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The role of bone scintigraphy in the assessment of chronic wrist pain without any trauma history

  • Cagatay OzturkEmail author
  • Onur Tirelioglu
  • Feyzi Tamgac
  • Tufan Kaleli
Original Article

Abstract

Bone scintigraphy of the hands and wrists represents an important adjunct imaging technique that complements plain film radiographic examination in the evaluation of chronic wrist pain. In this study, the effectiveness of bone scintigraphy was investigated in the evaluation of chronic wrist pain in the patients without the history of trauma and any radiological and rheumatological abnormalities. Seventy-one patients with normal conventional radiographs and unexplained wrist pain were evaluated prospectively between 1998 and 2003 in our hand surgery clinic. There was no trauma history and no specific physical examination findings in the patients. The bone scintigraphy was done in all patients. Fifty-two of the all patients had normal scintigram. Seventeen of the remaining 19 patients showed increased activity over triquetrum (5 cases), lunatum (4 cases), trapezium (4 cases), hamatum (2 cases) and psiforme (2 cases). As the additional radiological investigations like MRI and CT revealed no bony abnormalities, the results of bone scintigraphy were evaluated as chronic ligamentous injuries. Two patients had diffuse increased uptake compatible with synovitis. The evaluation of bone scintigraphy correlated with clinical findings is effective to choose the most efficient treatment method in chronic wrist pain.

Keywords

Bone scintigraphy Chronic wrist pain Evaluation 

Place de la scintigraphie dans l’évaluation d’une douleur du poignet sans aucun antécédent traumtqiue

Résumé

Etude concernant l’utilité de la scintigraphie osseuse dans l’évaluation du poignet douloureux atraumatique, en absence de signe radiologique au bilan standard. Une série de soixante-et-onze patients ont fait l’objet d’une étude prospective dans un Service spécialisé en chirurgie de la main, entre 1998 et 2003. Cinquante-deux patients présentaient une scintigraphie normale. Sur les dix-neuf cas restants – cinq présentaient une hyper-activité au niveau du triquetrum, quatre au niveau du lunatum, quatre – au niveau du trapèze, deux au niveau du hamatum, deux au niveau du pisiforme et deux une synovite diffuse. En l’absence de lésions anatomiques sur les examens supplémentaires (scanner et résonance magnétique), les résultats positifs de la scintigraphie ont été étiquetés comme lésions ligamentaires chroniques. L’utilisation du bilan scintigraphique peut être utile dans la prise en charge des douleurs chroniques du poignet.

Mots clés

Scintigraphie osseuse Douleur chronique du poignet Evaluation 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Cagatay Ozturk
    • 1
    • 2
    Email author
  • Onur Tirelioglu
    • 2
  • Feyzi Tamgac
    • 3
  • Tufan Kaleli
    • 2
  1. 1.Rehabilitation and Care CenterTurkish Armed ForcesBilkent AnkaraTurkey
  2. 2.Department of Orthopedic SurgeryUludag University Medical SchoolBursaTurkey
  3. 3.Department of Nuclear MedicineUludag University Medical SchoolBursaTurkey

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