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Amputation stumps studied by bone scanning. Work in progress.

A C Gonzalez, P F Macon, R R Sankey

    Radiology
    |April 1, 1984
    PubMed
    Summary
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    Bone scintigraphy using Tc-99m-etidronate reveals diminished activity in below-knee amputation stumps over time, indicating reduced blood flow, especially in diabetic patients.

    Area of Science:

    • Nuclear Medicine
    • Radiopharmaceuticals
    • Skeletal Imaging

    Background:

    • Below-knee amputations are common, particularly in diabetic patients.
    • Assessing post-amputation stump vascularity is crucial for patient management.
    • Tc-99m-etidronate scintigraphy offers insights into bone and soft tissue perfusion.

    Purpose of the Study:

    • To evaluate the changes in bone scintigraphy activity in below-knee amputation stumps over time.
    • To compare stump vascularity in diabetic versus nondiabetic patients.
    • To correlate scintigraphic findings with time since amputation and flow measurements.

    Main Methods:

    • Utilized a three-phase scanning technique (flow, blood pool, delayed equilibrium images) with Tc-99m-etidronate.
    • Scanned 9 diabetic and 7 nondiabetic patients aged 24-63 years post-amputation.

    Related Experiment Videos

  • Estimated arterial and capillary phase durations and plotted stump tip activity over time and flow.

    • Main Results:

    • Scintigraphic activity in amputation stumps generally diminished over approximately 50 months.
    • Activity typically became minimal or undetectable after 18 months post-amputation.
    • Stumps showed relative stasis compared to intact limbs, more pronounced in diabetics and long-standing amputations.

    Conclusions:

    • Tc-99m-etidronate scintigraphy demonstrates a progressive decrease in stump activity post-amputation.
    • Diabetic patients and those with longer amputation duration exhibit more significant reductions in stump vascularity.
    • These findings highlight the utility of bone scintigraphy in assessing stump healing and vascular status.