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Quantitative bone scintigraphy in reflex sympathetic dystrophy

R M Atkins1, W Tindale, D Bickerstaff

  • 1Department of Human Metabolism, University of Sheffield Medical School.

British Journal of Rheumatology
|January 1, 1993
PubMed
Summary
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Technetium-99m bone scans show increased uptake throughout the hand in patients with post-fracture reflex sympathetic dystrophy (RSD). This uptake correlates with tenderness and confirms bone scintigraphy as a sensitive diagnostic tool for RSD.

Area of Science:

  • Nuclear Medicine
  • Orthopedics
  • Radiology

Background:

  • Reflex sympathetic dystrophy (RSD) is a painful condition following fractures.
  • Previous studies suggested increased uptake in RSD bone scans was limited to periarticular areas.

Purpose of the Study:

  • To investigate the distribution of technetium-99m labelled methylene diphosphonate bone scan uptake in post-fracture RSD of the hand.
  • To assess the sensitivity of delayed bone scintigraphy for RSD diagnosis, even with concurrent wrist fractures.
  • To correlate bone scan findings with clinical indicators of disease severity.

Main Methods:

  • Analysis of 29 bone scans from 16 patients with post-fracture hand RSD.
  • Comparison of uptake patterns in metacarpophalangeal joints and metacarpal bones.

Related Experiment Videos

  • Evaluation of delayed scans at 3 months post-fracture in RSD patients versus controls.
  • Correlation of bone scan uptake with dolorimetry-assessed tenderness.

    • Main Results:

    • Increased technetium-99m uptake was observed throughout the affected hand, not just periarticular regions.
    • Delayed bone scintigraphy demonstrated significant uptake in RSD patients, distinguishing them from controls, even with wrist fractures.
    • Early increased uptake gradually normalized over time.
    • A strong correlation was found between bone scan uptake and local tenderness.

    Conclusions:

    • Bone scintigraphy reveals widespread increased uptake in post-fracture hand RSD.
    • Delayed bone scans are a sensitive diagnostic method for RSD, even in the presence of fractures.
    • Bone scan findings offer a quantitative measure of RSD severity, aiding treatment planning and assessment.