You are here

Article Text

Article menu
Download PDFPDF
Clinical and epidemiological research
Extended report
Association of bone scintigraphic abnormalities with knee malalignment and pain
  1. V B Kraus1,
  2. G McDaniel1,
  3. T W Worrell2,
  4. S Feng4,
  5. T P Vail3,
  6. G Varju6,
  7. R E Coleman5
  1. 1
    Duke University Medical Center, Departments of Medicine, Durham, North Carolina, USA
  2. 2
    Duke University Medical Center, Departments of Physical Therapy, Durham, North Carolina, USA
  3. 3
    Duke University Medical Center, Departments of Surgery, Durham, North Carolina, USA
  4. 4
    Duke University Medical Center, Departments of Bioinformatics, Durham, North Carolina, USA
  5. 5
    Duke University Medical Center, Departments of Radiology, Durham, North Carolina, USA
  6. 6
    Department of Medicine, East Carolina University, Greenville, North Carolina, USA
  1. Correspondence to Dr V B Kraus, Box 3416, Duke University Medical Center, Durham, NC 27710, USA; vbk{at}acpub.duke.edu

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 99mTechnetium 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).

Conclusion: 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.

http://dx.doi.org/10.1136/ard.2008.094722

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Funding This work was funded by NIH/NIAMS grant RO1 AR48769 and NIH/NIA Pepper OAIC P30 AG028716, and supported by the National Center for Research Resources NIH MO1-RR-30, supporting the Duke General Clinical Research Unit where this study was conducted.

    • Competing interests None.

    • Ethics approval This study was approved and in accordance with the policies of the Duke Institutional Review Board.

    • Patient consent Obtained.