title: Three-phase [99mTc]diphosphonate scintimetry in septic and nonseptic arthritis of the immature knee: an experimental investigation in dogs.
abstract: We compared the informative value of dynamic and static [99mTc]diphosphonate ([99mTc]DPD) scintimetry in early septic arthritis (SA) and chronic nonseptic arthritis (NSA) of the knee in puppies. SA (n = 10), induced by injection of Staphylococcus aureus into one knee, was examined after 48 h. NSA (n = 6) was induced by weekly intraarticular instillation of 1% carrageenan and examined at 2 and 12 weeks. Epiphyseal and metaphyseal count ratios (CRs) between experimental and control joint were calculated in an angiographic phase (0-20 s), a "blood pool" phase (20-256 s), and a bone uptake phase (2 hs). Control dogs (n = 4) had a CR of 1.0 in all regions and phases, the coefficients of variation being 0.06 and 0.03 in dynamic and static phases, respectively. In NSA, all scintimetric phases showed decreased metaphyseal uptake and largely unchanged epiphyseal uptake. Generally, SA exhibited vastly increased angiographic uptake in all regions and increased epiphyseal blood pool uptake, whereas delayed epiphyseal uptake varied and delayed metaphyseal uptake tended to decrease. Two septic joints had generalized reduction in dynamic uptake, probably owing to increased intraarticular pressure; in one of these, dynamic uptake in the distal femoral epiphysis (FE) was totally absent, suggesting temporary circulatory arrest during the dynamic scanning procedure. The use of regional dynamic and static [99mTc]DPD scintimetry increased the pathophysiologic and diagnostic value of joint scintigraphy, especially with respect to the early detection of SA and its avascular complications.
authors.affiliation: Orthopedic Hospital, Aarhus, Denmark.
authors.forename: E S
authors.initials: ES
authors.lastname: Hansen
authors.forename: V E
authors.initials: VE
authors.lastname: Hjortdal
authors.forename: I
authors.initials: I
authors.lastname: Noer
authors.forename: I E
authors.initials: IE
authors.lastname: Holm
authors.forename: H
authors.initials: H
authors.lastname: Ewald
authors.forename: C
authors.initials: C
authors.lastname: Bünger
mesh_terms: D000818:Animals; D001168:Arthritis / Q000139:chemically induced / Q000000981:diagnostic imaging*; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging*; D002351:Carrageenan; D004164:Diphosphonates; D004285:Dogs / Q000254:growth & development; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000254:growth & development; D011877:Radionuclide Imaging; D013203:Staphylococcal Infections; D013667:Technetium; D017556:Technetium Compounds; D013997:Time Factors
chemical_list: D004164:Diphosphonates; D017556:Technetium Compounds; D013667:Technetium; C029045:technetium Tc 99m diphosphonate; D002351:Carrageenan