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Traumatic, Surgical, Sports, and Thermal and Cold Injuries of the Skeleton

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Combined Scintigraphic and Radiographic Diagnosis of Bone and Joint Diseases

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Abstract

The high sensitivity and reliability of bone scintigraphy in the diagnosis of fractures, sports injuries, and operative lesions of bone are well known. 99mTc-MDP bone scintigraphy aided by pinhole scanning is particularly useful for the diagnosis of covert fractures in complex anatomical sites and small bones, bone contusion, stress fracture, and traumatic enthesopathy. Many of these conditions are elusory or even invisible not only on ordinary radiographs but also on CT scans that uses slices in which not every small anatomical part is included. Retractor rib injuries such as periosteal stripping, contusion, fracture, and costovertebral articular severance constitute another important indication for bone scintigraphy. Pinhole scintigraphy appears to be the method of choice for detecting these seemingly trivial yet clinically worrisome injuries. This technique has also been shown to be extremely useful for noninvasive anatomical and biochemical assessment of traumatized articulations, muscles, tendons, entheses, and even blood vessels. Furthermore, bone scintigraphy uniquely and often decisively provides real-time information on the vascularity and viability of fractured bone fragments and implanted bones as well as the existence, progress, and quality of callus and associated periosteal or adjacent soft-tissue mineralization.

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References

  • Apple JS, Martinez S, Allen MB et al (1983) Occult fractures of the knee: tomographic evaluation. Radiology 148:383–387

    Article  CAS  PubMed  Google Scholar 

  • Bahk WJ, Brien EW, Luck JV Jr, Mirra JM (2000) Avulsion of the ischial tuberosity simulating neoplasm—a report of 2 cases. Acta Orthop Scand 71:211–214

    Article  CAS  PubMed  Google Scholar 

  • Bahk YW (2007) The value of 99mTc-HDP scan in the diagnosis of tibial avascular necrosis caused by thermal injury: a case with multi-image correlation analysis. Nucl Med Mol Imaging 41:377–379

    Google Scholar 

  • Bahk YW, Jeon HS, Kim JM, Park JM, Chung YA et al (2010) Novel use of gamma correction for precise 99mTc-HDP pinhole bone scan diagnosis and classification of knee occult fractures. Skelet Radiol 39:807–813

    Article  Google Scholar 

  • Baisden CE, Greenwald LV, Symbas PN (1984) Occult rib fractures and brachial plexus injury following median sternotomy for open-heart operations. Ann Thorac Surg 38:192–194

    Article  CAS  PubMed  Google Scholar 

  • Berggren A, Weiland AJ, Ostrup LT (1982) Bone scintigraphy in evaluating the viability of composite bone grafts revascularized by microvascular anastomoses, conventional autogenous bone grafts, and free non revascularized periosteal grafts. J Bone Joint Surg Am 64:799–809

    Article  CAS  PubMed  Google Scholar 

  • Brander VA, Hinderer SR, Alpiner N, Oh TH (1995) Rehabilitation in joint and connective tissue diseases. 3. Limb disorders. Arch Phys Med Rehabil 76(5 Spec No):S47–S56

    Google Scholar 

  • Brukner P, Khan K (1993) Clinical sports medicine. McGraw-Hill, Sydney

    Google Scholar 

  • Chapman MW, Olson SA (1996) Open fractures. In: Rockwood CA, Green DP Jr, Bucholz RW, Heckman JD (eds) Fractures in adults, 4th edn. Lippincott-Raven, Philadelphia, pp 305–352

    Google Scholar 

  • Chapman MW (1986) The role of intramedullary fixation in open fractures. Clin Orthop 212:26–34

    Google Scholar 

  • Christie J (1981) Surgical heat injury of bone. Injury 13:188–190

    Article  CAS  PubMed  Google Scholar 

  • Cintron E, Gilula LA, Murphy WA, Gehweiler JA (1981) The widened disc space: a sign of cervical hyperextension injury. Radiology 141:639–644

