Usefulness of Bone Scintigraphy with Anterior Semiflexed View in the Evaluation of Patients with Chronic Knee Pain

利用前位半屈式骨造影評估慢性膝痛病人之價值

Seyda Turkolmez ； Mustafa Unlu ； Metln Ozalay ； Ertugrul Sener

《核子醫學雜誌》 16卷4期 (2003/12) Pp. 163-169

摘要

背景：利用前位半屈式傳統骨造影評估慢性膝痛所扮演的角色。
方法：43位膝痛病人接受傳統平面骨造影檢查，分別採前伸、後、外及內側位（造影-1）及膝部前屈30°之前位像（即造影-2，含前屈、後、外及內側位），並以關節鏡結果為診斷參考，每一病灶（含內、外半月軟骨，內、外及臏-股骨腔室部位）均計算其診斷敏感及特異性。
結果：23病人關節鏡發現有半月軟骨撕裂病灶（13位內側，10位外側），在其中14位有退化性關節炎病人中有17位並無半月軟骨撕裂。內、外及臏-股骨腔室異常者分別有18、16及14個膝關節。結果發現利用造影-2方式造影在偵測膝病灶之敏感性及特異性上高於造影-1方式。
結論：利用前屈位像可以減少膝部骨骼重疊現象，有助於疑似病灶的進一步確定。

關鍵字

慢性膝痛 ； 骨造影

並列摘要

Background: The aim of this study was to determine the role of planar bone scintigraphy with anterior semiflexed view in the evaluation of patients with chronic knee pain.
Methods: Bone scintigraphy was performed in 43 patients with chronic knee pain. Anterior extended, posterior, lateral and medial planar images (planar images-1) and an additional anterior view of the knee in 30° semiflexion were acquired. The results of planar images-1 and planar images-2 (anterior semiflexed view, posterior, lateral and medial planar images) were compared with use of arthroscopy as the reference. Each lesion (medial meniscus, lateral meniscus, medial compartment, lateral compartment and patellofemoral compartment) was analysed to determine the sensitivity and the specificity of the diagnosis.
Results: Twenty-three patients had meniscal tears at arthroscopy and 14 of these were associated with degenerative joint disease of the knee. Twenty-eight degenerative joint diseases in 17 patients were found without meniscal tears. There were 13 medial meniscus tears and 10 lateral meniscus tears at arthroscopy. The medial compartment was abnormal in 18 knees, the lateral compartment in 16 knees and the patellofemoral compartment in 14 knees. The sensitivities and specificities of planar images-2 were higher than those of planar images-1 for the detection of each lesion.
Conclusions: Anterior semiflexed view of the knee seems to provide the ability to separate activity form overlying or underlying bone and this enables equivocal lesions on planar imaging to be identified.

並列關鍵字

chronic knee pain ； bone scintigraphy