title: Low sensitivity of three-phase bone scintigraphy for the diagnosis of repetitive strain injury.
abstract: OBJECTIVE
  The diagnosis of repetitive strain injury (RSI) is subjective and solely based on clinical signs and physical examination. The aim of this paper was to assess the usefulness of three-phase bone scintigraphy (TPBS) in diagnosing RSI.
  
  
  METHODS
  Prospective study at the Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP).
  
  
  METHODS
  Seventy-three patients (mean age 31.2 years; 47 males) with clinical suspicion of RSI in the upper limbs were studied. A total of 127 joints with suspicion of RSI were studied. The shoulders, elbows and wrists were analyzed semi-quantitatively, using the shafts of the humeri and ulnae as references. The results were compared with a control group of 40 normal individuals. The patients signs and symptoms were used as the "gold standard" for calculating the probabilities.
  
  
  RESULTS
  From visual analysis, abnormalities were observed in the flow phase for four joints, in the blood pool phase for 11 joints and in the delayed images for 26 joints. Visual analysis of the joints of the control group did not show any abnormalities. Semi-quantitative analysis showed that most of the patients joint ratios were normal. The exceptions were the wrists of patients with left-sided RSI (p = 0.0216). However, the sensitivity (9%) and accuracy (41%) were very low.
  
  
  CONCLUSIONS
  TPBS with semi-quantitative analysis has very low sensitivity and accuracy in the detection of RSI abnormalities in the upper limbs.
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, CEP 13083-888 Campinas, São Paulo, Brazil. juarezbarbara@hotmail.com
authors.forename: Bárbara Juarez
authors.initials: BJ
authors.lastname: Amorim
authors.forename: Elba Cristina Sá de Camargo
authors.initials: EC
authors.lastname: Etchebehere
authors.forename: Graciella
authors.initials: G
authors.lastname: Dalla Torre
authors.forename: Mariana da Cunha Lopes de
authors.initials: Mda C
authors.lastname: Lima
authors.forename: Allan de Oliveira
authors.initials: Ade O
authors.lastname: Santos
authors.forename: Celso Darío
authors.initials: CD
authors.lastname: Ramos
authors.forename: Luiz Ricardo
authors.initials: LR
authors.lastname: Gonzalez
authors.forename: José Inácio
authors.initials: JI
authors.lastname: Oliveira
authors.forename: Edwaldo Eduardo
authors.initials: EE
authors.lastname: Camargo
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D012090:Cumulative Trauma Disorders / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013669:Technetium Tc 99m Medronate
chemical_list: D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate