Spine

Lumbar Spine Ray Women

Rheumatoid arthritis is not common in the thoracic and lumbar spine. However, the high incidence in the cervical spine is well known. One of the most recent studies has indicated the radiographic prevalence rate of rheumatoid arthritis in the cervical spine to be 88.5 (Zik-ou et al. 2005). In contrast, a random sampling study showed rheumatoid arthritis to involve the lumbar spine in only 5 of men and 3 of women (Lawrence et al. 1964). Rheumatoid ar- Fig. 10.40A, B Rheumatoid arthritis in the...

Patellar Femoropatellar Osteoarthritis

Patellar osteoarthritis is characterized by tracer uptake at the lower or upper edge of the retro-patellar facet (Figs. 9.14 and 9.15). The narrowing of the patellofemoral joint and increased uptake in other articular compartments of the knee are important diagnostic features of os-teoarthritis. Due to altered locomotion, osteo-arthritis in genu valgum and genu varus tends to occur in the lateral and medial femorotibial compartment, respectively, whereas osteoar-thritis in flexion deformity is...

Insufficiency Fracture in Rheumatoid Arthritis

Patients receiving corticosteroid therapy often suffer from insufficiency fractures (trabecular disruption in nonlesional bones) of, for example, the spine, hip, and knee. Pathologically, osteopenia and osteonecrosis precede the fractures because they begin earlier as a result of microvascular occlusion and infraction. Radiographic manifestations include osteopenia, crescent or patchy lucency, and bone collapse and condensation due to impaction. In the spine, the vertebral bodies show...

References

Ansell BM, Kent PA (1977) Radiological changes in juvenile chronic arthritis. Skeletal Radiol 1 129-144 Arnett FC, Edworthy SM, Bloch DA, et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31 315-324 Babini JC, Gusis SS, Babini SM, et al (1992) Superolateral erosions of the humeral head in chronic inflammatory arthropathies. Skeletal Radiol 21 515-517 Beckers C, Ribbens C, Andre B, et al (2004) Assessment of...

Enteropathie Arthropathies

Evolution Ankylosing Spondylitis

Enteropathic arthropathies are arthritides that are associated with either nonspecific or infective inflammatory diseases of the intestine. Nonspecific enteropathies include ulcerative colitis, Crohn's disease, and Whipple's disease, and common i nfective enteritides are salmo-nellosis, shigellosis, and yersiniasis. The exact cause-and-effect relationship between arthritis and inflammatory intestinal diseases is not fully clarified, although both immune mechanism and articular infection either...

Sjogrens Syndrome

Heel Pad Syndrome

Sjogren's syndrome consists of keratoconjunctivitis sicca, xerostomia, and rheumatoid arthritis, and is considered to be a generalized autoimmune exocrinopathy (Strand and Talal 1980). Like most autoimmune diseases, Sjogren's syndrome occurs predominantly in women in fourth to seventh decades of life. The syndrome may be either primary or secondary to rheumatoid arthritis and less commonly SLE. Arthritic involvement may or may not be present, and when obvious it is almost always due to...

Other Common Sites of Osteoarthritis

Osteoarthritis commonly affects the symphysis pubis, the interphalangeal joints of the hands and feet, and the sesamoidometatarsal joint of the great toe with hallux valgus (Resnick 2002) as well as the type II accessory bone of the navicular bone (Lawson et al. 1984). As elsewhere, common radiographic features include bone erosions, eburnation, articular narrowing, and cystic formation. Scintigraphy shows increased uptake and articular narrowing. Not infrequently, the scintigraphic changes...

Hip

Sacroiliac Joints Sclerosis Iliac

The hip is less commonly affected than the knee. The more classical changes are observed in patients with longstanding disease, especially those receiving corticosteroid therapy. Radiographic features include bone erosions, eb-urnation, and concentric articular narrowing. In addition, small cysts may be seen in scle-rosed periarticular bones. With concentric narrowing of the joint, the femoral head migrates axially within the acetabular fossa (Fig. 10.35A). Rarely, the femoral head migrates...

Systemic Lupus Erythematosus

Avascular Necrosis The Knee

SLE is a relatively common chronic disorder of an inflammatory nature of unknown etiology. SLE affects multiple organ systems of the body including the skin, joints, entheses, kidneys, lungs, serous membranes, nervous system, and others. SLE may cause immunological changes and abnormalities, especially antinuclear antibodies. The clinical course is characterized by remission and acute relapse, and long-term steroid administration may result in osteoporosis, avascular necrosis, and...

Increased Tracer Uptake Left Ischiam Enthesopathy

Calcaneal Spur Alponeurosis

Heel pad (Fig. 12.32A) is difficult if not associated with a bone change, whereas pinhole scin-tigraphy can specifically indicate their diagnosis by showing tracer uptake at the site in question even in the absence of radiographic change (Figs. 12.30B, 12.31B and 12.32B). Established plantar fasciitis always reveals a characteristic calcaneal spur (Fig. 12.33 A). MRI may demonstrate edema in acute tenosynovitis Fig. 12.30A, B Tenosynovitis of the flexor carpi ulnaris tendon. A Dorsoventral...