    Article  CAS  PubMed  Google Scholar 

  • Cruess RL, Dumont J (1975) Healing of bone, tendon and ligament. In: Rockwood CA Jr, Green DP (eds) Fractures. Lippincott, Philadelphia

    Google Scholar 

  • Dayanandan A, Ho YY (2005) Bone scintigraphy appearances of incidentally diagnosed soft tissue disorders in musculoskeletal imaging. Australas Radiol 49:1–7

    Article  CAS  PubMed  Google Scholar 

  • Dee P, Lambruschi PG, Hiebert JM (1981) The use of Tc99 m MDP bone scanning in the study of vascularized bone implants. J Nucl Med 22:522–525

    CAS  PubMed  Google Scholar 

  • Denis F (1983) The three column spine and its significance in the classification of acute thoracolumbar spine injuries. Spine 8:817–831

    Article  CAS  PubMed  Google Scholar 

  • Flynn M (1972) Disruption of the symphysis pubis whilst horse riding: a report of two cases. Injury 4:357–359

    Article  Google Scholar 

  • Foster SC, Foster RR (1976) Lisfranc’s tarsometatarsal fracture-dislocation. Radiology 120:79–83

    Article  CAS  PubMed  Google Scholar 

  • Geslin GE, Thrall JH, Espinosa JL et al (1976) Early detection of stress fractures using Tc-99 m polyphosphate. Radiology 121:683–687

    Article  Google Scholar 

  • Harbert JC, George FH, Kerner ML (1981) Differentiation of rib fractures from metastases by bone scanning. Clin Nucl Med 6:359–361

    Article  CAS  PubMed  Google Scholar 

  • Holdsworth F (1970) Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg Am 52:1534–1551

    Article  CAS  PubMed  Google Scholar 

  • Johnson DL, Urban WP Jr, Caborn DN et al (1998) Articular cartilage changes seen with magnetic resonance imaging-detected bone bruises associated with acute anterior cruciate ligament rupture. Am J Sports Med 26:409–414

    Article  CAS  PubMed  Google Scholar 

  • Kaewlai R, Avery LL, Asrami AV, Abujudeh HH et al (2008) Multidetector CT of carpal injuries: anatomy, fractures, and fracture-dislocation. Radiographics 28:1771–1784

    Article  PubMed  Google Scholar 

  • Lauer I, Czech N, Zieron J et al (2000) Assessment of the viability of microvascularized bone graft s after mandibular reconstruction by means of bone SPET and semiquantitative analysis. Eur J Nucl Med 27:1552–1556

    Article  CAS  PubMed  Google Scholar 

  • Lim ST, Sohn MH, Jeong HJ (2008) Cold exposure-induced rhabdomyolysis demonstrated by bone scintigraphy. Clin Nucl Med 33:349–350

    Article  PubMed  Google Scholar 

  • Lisbona R, Rosenthall L (1976) Assessment of bone viability by scintiscanning in frostbite injuries. J Trauma 16:989–992

    Article  CAS  PubMed  Google Scholar 

  • Lisbona A, Rennie WRJ, Daniel RK (1980) Radionuclide evaluation of free vascularized bone graft viability. AJR Am J Roentgenol 134:387–388

    Article  CAS  PubMed  Google Scholar 

  • Matin P (1979) Appearance of bone scans following fractures including immediate and long-term studies. J Nucl Med 20:1227–1331

    CAS  PubMed  Google Scholar 

  • Mehta RC, Wilson MA (1989) Frostbite injury: prediction of tissue viability with triple-phase bone scanning. Radiology 170:511–514

    Article  CAS  PubMed  Google Scholar 

  • Michael RH, Holder LE (1985) The soleus syndrome. A cause of medial tibia stress (shin splints). Am J Sports Med 13:87–94

    Article  CAS  PubMed  Google Scholar 

  • Mink JH, Deutch AL (1989) Occult cartilage and bone injuries of the knee: detection, classification, and assessment with MR imaging. Radiology 170:823–829

