Skip to main content
Log in

Age-related changes in the hemodynamics of the femoral head as evaluated by early phase of bone scintigraphy

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

The femoral head is reported to be in a markedly hypoemic state as compared with other tissues even under normal conditions, and it is therefore necessary to understand its hemodynamics to investigate the pathogenesis of hip disorders. It is known that aspects of intraosseous hemodynamics including blood flow and blood pool can be evaluated soon after radioisotope administration. In this study, hemodynamic changes in the femoral head according to gender and age were examined by investigating accumulation of radioisotope in the tissue during the early phase of bone scintigraphy.

Methods

The subjects of this study consisted of 58 joints of 31 men and 75 joints of 41 women, whose ages ranged from 15 to 87 years (average age: 67.9 years). Images of bone scintigraphy were obtained for 15 to 20 minutes at 5 minutes and at 3 hours after radioisotope administration. The ratio of accumulation in the femoral head to that in the diaphysis (head-to-diaphysis ratio, HD ratio) was calculated.

Results

HD ratios obtained 15-20 minutes later ranged from 0.01 to 7.35 (1.88 ± 0.91, mean ± SD). HD ratios decreased with age, and a significant inverse correlation was observed between age and HD ratio, demonstrating a correlation coefficient of-0.27 (p = 0.001). The HD ratio among men was 0.01-3.57 (1.66 ± 0.71), while that among women was 0.53-7.35 (2.05 ± 1.01), and a significant difference was observed in HD ratio between men and women (p = 0.02). There was a significant difference in HD ratios between men and women in their teens to forties (p = 0.03), while no significant differences was observed in the other age groups. HD ratios obtained 3 hours later ranged from 0.44 to 6.32 (1.95 ± 0.79, mean ± SD), and no significant correlation was observed between age and HD ratio, demonstrating a correlation coefficient of-0.14.

Conclusion

The present study demonstrated that blood flow and blood pool of the femoral head decrease with aging particularly in women. This hemodynamic deterioration of the femoral head caused by aging may have an effect on the onset and progression of hip disorders by influencing bone metabolism.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kubo T, Kimori K, Nakatnura F, Inoue S, Fujioka M, Ueshima K, et al. Blood flow and blood volume in the femoral heads of healthy adults according to age: Measurement with positron emission tomography (PET).Ann Nucl Med 2001; 15: 231–235.

    Article  PubMed  CAS  Google Scholar 

  2. Arlet J. Nontraumatic avascular necrosis of the femoral head. Past, present, and future.Clin Orthop Relat Res 1992; 277: 12–21.

    PubMed  Google Scholar 

  3. Postel M, Kerboull M. Total prosthetic replacement in rapidly destructive arthrosis of the hip joint.Clin Orthop 1970; 72: 138–144.

    PubMed  CAS  Google Scholar 

  4. Yamamoto T, Bullough PG. The role of subchondral insufficiency fracture in rapid destruction of the hip joint: a preliminary report.Arthritis Rheum 2000; 43: 2423–2427.

    Article  PubMed  CAS  Google Scholar 

  5. McPherson A, Scales JT, Gordon LH. A method of estimating qualitative changes of blood-flow in bone.J Bone Joint Surg Br 1961; 43B: 791–799.

    Google Scholar 

  6. Kelly PJ, Yipintsoi T, Bassingthwaighte JB. Blood flow in canine tibial diaphysis estimated by iodoantipyrine-125I washout.J Appl Physiol 1971; 31 (1): 38–47.

    PubMed  CAS  Google Scholar 

  7. Paradis GR, Kelly PJ. Blood flow and mineral deposition in canine tibial fractures.J Bone Joint Surg Am 1975; 57 (2): 220–226.

    PubMed  CAS  Google Scholar 

  8. Leo AW, Peggy AL, David JS. Measurement of regional bone and bone marrow blood flow in the rabbit using the hydrogen washout technique.Clin Orthop 1977; 122: 340–346.

    Google Scholar 

  9. Martiat P, Ferrant A, Cogneau M, Bol A, Michel C, Rodhain J, et al. Assessment of bone marrow blood flow using positron emission tomography: no relationship with bone marrow cellularity.Br J Haematol 1987; 66 (3): 307–310.

