Diffusely increased bone scintigraphic uptake in patellofemoral pain syndrome.
OBJECTIVE
Painful disorders of the patellofemoral joint are one of the most frequent complaints in orthopaedic and sports medicine. The aims of this study were to determine whether bone scintigrams of patients suffering from patellofemoral pain syndrome (PFPS) show diffuse uptake and in what bony compartment of the knee uptake, if any, was localised.


METHODS
Fifty eight patients with chronic PFPS were examined. All patients underwent a detailed clinical history and a thorough physical examination of the knee. Anterior and lateral static images of both knees were made using a gamma camera 3 h after injection of 550 MBq of (99m)Tc-HMDP. Two experienced radiologists visually evaluated the scans blindly and separately. As 51 patients had bilateral pain, 109 painful knees are included in the results.


RESULTS
Diffuse uptake on bone scintigrams was found in 48 knees in 30 of the patients. In 33 knees the uptake was localised to only one bone compartment, in 10 knees diffuse uptake was found in two of the bones forming the knee joint, and in six knees all three bone compartments (the distal femur, the patella, and the proximal tibia) exhibited diffuse uptake.


CONCLUSIONS
Scintigrams of approximately half of the patients with PFPS will show diffuse uptake in one or more of the bony compartments of the knee joint and radioactive tracer accumulation will occur as often in the proximal tibia as in the patella.
Näslund
J E
JE
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. j.naslund@mailbox.calypso.net <j.naslund@mailbox.calypso.net>
Odenbring
S
S
Näslund
U-B
UB
Lundeberg
T
T
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D046788:Patellofemoral Pain Syndrome / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D016059:Range of Motion, Articular; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*
D019275:Radiopharmaceuticals; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate
Semin Nucl Med. 1997 Oct;27(4):309-20
9364640
Am J Sports Med. 1997 Mar-Apr;25(2):207-12
9079175
Calcif Tissue Int. 1998 Jun;62(6):548-53
9576985
J Orthop Sports Phys Ther. 1998 Nov;28(5):299-306
9809278
Ann Rheum Dis. 1999 Jan;58(1):20-6
10343536
Med Hypotheses. 1999 Nov;53(5):363-8
10616033
Am J Sports Med. 2000 Sep-Oct;28(5):725-31
11032232
Am J Sports Med. 2001 Nov-Dec;29(6):712-5
11734482
Ann Rheum Dis. 2002 Nov;61(11):981-5
12379520
J Rehabil Med. 2002 Sep;34(5):231-8
12392239
Nucl Med Commun. 2003 Jan;24(1):3-10
12501015
Curr Womens Health Rep. 2003 Feb;3(1):81-6
12521558
Nucl Med Commun. 2003 Apr;24(4):403-10
12673169
Am J Sports Med. 2003 Jul-Aug;31(4):596-600
12860551
Arch Orthop Trauma Surg. 2003 Nov;123(9):455-9
12910357
Clin Sports Med. 1985 Apr;4(2):247-57
3986927
Orthop Clin North Am. 1986 Apr;17(2):249-62
3714208
Orthopedics. 1986 May;9(5):663-7
3714580
Arthroscopy. 1986;2(2):103-7
3730060
Am J Sports Med. 1987 Jan-Feb;15(1):79-85
3812865
Sports Med. 1987 Jan-Feb;4(1):65-75
3547540
Int Orthop. 1987;11(1):29-33
3557753
Arthroscopy. 1988;4(4):235-40
3233111
Acta Orthop Scand Suppl. 1991;244:1-29
1882690
Acta Orthop Scand. 1992 Feb;63(1):90-3
1738981
Bull Hosp Jt Dis Orthop Inst. 1991 Fall;51(2):218-29
1666010
Clin Orthop Relat Res. 1993 Aug;(293):208-10
7687940
Am Fam Physician. 1993 Nov 15;48(7):1254-62
7993393
Orthop Rev. 1993 Aug;22(8):901
8265228
Pediatr Ann. 1997 Jan;26(1):32-5
9007968
Clin J Sport Med. 1997 Jan;7(1):40-5
9117525
Surg Radiol Anat. 1997;19(6):345-51
9479707