title: Frostbite and bone scanning: the use of 99m-labeled phosphates in demarcating the line of viability in frostbite victims.
abstract: Early diagnosis of the extent of bone and soft tissue damage is a very important step in treating a frostbite victim. The diagnostic use of Tc-99m-phosphates in assessing the viability of soft tissue and bone in frostbite was evaluated in the early post-thaw period. Four patients were treated with a combination of warm baths, rehydration, vasodilators, epidural block, fasciotomy, and debridement. Six scans were done to stage involvement. In three of the four cases, final involvement could be determined as early as the third day. When a specific level of soft tissue or bone uptake was determined, future scanning showed either improvement, or no change in three of the four patients. In our experience, Tc-99m-phosphate scans represent an improvement over other diagnostic tests for viability of tissues.
mesh_terms: D000328:Adult; D002648:Child; D011756:Diphosphates; D005260:Female; D005627:Frostbite / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D013667:Technetium; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*; D016698:Technetium Tc 99m Pyrophosphate
chemical_list: D011756:Diphosphates; D016698:Technetium Tc 99m Pyrophosphate; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013667:Technetium; D013669:Technetium Tc 99m Medronate