title: Increased extremity uptake on three-phase bone scans caused by peripherally induced ischemia prior to injection.
abstract: During arterial flow scintigraphy, increased tracer uptake in the upper extremity has been noted secondary to induced ischemia distal to blood-pressure cuffs and simple tourniquets, employed prior to the injection. We prospectively studied 68 patients undergoing three-phase bone scintigraphy to evaluate the frequency and magnitude of this artifact. The results showed that when a blood-pressure cuff was applied virtually all patients demonstrated increased activity in the extremity of cuff application. When a simple rubber tourniquet was applied few patients demonstrated the artifact. Only one patient, a case of reflex sympathetic dystrophy syndrome, had increased uptake on blood-pool and skeletal-phase images. We recommend that in flow studies of the hands, wrists, and forearms, blood pressure cuffs not be employed and that at least 3 min should elapse between release of the occlusive device and injection. Asymmetry of flow under these conditions is unlikely to be artifact.
mesh_terms: D001795:Blood Pressure Determination / Q000009:adverse effects; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D006225:Hand / Q000098:blood supply* / Q000378:metabolism; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012039:Regional Blood Flow; D013669:Technetium Tc 99m Medronate / Q000008:administration & dosage; D014111:Tourniquets / Q000009:adverse effects
chemical_list: D013669:Technetium Tc 99m Medronate