    Article  PubMed  CAS  Google Scholar 

  10. Ashcroft GP, Evans NT, Roeda D, Dodd M, Mallard JR, Porter RW, et al. Measurement of blood flow in tibial fracture patients using positron emission tomography.J Bone Joint Surg Br 1992; 74 (5): 673–677.

    PubMed  CAS  Google Scholar 

  11. Kahn D, Weiner GJ, Ben-Haim S, Boles Ponto LL, Madsen MT, Bushneil DL, et al. Positron emission tomographic measurement of bone marrow blood flow to the pelvis and lumbar vertebrae in young normal adults.Blood 1994; 83: 958–963.

    PubMed  CAS  Google Scholar 

  12. Kubota T, Ushijima Y, Okuyama C, Kubo T, Nishimura T. Tracer accumulation in femoral head during early phase of bone scintigraphy after renal transplantation.J Nucl Med 2001; 42: 1789–1794.

    PubMed  CAS  Google Scholar 

  13. Genant HK, Bautovich GJ, Singh M, Lathrop KA, Harper PV. Bone-seeking radionuclides: anin vivo study of factors affecting skeletal uptake.Radiology 1974; 113: 373–382.

    PubMed  CAS  Google Scholar 

  14. McCarthy ID, Hughes SPF. The role of skeletal blood flow in determining the uptake of99mTc-Methylene Diphos-phonate.Calcif Tissue Int 1983; 35: 508–511.

    Article  PubMed  CAS  Google Scholar 

  15. Gaucher A, Bertrand A, Tonnel F, Hocquard C, Adolphe J, Pere P. Bone angioscintigraphy.Rev Rhum Mal Osteoartic 1985; 52 (12): 701–705.

    PubMed  CAS  Google Scholar 

  16. Tucker FR. Arterial supply to the femoral head and its clinical importance.J Bone Joint Surg Br 1949; 31: 82–93.

    Google Scholar 

  17. Mussbichler H. Angiography of the hip region. Comparison between different angiographic modifications.Acta Radiol 1971;11:593–603.

    CAS  Google Scholar 

  18. Wertheimer LG, Lopes Sde L. Arterial supply of the femoral head. A combined angiographic and histological study.J Bone Joint Surg Am 1971; 53 (3): 545–556.

    PubMed  CAS  Google Scholar 

  19. Guyton AC. Textbook of medical physiology. Philadelphia; WB Saunderes, 1991: 186.

    Google Scholar 

  20. Shafer RB, Edeburn GF. Can the three-phase bone scan differentiate osteomyelitis from metabolic or metastatic bone disease?Clin Nucl Med 1984; 9 (7): 373–377.

    Article  PubMed  CAS  Google Scholar 

  21. Cuartero PA, Martinez ME, Benito RP, Martinez PS, Sanz MP. Abnormal bone scintigraphy and silent radiography in localized reflex sympathetic dystrophy syndrome.Eur J Nucl Med 1992; 19 (5): 330–333.

    Article  Google Scholar 

  22. Nishiyama Y, Yamamoto Y, Yokoe K, Kawaguchi Y, Toyama Y, Satoh K, et al. A comparative study of201T1 scintigraphy and three-phase bone scintigraphy following therapy in patients with bone and soft-tissue tumors.Ann Nucl Med 2004; 18 (3): 235–241.

    PubMed  Google Scholar 

  23. Masaoka S. Evaluation of arterial obstructive leg and foot disease by three-phase bone scintigraphy.Ann Nucl Med 2001; 15 (3): 281–287.

    PubMed  CAS  Google Scholar 

  24. Kawano M, Taki J, Tsuchiya H, Tomita K, Tonami N. Predicting the outcome of distraction Osteogenesis by 3- phase bone scintigraphy.J Nucl Med 2003; 44 (3): 369–374.

    PubMed  Google Scholar 

  25. Malizos KN, Soucacos PN, Vragalas V, Dailiana ZH, Schina I, Fotopoulos A. Three phase bone scanning and digital arteriograms for monitoring vascularized fibular grafts in femoral head necrosis.Int Angiol 1995; 14 (3): 319–326.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mikihiro Fujioka.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hamaguchi, H., Fujioka, M., Takahashi, K.A. et al. Age-related changes in the hemodynamics of the femoral head as evaluated by early phase of bone scintigraphy. Ann Nucl Med 20, 35–40 (2006). https://doi.org/10.1007/BF02985588

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02985588

Key words

Navigation