    Article  CAS  PubMed  Google Scholar 

  • de Peretti F, Cambas PM, Hovorka I, Veneau B, Argenson C (1994) Motorcycle petrol tanks and the role in server pelvic injuries. Injury 25:223–225

    Article  PubMed  Google Scholar 

  • Price N, Ragoowansi R, Mircher M (1996) Pelvic ring diastasis and pseudodiastasis in motorcycle pillion passengers. Injury 27:441–444

    Article  CAS  PubMed  Google Scholar 

  • Rangger C, Katherin FMC et al (1998) Bone bruise of the knee: histology and cryosections in 5 cases. Acta Orthop Scand 69:291–294

    Article  CAS  PubMed  Google Scholar 

  • Resnick D, Niwayama G (eds) (1988) Diagnosis of bone and joint disorders, 2nd edn. WB Saunders, Philadelphia

    Google Scholar 

  • Rivas Doblado JS, Artes Leon JL, Arjona Barcia J et al (2004) How to reduce the incidence of traumatic phlebitis (in Spanish). Rev Enferm 27:42–46

    PubMed  Google Scholar 

  • Rossi F, Dragoni S (2001) Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected. Skelet Radiol 30:127–131

    Article  CAS  Google Scholar 

  • Roub LW, Gumerman LW, Hanley EN Jr et al (1979) Bone stress: a radionuclide imaging prospective. Radiology 132:431–438

    Article  CAS  PubMed  Google Scholar 

  • Rupani HD, Holder LE, Espinola DA, Engin SI (1985) Three-phase radionuclide bone imaging in sports medicine. Radiology 156:187–196

    Article  CAS  PubMed  Google Scholar 

  • Soost F, Ivancevic V, Stoll C, Prochno T (1999) 3-phase bone scintigraphy of microsurgically attached bone transplants as early graft survival assessment (in German). Handchir Mikrochir Plast Chir 31:42–46

    Article  CAS  PubMed  Google Scholar 

  • Sweet DE, Allman RM (1971) Stress fracture. RPC of the month from the AFIP. Radiology 99:687–692

    Article  CAS  PubMed  Google Scholar 

  • Taylor GA (1983) The current status of free vascularized bone grafts. Clin Plast Surg 10:185–208

    CAS  PubMed  Google Scholar 

  • Tile M (1988) Pelvic ring fractures: should they be fixed? Bone Joint Surg 70B:1–12

    Google Scholar 

  • Vellet AD, Marks PH, Fowler PJ, Munro TG (1991) Occult posttraumatic osteochondral lesions of the knee: prevalence, classification, and short-term sequelae evaluated with MR imaging. Radiology 178:271–276

    Article  CAS  PubMed  Google Scholar 

  • Welling RD, Jacobson JA, Jamadar DA, Chong S et al (2008) MDCT and radiography of wrist fractures: radiographic sensitivity and fracture patterns. AJR Am J Roentgenol 190:10–16

    Article  PubMed  Google Scholar 

  • Yao L, Lee JK (1988) Occult intraosseous fracture: detection with MR imaging. Radiology 167:749–751

    Article  CAS  PubMed  Google Scholar 

  • Zwas ST, Elkanovitch R, Frank G (1987) Interpretation and classification of bone scintigraphic findings in stress fractures. J Nucl Med 28:452–457

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Nuclear Medicine and Radiology, Sun Ae General Hospital, Seoul, South Korea

    Yong-Whee Bahk MD, PhD, FACS

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  1. Yong-Whee Bahk MD, PhD, FACS
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Correspondence to Yong-Whee Bahk MD, PhD, FACS .

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Bahk, YW. (2017). Traumatic, Surgical, Sports, and Thermal and Cold Injuries of the Skeleton. In: Combined Scintigraphic and Radiographic Diagnosis of Bone and Joint Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-10-2759-8_16

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  • DOI: https://doi.org/10.1007/978-981-10-2759-8_16

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-2758-1

  • Online ISBN: 978-981-10-2759-8

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