title: Predictive value of bone scintigraphy for the detection of joint involvement in Behçet's disease: Dermatologists' perspectives.
abstract: Behçet's disease (BD) is a multisystemic inflammatory disease with articular involvement. Non-specific arthralgia without objective signs of arthritis, such as swelling or effusion, is common in such patients. Thus, an accurate diagnosis of joint involvement may be challenging for dermatologists.
  
  
  
  To evaluate the validity of (99m)Tc-methylene diphosphonate (Tc-99m-MDP) bone scintigraphy for joint involvement assessment in patients with BD.
  
  
  
  In 211 patients with BD who had scintigraphic evaluations due to joint symptoms, agreement between bone scintigraphy findings and clinically evaluated joint complaints was retrospectively assessed using Cohen's kappa (κ) statistic. A patient subset (n = 104) showing agreement between joint complaints and scintigraphy results was re-evaluated by a rheumatologist to determine the level of diagnostic specificity attained by combining bone scintigraphy with clinical examinations of dermatologists.
  
  
  
  The total kappa value (211 patients) was 0.604, indicating fair agreement between joint complaints and scintigraphy results. Individual analysis of eleven joint categories revealed statistically significant correlations for wrist (κ = 0.677), shoulder (κ = 0.661), and foot joints (κ = 0.618). Of the 104 referrals to a rheumatologist, 95 (91.34%) were confirmed as having BD-associated articular involvement. Joint acral areas (e.g., foot, hand, wrist and shoulder) that had the highest kappa value correlations also ranked highest in diagnostic specificity.
  
  
  
  Bone scintigraphy presents a simple and useful option for dermatologists to assess joint involvement in BD patients, especially for specific anatomic sites.
authors.affiliation: Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jimyung
authors.initials: J
authors.lastname: Seo
authors.affiliation: Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Minseok
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Min Ju
authors.initials: MJ
authors.lastname: Choi
authors.affiliation: Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea, Department of Dermatology, Yanbian University College of Medicine, Yanji, China.
authors.forename: Zhenlong
authors.initials: Z
authors.lastname: Zheng
authors.affiliation: Department of Nuclear Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemoon-Gu, Seoul 120-752, Korea.
authors.forename: Arthur
authors.initials: A
authors.lastname: Cho
authors.affiliation: Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dongsik
authors.initials: D
authors.lastname: Bang
authors.affiliation: Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea, Department of Dermatology, Catholic Kwandong University, International St. Mary's Hospital, Incheon, Korea.
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D018771:Arthralgia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D001168:Arthritis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D001528:Behcet Syndrome / Q000150:complications* / Q000000981:diagnostic imaging*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000503:physiopathology; D015331:Cohort Studies; D016208:Databases, Factual; D003880:Dermatology / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D056910:Republic of Korea; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013669:Technetium Tc 99m Medronate; D051598:Whole Body Imaging / Q000379:methods; D055815:Young Adult
chemical_list: D013669:Technetium Tc 99m Medronate
keywords: Arthritis; Behçet's disease; Bone scintigraphy; Dermatologists