Association of bone scintigraphic abnormalities with knee malalignment and pain.
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.
Kraus
V B
VB
Duke General Clinical Research Unit, Duke University Medical Center, Durham, NC 27710, USA. vbk@acpub.duke.edu
McDaniel
G
G
Worrell
T W
TW
Feng
S
S
Vail
T P
TP
Varju
G
G
Coleman
R E
RE
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
D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate