title: Association of bone scintigraphic abnormalities with knee malalignment and pain.
abstract: OBJECTIVE
  The information content of knee bone scintigraphy was evaluated, including pattern, localisation and intensity of retention relative to radiographic features of knee osteoarthritis, knee alignment and knee symptoms.
  
  
  METHODS
  A total of 308 knees (159 subjects) with symptomatic and radiographic knee osteoarthritis of at least one knee was assessed by late-phase (99m)Technetium methylene disphosphonate bone scintigraph, fixed-flexion knee radiograph, full limb radiograph for knee alignment and for self-reported knee symptom severity. Generalised linear models were used to control for within-subject correlation of knee data.
  
  
  RESULTS
  The compartmental localisation (medial vs lateral) and intensity of knee bone scan retention were associated with the pattern (varus vs valgus) (p<0.001) and severity (p<0.001) of knee malalignment and localisation and severity of radiographic osteoarthritis (p<0.001). Bone scan agent retention in the tibiofemoral, but not patellofemoral, compartment was associated with severity of knee symptoms (p<0.001) and persisted after adjusting for radiographic osteoarthritis (p<0.001).
  
  
  CONCLUSIONS
  To the authors' knowledge, this is the first study describing a relationship between knee malalignment, joint symptom severity and compartment-specific abnormalities by bone scintigraphy. This work demonstrates that bone scintigraphy is a sensitive and quantitative indicator of symptomatic knee osteoarthritis. Used selectively, bone scintigraphy is a dynamic imaging modality that holds great promise as a clinical trial screening tool and outcome measure.
authors.affiliation: Duke General Clinical Research Unit, Duke University Medical Center, Durham, NC 27710, USA. vbk@acpub.duke.edu
authors.forename: V B
authors.initials: VB
authors.lastname: Kraus
authors.forename: G
authors.initials: G
authors.lastname: McDaniel
authors.forename: T W
authors.initials: TW
authors.lastname: Worrell
authors.forename: S
authors.initials: S
authors.lastname: Feng
authors.forename: T P
authors.initials: TP
authors.lastname: Vail
authors.forename: G
authors.initials: G
authors.lastname: Varju
authors.forename: R E
authors.initials: RE
authors.lastname: Coleman
mesh_terms: D000368:Aged; D017760:Bone Malalignment / Q000150:complications* / Q000000981:diagnostic imaging; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000209:etiology*; D010147:Pain Measurement; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D013669:Technetium Tc 99m Medronate
chemical_list: D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate