylene diphosphonate (Tc-99m-MDP) bone scintigraphy in the detection of the articular involvement of Behçet’s disease (BD). Bone scintigraphy with Tc-99m-MDP was performed in 32 (17 male, 15 female) consecutive patients with BD. The sacroiliac (SI) joints with SI index higher than 1.34 were diagnosed as having sacroiliitis. Although joint complaints were present in only 8 (25%) patients, we detected joint involvement by scintigraphy in 27/32 (84.4%) Behçet patients mostly affecting the knees (62.5%), ankles (59.4%), SI joints (25%), wrists (21.9%), shoulders (18.7%), elbows (12.5%) and hips (3.1%). The articular involvement was monoarticular in four cases (12.5%) and was oligoarticular in the remaining. There was no correlation between joint involvement and age, gender, disease duration, drug usage or other clinical manifestations. Despite the fact that our patients were clinically asymptomatic and had normal pelvis radiography, sacroiliitis was found in 8 patients (25%). Bone scintigraphy is sensitive in the diagnosis of joint involvement allowing earlier diagnosis and showing the presence of articular involvement, especially in SI joints.

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References

  1. Jorizzo JL. Behçet’s Disease. In: Fitzpatrick TB, Eisen AZ, Wolff K, et al. eds.Dermatology in General Medicine 4th edn. New York; McGraw-Hill Inc., 1993: 2290–2294.

    Google Scholar 

  2. International Study Group for Behçet’s Disease. Evaluation of diagnostic (“classification”) criteria in Behçet’s Disease: towards internationally agreed criteria.Br J Rheumatol 1992;31:299–308.

    Article  Google Scholar 

  3. Al-Mutawa SA, Hegab SM. Behçet’s disease.Clin Exp Med 2004; 4: 103–131.

    Article  PubMed  CAS  Google Scholar 

  4. Gharibdoost F, Davatchi F, Shahram F, et al. Clinical Manifestations of Behçet’s Disease in Iran Analysis of 2176 cases. In: Godeau P, Wechsler B, eds.Behçet’s Disease. Amsterdam; Elsevier Science Publishers, 1993: 153–158.

    Google Scholar 

  5. DilşFen N, Koniçe M, Aral O. et al. Risk factors for vital organ involvement in Behçet’s Disease. In: Godeau P, Wechsler B, eds.Behçet’s Disease. Amsterdam; Elsevier Science Publishers, 1993: 165–169.

    Google Scholar 

  6. Prokaeva T, Madanat W, Yermakova N, Alekberova Z. Sex dimorphism of Behçet’s Disease. In: Godeau P, Wechsler B, eds.Behçet’s Disease. Amsterdam; Elsevier Science Publishers, 1993:219–221.

    Google Scholar 

  7. Zouboulis CHC, Djawari D, Kirch W, et al. Adamantiades-Behçet’s Disease in Germany. In: Godeau P, Wechsler B, eds.Behçet’s Disease. Amsterdam; Elsevier Science Publishers, 1993: 193–196.

    Google Scholar 

  8. Yazici H, Tüzün Y, Pazarli H,et al. Influence of age of onset and patient’s sex on the prevalence and severity of manifestations of Behçet’s syndrome.Ann Rheum Dis 1984; 43: 783–789.

    Article  PubMed  CAS  Google Scholar 

  9. Yurdakul S, Yazici H, Tuzun Y, Pazarli H, Yalcin B, Altac M, et al. The arthritis of Behçet’s disease: a prospective study.Ann Rheum Dis 1983; 42: 505–115.

    Article  PubMed  CAS  Google Scholar 

  10. Kim HA, Choi KW, Song YW. Arthropathy in Behçet’s disease.Scand J Rheumatol 1997; 26: 125–129.

    PubMed  CAS  Google Scholar 

  11. Kim HS, Lee J, Lee CH, Song JH, Bang DS, Lee SK. Heel pain in Behçet’s disease.J Korean Rheum Assoc 1995; 2: 151–156.

    Google Scholar 

  12. Yapar Z, Kibar M, Soy M, Ozbek S. Osteonecrosis in Behçet’s disease seen on bone scintigraphy.Clin Nucl Med 2001;26:267–268.

    Article  PubMed  CAS  Google Scholar 

  13. Tanaka E, Nishinarita M, Uesato M, Kamatani N. A case of intestinal Behcet’s disease with abnormal ossification complicated by myelodysplastic syndrome, symptoms revealed after the perforation of ileum ulcer.Ryumachi 2000; 40: 711–718.

    PubMed  CAS  Google Scholar 

  14. Kane D, Balint PV, Wood F, Sturrock RD. Early diagnosis of pyomyositis using clinic-based ultrasonography in a patient receiving infliximab therapy for Behçet’s disease.Rheumatology (Oxford) 2003; 42: 1564–1565.

    Article  CAS  Google Scholar 

  15. Davis MC, Turner DA, Charters JR, Golden HE, Ali A, Fordham EW. Quantitative sacroiliac scintigraphy. The effect of method of selection of region of interest.Clin Nucl Med 1984; 9: 334–340.

    Article  PubMed  CAS  Google Scholar 

  16. Prakash S, Gopinath PG, Bhargava S, Mehra NK, Malaviya AN. Evaluation of quantitative sacroiliac scintigraphy for the early detection of sacroiliitis.Eur J Nucl Med 1983; 8: 531–534.

