Negative scintigraphy despite spinal fractures in the multiply injured

Skeletal injuries may be overlooked in multiply-injured patients. Skeletal scintigraphy, a very sensitive indicator of skeletal injuries, may give complementary information. We therefore performed scintigraphic screening in 20 patients with multiple injuries. In all, 38 fractures were diagnosed by plain skeletal radiography, and were also visualized scintigraphically. Furthermore, scintigraphy revealed a fracture of the pelvis in one patient and a tibial plateau fracture in another. Scintigraphy was, however, negative in three patients; two with fractures of the transverse processes in the lumbar spine and one with a cervical spine fracture of the articular processes with dislocation. The use of scintigraphy as a screening method in patients with multiple injuries may be helpful in the diagnosis of skeletal injuries. However, fractures of the vertebral column were not always visualized, possibly because of technically inadequate examinations in injured patients unable to co-operate.