Bone scintigraphy in preschool children with lower extremity pain of unknown origin

Area of Science:

• Pediatric Orthopedics
• Nuclear Medicine
• Radiology

Background:

• Young children often struggle to articulate the precise location of bone pain.
• Diagnosing lower extremity pain and gait abnormalities in this age group presents a clinical challenge.

Purpose of the Study:

• To evaluate the utility of bone scans in diagnosing lower extremity pain and gait abnormalities in children under five.
• To identify common sites and types of bone abnormalities detected by bone scans in this pediatric population.

Main Methods:

• Bone scans were conducted on 56 children under five years old presenting with lower extremity pain or gait abnormalities.
• Exclusion criteria included fever, known infection, child abuse, malignancy, and radiographic abnormalities.
• Abnormalities were categorized by location and type.

Main Results:

• Thirty out of 56 children (53.6%) showed abnormal bone scan findings.
• Tarsal bone abnormalities were most common (16 cases), accounting for over half of all scintigraphic abnormalities.
• Abnormal uptake near the cuboid bone was frequently observed (9 cases), potentially indicating stress injuries.

Conclusions:

• Bone scans are valuable for identifying the etiology of lower extremity pain and gait disturbances in young children.
• Tarsal bone abnormalities, especially those involving the cuboid, are prevalent in this cohort and may represent overuse injuries.
• Findings highlight the importance of considering tarsal bone pathology in the differential diagnosis of pediatric gait abnormalities.