Abstract
Diagnosis of sacroiliitis (SI) with bone sointigraphy may involve difficultios even with a quantitative approach. The aim of this study was to evaluate the combined use of bone and bone marrow scintigraphies for the diagnosis of active sacroiliitis.
Thirty-one patients who were clinically suspected to have SI were included in the study. Bone and bone marrow scintigraphies were done after injections of 740 MBq of99mTc-MDP (MDP) and 370 MBq of99mTc-sulfur colloid (SC) respectively with a 2-day interval. Both visual and quantitative assessment of MDP uptake and visual assessment of SC uptake in sacroiliac joints were performed. Also sacroiliac joint radiographic findings for each patient were evaluated and graded from 0 to 4 according to the New York grading system. Patients were divided into 2 groups according to their x-ray findings (Group A: grade 0–2, Group B: grade 3–4).
A total of 14 patients (10 bilateral, 4 unilateral) had increased MDP uptake with decreased/normal SC uptake. Twelve of 14 patients had grade 0–2 radiographic changes while only 2 patients had grade 3–4 radiographic changes. Increased MDP uptake with decreased/normal SC uptake is the most common scintigraphic pattern seen in acute phase SI in which radiographic findings are generally found to be normal or slightly changed. In at least in 8 patients the decreased bone marrow uptake of SC was demonstrated, supporting the diagnosis.
Although our results did not reveal any significant superiority of bone marrow scintigraphy to bone scan for the detection of active sacroiliitis, combined use of bone and bone marrow scintigraphies was presented as an alternative method to characterize patients with active sacroiliitis.
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References
Van der Linden SM, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A statistical evaluation.Ann Rheum Dis 1984; 27: 361–368.
Forrester DM, Hollingsworth PN, Dawkins RL. Difficulties in the radiographic diagnosis of sacroilitis.Clin Rheum Dis 1983; 9: 323–332.
Russell AS, Lentle BC, Percy JS. Investigation of sacroiliac disease: comparative evaluation of radiological and radionuclide techniques.J Rheumatol 1975; 2: 45–51.
Lin WY, Wang SJ. Influence of age and gender on quantitative sacroiliac joint scintigraphy.J. Nucl Med 1998; 39: 1269–1272.
Shichikawa K, Tsujimoto M, Nishioka J, Nishibayashi Y, Matsumoto K. Histopathology of early sacroiliitis and enthesis in ankylosing spondylitis. InAdvances in Inflammation Research, Vol. 9. The Spondyloarthropathies. Ziff M, Cohen SB (eds), New York: Raven Press, 1985
Fogelman I, Maisey MN, Clarke SEM. Sacroiliitis. InAn Atlas of Clinical Nuclear Medicine. Fogelman I, Maisey MN, Clarke SEM (eds), 2nd ed, Singapore; Martin Dunitz, Ltd., 1994; 84.
Bennett PH, Wood PHN. Population studies of the rheumatic disease. In:Proceedings of the Third International Symposium. Bennett PH, Wood PHN, eds, Amsterdam; Excerpta Medica, 1968: 456–457.
Moll JMH, Wright V. New York clinical criteria for ankylosing spondylitis. A statistical evaluation.Ann Rheum Dis 1973; 32: 354–363.
Yazici H, Turunç M, Özdogan H, Yurdakul S, Akinci A, Barnes CG. Observer variation in grading sacroiliac radiographs might be a cause of sacroiliitis reported in certain disease states.Ann Rheum Dis 1987; 46: 139–145.
Taggart AJ, Desai SM, Iveson JM, et al. Computerised tomography of the sacroiliac joints in the diagnosis of sacroiliitis.Br J Rheumatol 1984; 23: 258–266.
Fam AG, Rubenstein JD, Chin-Sang H, et al. Computerised tomography in the diagnosis of early ankylosing spondylitis.Arthritis Rheum 1985; 28: 930–937.
Ahlström H, Feltelius N, Nyman R, Hallgren R. Magnetic resonance imaging of sacroiliac joint inflammation.Arthritis Rheum 1990; 33: 1763–1769.
Battafarano DF, West SG, Rak KM, Fortenbery EJ, Chanieleis AE. Comparison of bone sear, computed ismography, and magnetic resonance imaging in the diagnosis of active sacroiliitis.Semin Arthritis Rheum 1993; 23: 161–176.
Verlooy H, Mortelmans L, Vleugels S, deRoo M. Quantitative scintigraphy of the sacroiliac joints.Clin Imaging 1992; 16: 230–233.
Ryan PJ, Fogelman I. Sacroiliac quantitative bone scintigraphy in ankylosing spondylitis: any clinical relevance?Nucl Med Commun 1993; 14: 19–20.
Ryan PJ, Fogelman I. The bone scan: Where are we know?Semin Nucl Med 1995; 25: 76–91.
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Bozkurt, M.F., Uöur, Ö., Ertenli, I. et al. Combined use of bone and bone marrow scintigraphies for the diagnosis of active sacroiliitis: A new approach. Ann Nucl Med 15, 117–121 (2001). https://doi.org/10.1007/BF02988601
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DOI: https://doi.org/10.1007/BF02988601