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Can (99m)technetium methylene diphosphonate bone scans objectively document costochondritis?
G Mendelson1, H Mendelson, S F Horowitz
1Department of Medicine, Beth Israel Medical Center, New York, NY 10003, USA.
Chest
|June 1, 1997
Summary
Bone imaging using 99mTc methylene diphosphonate is not a specific diagnostic tool for costochondritis in patients with chest pain. The study found similar uptake in both patients and controls, indicating limited diagnostic value.
Area of Science:
- Nuclear medicine
- Diagnostic imaging
- Musculoskeletal disorders
Background:
- Chest pain is a common presenting complaint in emergency departments.
- Costochondritis is a frequent cause of non-cardiac chest pain.
- Accurate diagnosis of costochondritis is essential to avoid unnecessary cardiac investigations.
Purpose of the Study:
- To evaluate the specificity of bone imaging with 99mTc methylene diphosphonate for diagnosing costochondritis.
- To determine if technetium uptake patterns can differentiate costochondritis from other causes of chest pain.
Main Methods:
- A prospective, nonblinded, controlled study involving 20 patients with clinically diagnosed costochondritis and 10 control subjects.
- Bone imaging was performed using intravenous 99mTc methylene diphosphonate.
- Scans were independently reviewed by two nuclear medicine specialists.
Main Results:
- 16 out of 20 patients with costochondritis showed increased technetium uptake at costochondral junctions.
- Six patients also had increased uptake in other chest wall areas.
- All 10 control subjects demonstrated increased technetium uptake at costochondral junctions.
Conclusions:
- Bone imaging with 99mTc methylene diphosphonate lacks specificity for diagnosing costochondritis.
- The imaging technique showed similar uptake patterns in both patients with costochondritis and healthy controls.
- This suggests bone scintigraphy is not a reliable method for confirming costochondritis in patients presenting with chest pain.