Transient ischaemia of the proximal femoral epiphysis in the child. Interpretation of bone scintimetry for diagnosis in hip pain.
99mTc-MDP-scintimetry was performed in 25 consecutive cases of radiographically silent transient synovitis of the hip in children. Fourteen cases had normal scintimetry; seven cases had an increased uptake in the epiphysis; four cases had markedly defective uptake in the epiphysis, indicating interrupted vascular supply. At repeat scintimetry 6 weeks later, the uptake was normal or increased in three of these four cases; the one case with a persistent defect was the only case in this series who later developed radiographic evidence of Legg-Calvé-Perthes' disease. In some cases presenting with clinical symptoms of synovitis of the hip, there is a transient, spontaneously recovering ischaemia of the proximal femoral epiphysis, not followed by radiographic evidence of necrosis. This should be considered in attempts to make a pre-radiographic diagnosis of Legg-Calvé-Perthes' disease by radionuclide methods.
Wingstrand
H
H
Bauer
G C
GC
Brismar
J
J
Carlin
N O
NO
Pettersson
H
H
Sundén
G
G
D002648:Child; D002675:Child, Preschool; D004164:Diphosphonates; D005260:Female; D005270:Femur Head / Q000098:blood supply*; D006615:Hip; D006801:Humans; D007223:Infant; D007511:Ischemia / Q000150:complications / Q000000981:diagnostic imaging*; D007873:Legg-Calve-Perthes Disease / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D010146:Pain / Q000209:etiology*; D011877:Radionuclide Imaging; D013585:Synovitis / Q000209:etiology; D013667:Technetium; D013669:Technetium Tc 99m Medronate
D004164:Diphosphonates; D013667:Technetium; D013669:Technetium Tc 99m Medronate