title: Kohler disease: diagnoses and assessment by bone scintigraphy.
abstract: Limping is a frequent occurrence in children and may be caused by various conditions, including trauma, inflammation, infection, and malignancy. Nontraumatic avascular necrosis of the tarsal bones should be included in the differential diagnosis. Accumulated data have supported the superiority of bone scans to radiography in the early diagnosis of avascular necrosis. Bone scintigraphy is a useful tool for investigating pain when symptoms, laboratory examinations, and radiography do not point to a specific diagnosis. In the early phase of disease, bone scans may demonstrate decreased tracer uptake (photopenic region), subsequently a hot area is seen during the reparative process. Although magnetic resonance imaging has important implications in the diagnosis of avascular necrosis, bone scintigraphy with its ready availability has a significant role as a primary tool in the evaluation of a limping child.
authors.affiliation: Department of Nuclear Medicine, Western Galilee Hospital, Nahariya, Israel. Jabourk@yahoo.com
authors.forename: Jabour
authors.initials: J
authors.lastname: Khoury
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Jerushalmi
authors.forename: Norman
authors.initials: N
authors.lastname: Loberant
authors.forename: Haim
authors.initials: H
authors.lastname: Shtarker
authors.forename: Daniela
authors.initials: D
authors.lastname: Militianu
authors.forename: Zohar
authors.initials: Z
authors.lastname: Keidar
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010020:Osteonecrosis / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013639:Tarsal Bones / Q000000981:diagnostic imaging*