Diagnostic Role of Bone Scintigraphy in Patients with Rheumatoid Arthritis during Hip Arthroplasty

P.O. Korol, M.M. Tkachenko, V.K. Bondar


Introduction. Rheumatoid arthritis is one of the most common chronic inflammatory joint diseases. The prevalence of the disease among adults in different countries of the world ranges from 0.6 to 5 %. People of working age suffer more often. The peak incidence occurs in the 40–50 years, while women suffer 2–4 times more often than men. The incidence of rheumatoid arthritis in women increases after 30 years, reaching the greatest figures in the 45–75 years. Objective: to determine the diagnostic role of bone scintigraphy in patients with rheumatoid arthritis during hip replacement. Material and methods. Bone scintigraphy was performed on single-head tomographic scintillation gamma camera Tamara-301 T after intravenous injection of 99m-Tc-pyrophosphate with activity of 550–770 MBq. Results. All patients were divided into three diagnostic groups. The first group included 34 (45 %) patients, in whom radiopharmaceutical accumulation in the projection of the affected joint was +10–80 %; the second one — 27 (36 %) patients, in which the indicator accumulation in the projection of the affected joint was + 81–150 %; the third group consisted of 13 (19 %) patients with indicator accumulation in the projection of the affected joint more than +150 %. One year after arthroplasty of the affected knee joint, postoperative complications weren’t detected in patients of the first diagnostic group. Three (11 %) patients of the second diagnostic group and 19 (30 %) patients from the third diagnostic group developed implant-associated infectious complications one year after the hip arthroplasty. Conclusions. The higher the percentage of radiopharmaceutical inclusion in the projection of a joint affected by rheumatoid arthritis during bone scintigraphy in the preoperative period, the higher the likelihood of implant-related complications after arthroplasty (p < 0.05).


bone scintigraphy; rheumatoid arthritis; hip joints; arthroplasty


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