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Effect of sympathetic block demonstrated by triple-phase bone scan
J Hoffman1, W Phillips, M Blum
1Department of Anesthesiology, University of Texas Health Science at San Antonio 78284-7838.
The Journal of Hand Surgery
|September 1, 1993
Summary
Triple-phase bone scans help diagnose reflex sympathetic dystrophy. Increased blood flow after sympathetic block correlates with typical scan findings, supporting vascular flow as the cause.
Area of Science:
- Nuclear Medicine
- Radiology
- Pain Management
Background:
- Triple-phase bone scans are commonly used for diagnosing reflex sympathetic dystrophy (RSD).
- The underlying cause of abnormal findings on these scans remains unclear.
- Sympathetic block procedures offer relief for RSD patients.
Purpose of the Study:
- To investigate the impact of enhanced blood flow, resulting from sympathetic block, on triple-phase bone scan results.
- To determine the relationship between sympathetic block-induced hyperemia and diagnostic imaging findings in RSD.
Main Methods:
- Analyzed baseline and post-sympathetic block triple-phase bone scans in 15 RSD patients.
- Quantified changes in radiotracer uptake on blood pool and bone uptake images.
- Correlated imaging changes with clinical symptom relief post-block.
Main Results:
- A significant linear correlation was observed between increased counts on blood pool and bone uptake images post-sympathetic block.
- Higher blood pool and bone uptake counts were associated with a greater likelihood of typical RSD findings on visual inspection.
- Patients experiencing significant relief from sympathetic block showed increased uptake on scans.
Conclusions:
- Increased periarticular uptake on triple-phase bone scans in RSD is strongly linked to enhanced vascular flow.
- Sympathetic blockade's effect on bone scan findings supports the role of hyperemia in RSD pathophysiology.
- These findings provide etiological insight into abnormal triple-phase bone scans in reflex sympathetic dystrophy.