Fluoride-18 scintigraphy in avascular necrotic disorders of bone

Fluoride-18 scintigraphy is a simple, safe method for evaluating perfusion to bone, and obviates objections to earlier techniques. The scintillation camera with positron detection represents a unique instrumentation system because of its tomographic effect, relative insensitivity to vascular radioactivity in the surrounding skeleton, and excellent spatial resolution despite low counting efficiency. In 75 patients with avascular disorders about the hip, knee, elbow, foot and hand, the impressions obtained from fluoride-18 scintigraphy were correlated with clinical findings and roentgenograms and when possible confirmed by tetracycline labeling and histological examination. Fluoride-18 scintigraphy was useful: in determining the vascularity of the femoral head following femoral neck fractures; in determining results of treatment; and in diagnosing early the various avascular necrotic disorders of the bone.