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Upper extremity radionuclide bone imaging: the wrist and hand
P Vande Streek1, R F Carretta, F L Weiland
1Sutter Roseville Medical Center, Department of Nuclear Medicine, CA 95661, USA.
Seminars in Nuclear Medicine
|February 19, 1998
Summary
Bone scintigraphy, a three-phase bone scan, aids in diagnosing hand and wrist conditions like occult fractures and osteomyelitis when X-rays are unclear. This imaging technique offers valuable insights into bone health and disease processes.
Area of Science:
- Nuclear Medicine
- Musculoskeletal Imaging
- Radiology
Background:
- Plain film radiography is standard for hand and wrist evaluation.
- Limitations exist in detecting subtle fractures and certain bone pathologies.
- Advanced imaging modalities are needed for comprehensive assessment.
Purpose of the Study:
- To highlight the utility of bone scintigraphy in evaluating hand and wrist conditions.
- To demonstrate its role in diagnosing occult fractures, infections, and tumors.
- To emphasize its value as an adjunct to radiography.
Main Methods:
- Three-phase bone scintigraphy utilizing radiotracers.
- Evaluation of osseous uptake, blood flow, and extravascular distribution.
- Integration with other imaging techniques like gallium-67 citrate or radiolabeled leukocytes.
Main Results:
- Bone scans effectively identify occult fractures, particularly scaphoid fractures.
- Useful in diagnosing chronic pain syndromes, including reflex sympathetic dystrophy.
- Aids in evaluating osteomyelitis, primary bone tumors, and metastatic disease.
- Helps identify conditions like fibrous dysplasia, histiocytosis X, and Paget's disease.
Conclusions:
- Bone scintigraphy is a valuable tool for diagnosing a wide spectrum of hand and wrist pathologies.
- It provides crucial information beyond plain film radiography.
- Its application extends to acute, chronic, and oncologic conditions affecting the hand and wrist.