The role of bone scintigraphy with pinhole collimation in the evaluation of symptomatic paediatric hips

Sixty-two children with signs and symptoms of hip pathology underwent bone scintigraphy with pinhole collimation of the hip joints. Three distinct patterns of isotope uptake were observed: a normal uptake of isotope, a focal increase or decrease of isotope uptake and a mild diffuse increase of isotope uptake. Forty-four children had normal isotope scans, an average hospital stay of 6.8 days and no significant pathology on follow-up. Ten children had a focal increase or decrease of isotope uptake, an average hospital stay of 21 days and on follow-up all had significant pathology. Eight children had a mild diffuse increase of isotope uptake, an average hospital stay of 8.75 days and no significant pathology on follow-up. We conclude: (1) Normal isotope hip scintigrams with pinhole collimation indicate an excellent prognosis in symptomatic paediatric hips; (2) Focal scintigraphic abnormalities are indicative of significant pathology; (3) A mild diffuse increase in isotope uptake on both sides of the joint is not associated with significant pathology; (4) There is a good correlation between scintigrams and the length of hospital stay; (5) Scintigraphy is at least twice as sensitive at the time of presentation as plain radiographs in the detection of pathology.