Diagnostic role of bone scintigraphy and magnetic resonance imaging in hip arthroplasty in patients with deforming osteoarthritis
Background. At present, methods of bone scintigraphy (BS) and magnetic resonance imaging (MRI) are widely used in clinical practice with the aim of differential diagnosis of dystrophic-degenerative and inflammatory processes of the hip and knee joints. The purpose was to determine the diagnostic role of BS and MRI in hip replacement. Materials and methods. BS was performed on a Tamara-301T scintillation gamma camera according to a standard protocol after bolus administration of 600–800 MBq of 99mTc-me-t-hylene diphosphonate. The nature of each focus was clearly determined by the results of clinical and laboratory methods and magnetic resonance imaging, and also confirmed by repeated scintigraphic examinations. MRI study was performed on the Toshiba Vantage Elan 1.5T system. Results. In order to determine the diagnostic role of BS and MRI, 65 patients with deforming osteoarthritis, aged 37 to 85 years, were examined. In 48 (74 %) patients, with a qualitative evaluation of MRI images, a slight joint space narrowing and marginal sharpening of articular surfaces were observed due to insignificant osteophytes, local lime deposits in the form of hyperdense areas. According to the results of the quantitative BS analysis, the percentage of radiopharmaceutical inclusion in the areas of increased accumulation of joint components was from +10 to +150 %. In 17 (26%) patients, MRI revealed a significant contraction of the joint space, significant subchondral sclerosis and marginal bone growth, which were located not only on the cavity, but also on the joint head. According to BS, the percentage of radiopharmaceutical inclusion in the foci of increased accumulation of joint components was from +151 to +400 %. Conclusions. These methods can be used for the diagnostic screening of patients with deforming osteoarthritis during hip arthroplasty. BS can be used when determining the stage of pathological process in the hip joint, and in combination with MRI — to monitor the dynamics of the pathological process after
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