What does arthritis look like on bone scan

Distribution of diagnostic groups according to multiple categories. OA, osteoarthritis; ID, internal derangement; MP, myofacial pain

15. Seo BJ, Ko MY. A study on clinical diagnosis of temporomandibular joint disorders using bone scan. Korean J Oral Med 1996; 21 :103–113 [Google Scholar]

There were no significant differences in uptake ratios associated with pain and bone change. However, significant results were obtained when comparing uptake ratios between the osteoarthritis and non-osteoarthritis groups.

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The simple uptake rates of normal joints (n=5), temporomandibular ID (n=21) and osteoarthritis (n=18) as diagnosed on the basis of clinical symptoms and radiographs were compared. Osteoarthritic joints showed a tendency towards higher simple uptake rates, and in temporomandibular ID cases the uptake rates were lower than those of normal joints. Nevertheless, statistically significant differences between these two groups were not observed (p=0.098) ( Table 4 ). However, when the subjects studied were divided into osteoarthritis (n=18) and non-osteoarthritis (n=26) groups, the former group showed significantly higher uptake rates than the latter group (p=0.034) ( Table 5 ).

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The acquisition and analysis of bone scan images

A few knees[26,27] had radiographic evidence of OA without any scan abnormality, however, and several compartments had scintigraphic changes only. This indicates that scintigraphy provides a different type of information to that present on the radiograph.

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You should move slowly when getting up from the scanner table to avoid any dizziness or lightheadedness from lying flat for the length of the procedure.

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Why might I need a bone scan?

Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.

Receiver operating characteristic (ROC) curve of uptake ratio (UR) and asymmetrical index (AI); the closer the curve follows the left-hand border and then the top border of the ROC space, the more accurate the test

Scintigraphic changes of osteoarthritis: An analysis of findings during routine bone scans to evaluate the incidence in an Indian population


Another point to note is that the incidence of joint involvement was not affected by weight. In our patient population, gross obesity was not seen.

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The following criteria were used to assess the involvement of joints. In general, the intensity of uptake was considerably more than the adjacent bone. No attempt was made to quantify the intensity of the uptake [Figures ​ [Figures1 1 – 3 ].

The less common extended pattern of isotope uptake in sub-chondral bone was associated with more severe radiographic damage and may be indicative of advanced changes or active disease progression. The generalized pattern of uptake may be of most clinical significance. Early generalized isotope retention reflects abnormal perfusion and is sensitive to intra-articular steroids. It would therefore appear to reflect an inflammatory component of the disease.

In bone scan procedures, 99 Tc m is injected and after 3 h the uptake of 99 Tc m is examined. Uptake measurements depend on the blood flow volume and the amount of calcium contained in the phosphate binding sites on bone crystals; the uptake is increased in the areas where osteoblast activity is high with abundant blood flow. 12 It has been reported that in bone scans, the uptake rate is highest in younger patients and in menopausal women, the uptake in the cranial area is higher than that observed in non-menopausal women. 8,13 Kigami et al 14 have reported that uptake rates are noticeably higher in females than in males.

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Among patients who visited the Bundang Seoul University dental clinics from February 2009 to June 2009 and were clinically diagnosed with TMJ impairment, 22 patients (44 TMJs) were suspected to have osteoarthritis and standard bone scan procedures were performed. These patients (4 males and 18 females) were selected as the subjects for this study. The age distribution ranged from 18 years to 70 years, with a mean age of 36.2 years. Diagnostic methods included consideration of clinical findings, the research diagnostic criteria for temporomandibular disorders (RDC/TMD) chart, standard panoramic radiography, TMJ panoramic radiography and bone scan results. Clinical diagnosis was based on RDC/TMD Axis I (clinical physical examination) and the clinical findings—amount of mouth opening, pain, joint sound, tenderness etc. Internal derangement (ID) of the TMJ can be defined as an abnormal relationship between the articular disc and the mandibular condyle, articular fossa and the articular eminence. 10 In patients with symptoms of joint noise during normal function, mouth opening limitations, temporary joint locking and pain were defined as ID. Osteoarthritis was defined if there was palpation pain, subjective pain report, any coarse crepitus sound during any movement, bony change on radiography and increased uptake on bone scan. Patients received a diagnosis of normal joint, ID or osteoarthritis ( Table 1 ). Detailed diagnostic groups are listed in Figure 1 . There was an additional myofacial pain group which was characterized by the existence of palpation pain on the muscle site and more than 40 mm of pain-free opening. However, in our study, myofacial pain diagnosis was excluded because of the pathological state related to soft tissue.

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13. Senda K, Itoh S. Evaluation of diffusely high uptake by the calvaria in bone scintigraphy. Ann Nucl Med 1987; 1 :23–26 [PubMed] [Google Scholar]

It was concluded from this study that bone scans may help to diagnose osteoarthritis when increased uptake ratios are observed.

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