    Article  PubMed  CAS  Google Scholar 

  17. Lee SK, Lee J. Behçet’s disease—a rheumatologic perspective.Yonsei Medical Journal 1997; 38: 395–400.

    PubMed  CAS  Google Scholar 

  18. Tursen U, Gurler A, Boyvat A. Evaluation of clinical findings according to sex in 2313 Turkish patients with Behçet’s disease.Int J Dermatol 2003; 42: 346–351.

    Article  PubMed  Google Scholar 

  19. Kim NH, Yang IH, Kim SM, Bang DS. Behçet’s arthritis.J Korean Orthop Assoc 1993; 28: 1890–1897.

    Google Scholar 

  20. Kastner DL. Intermittent and Periodic Arthritic Syndromes: Behcet’s Disease. In: Koopman WJ, ed.Arthritis and Allied Conditions. 13th ed. Baltimore, Md; Williams & Wilkins Co., 1997: 1291–1297.

    Google Scholar 

  21. Takeuchi A, Mori M, Hashimoto A. Radiographic abnormalities in patients with Behcet’s disease.Clin Exp Rheumatol 1984; 3: 59–62.

    Google Scholar 

  22. Duzgun N, Ates A. Erosive arthritis in a patient with Behcet’s disease.Rheumatol Int 2003; 5: 265–267.

    Article  Google Scholar 

  23. Bernard TN, Cassidy JD. The sacroiliac joint syndrome. In: Frymoyer JW (ed).The adult spine. New York; Raven, 1991: 2107–2130.

    Google Scholar 

  24. Rosenthall L. Nuclear medicine techniques in arthritis.Rheum Dis Clin North Am 1991; 17: 585–597.

    PubMed  CAS  Google Scholar 

  25. Ryan PJ, Fogelman I. The bone scan: where are we now?Semin Nucl Med 1995; 25: 76–91.

    Article  PubMed  CAS  Google Scholar 

  26. Silberstein EB, Elgazzar AH, Fernandez-Ulloa M, Nishiyama H. Skeletal scintigraphy in non-neoplastic osseous disorders. In: Henkin RE (ed).Nuclear Medicine. New York; Mosby, 1996.

    Google Scholar 

  27. Yildiz M, Tunc SE, Sahin M, Okudan B, Aydin O, Suslu H, et al.. Evaluation of joints using Tc 99m-MDP bone scintigraphy in patients with familial Mediterranean fever: should bone scans be used for diagnosis and follow-up?Rheumatol Int 2006; 3: 220–223.

    Article  Google Scholar 

  28. Krause L, Leibovici L, Guedj D, Molad Y, Weinberger A. Disease patterns of patients with Behçet’s disease demonstrated by factor analysis.Clin Exp Rheumatol 1999; 17: 347–350.

    PubMed  CAS  Google Scholar 

  29. Dilsen N, Konice M, Aral O. Why Behcet’s disease should be accepted as a seronegative arthritis. In: Lehner T, Barnes CG, eds.Recent advances in Behcet’s disease. London; Royal Society of Medicine Services, 1986: 281–284.

    Google Scholar 

  30. Olivieri I, Salvarani C, Cantini F. Is Behcet’s disease part of the Spondarthritis complex?J Rheumatol 1997; 24: 1870- 1872.

    PubMed  CAS  Google Scholar 

  31. Chamberlain MA, Robertson RJH. A controlled study of sacroiliitis in Behcet’s disease.Br J Rheumatol 1993; 32: 693–698.

    Article  PubMed  CAS  Google Scholar 

  32. Maghraoui AE, Tabache F, Bezza A, Abouzahir A, Ghafir D, Ohayon V, et al. A controlled study of sacroiliitis in Behcet’s disease.Clin Rheumatol 2001; 20: 189–191.

    Article  PubMed  CAS  Google Scholar 

  33. Chang HK, Cho EH, Kim JU, Herr H. A case of coexisting Behcet’s disease and ankylosing Spondylitis.Korean J Intern Med 2000; 15: 93–95.

    PubMed  CAS  Google Scholar 

  34. Miron SD, Khan MA, Wiesen EJ, Kushner I, Bellon EM. The value of quantitative sacroiliac scintigraphy in detection of sacroiliitis.Clin Rheumatol 1983; 2: 407–414.

    Article  PubMed  CAS  Google Scholar 

  35. Kacar G, Kacar C, Karayalcin B, Gungor F, Tuncer T, Erkilic M. Quantitative sacroiliac joint scintigraphy in normal subjects and patients with sacroiliitis.Ann Nucl Med 1998; 12: 169–173.

    Article  PubMed  CAS  Google Scholar 

  36. Inanc N, Atagunduz P, Sen F, Biren T, Turoğlu HT, Direskeneli H. The investigation of sacroiliitis with different imaging techniques in spondyloarthropathies.Rheumatol Int 2005; 25: 591–594.

    Article  PubMed  CAS  Google Scholar 

  37. Esdaile JM, Rosenthall L, Terkeltaub R, Kloiber R. Prospective evaluation of sacroiliac scintigraphy in chronic inflammatory back pain.Arthritis Rheum 1980; 23: 998–1003.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Mehmet ahin.

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ahin, M., Tunc, S.E., Yildiz, M. et al. The usefulness of Tc-99m-MDP bone scintigraphy in detection of articular involvement of Behçet’s disease. Ann Nucl Med 20, 649–653 (2006). https://doi.org/10.1007/BF02984675

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  • DOI: https://doi.org/10.1007/BF02984675

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