Other Rheumatic Osteoarthropathies and Soft Tissue Rheumatism Syndromes

Sjogren Finger

From among a larger group of rheumatic and similar osteoarthropathies, Sjogren's syndrome, Behcet's syndrome, systemic lupus erythematosus (SLE), tophaceous gouty arthritis, Char-cot's joint, and secondary hypertrophic osteo-arthropathy deserve appropriate descriptions since these disorders show 99mTc-MDP bone scintigraphic changes that suggest or often indicate the diagnosis. This is especially true in Sjogren's syndrome, Behcet's syndrome, SLE, and gouty arthritis, in which radiography often...

Ankle and Tarsus

Articular Space

Rheumatoid arthritic involvement of the ankle and tarsus may be generalized or limited to one or a few joints. Normally, the larger joints of the ankle, the talus, and the calcaneus are readily discerned by radiography and pinhole scintigraphy Chap. 4 . These larger joints are also clearly visible in the early inflammatory phase Fig. 10.27A, B Delimitation of tracer uptake by physeal cartilages in rheumatoid digits and sesamoidal rheumatoid arthritis. A Dorsal pinhole scintigraph of the right...

Elbow

Osteoarthritis Elbow

The elbow joint is a compound synovial articulation that consists of two components the hu-meroulnar joint and the humeroradial joint. The former is between the humeral trochlea and the ulnar trochlear notch and the latter be- Fig. 9.30A, B Osteoarthritis in the manubriosternal joint. A Conventional X-ray tomography of the sternum in a 57-year-old male with chronic sternal pain shows curved linear lucency in the centro-left-lateral portion of the manubriosternal joint arrow with the...

Seronegative Spondyloarthropathies

Seronegative spondyloarthropathies SNSA affect genetically predisposed individuals and are triggered by environmental factors Khan 2002 . They consist of a group of closely related skeletal disorders characterized by the concurrence of arthritis and spondylitis, in which serological rheumatoid factor is absent, hence seronegative. SNSA include ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis, arthritis associated with inflammatory bowel disease, and other rare forms of...

Juvenile Rheumatoid Arthritis

Arthritis Bone Scan

Juvenile rheumatoid arthritis is one of the most common pediatric rheumatic disorders and a major cause of chronic disability and occasional crippling deformity. The clinical manifestations include synovitis of the peripheral joints with effusion and periarticular soft-tissue swelling. Onset is before 16 years of age, and overall prevalence is estimated tobe 113 100,000 Fig. 10.47A, B Insufficiency fractures and avascular bone necrosis in rheumatoid arthritis treated with corti-costeroids. A...

Disuse and Immobilization Osteoporosis

Old Ladies After Mastectomy Pictures

Fig. 15.8A, B Immobilization osteoporosis. A Antero-posterior radiograph of the left shoulder girdle in a 48-year-old woman with disuse after mastectomy for breast cancer shows diffusely washed out regional bones open arrows . B Anterior pinhole scintigraph reveals intense tracer uptake in porotic bones arrows Bone is not a mere lazy weight-bearing or protective scaffold for the body, but is day and night engaged with modeling and remodeling through the active physicochemical and metabolic...

Gouty Arthritis

Year Old Man Toe

Gouty arthritis is caused by the aggregated presence of monosodium urate crystals in the limb joints or their deposition in the periarticular soft-tissue structures as foreign bodies. It is categorized into a acute gouty arthritis, b intercritical gout, and c chronic tophaceous gout. Of these, acute gouty arthritis and chronic tophaceous gout are discussed because the combined use of scintigraphy and radiography in these two diseases synergistically enhances diagnostic accuracy. Initial or...

Knee

Condylar Rheumatoid Arthritis Images

The knee is a common site of rheumatoid arthritis. It is the largest synovial joint, rendering the arthritic changes most clearly observable both on the radiograph and the pinhole scinti-graph. Radiographic features include synovitis, Fig. 10.32 Irregular, spotty tracer uptake in marginal rheumatoid bone erosions in the knee. Anterior pinhole scan of the left knee in a 26-year-old woman with relatively early rheumatoid arthritis shows small segmental and spotty areas of increased tracer uptake...

Nuclear Angiography in Rheumatoid Arthritis

Rheumatoid Arthritis Nuclear

Fig. 10.49 Value of whole-body bone scintigraphy in the diagnosis of juvenile rheumatoid arthritis. Anterior whole-body bone scan in an 18-year-old female with polyarthritis clearly shows prominent symmetrical multiarticular tracer uptake arrows Nuclear angiography is widely used for a dynamic assessment of vascular alteration in rheumatoid arthritis, especially in the early stage Hopfner et al. 2002, 2004 . As in any inflammatory or infective diseases of the skeleton, nuclear angiography...

Vascularity Related Osteoporosis

Rsd Radiographs

Vascularity-related osteoporosis is arbitrarily assigned to include disuse immobilization osteoporosis, reflex sympathetic dystrophy RSD , transient painful regional osteoporosis with hypervascularity, and nonspecific marrow edema. Osteoporosis and osteopenia is a condition in which bone mass is reduced with resultant increase in porosity. The former term emphasizes porosity and the latter reduced bone mass. The pathophysiology and precipitating factors are not fully clarified except disuse,...

Ankylosing Spondylitis

Ankylosing Spondylitis Exercises

Ankylosing spondylitis denotes nonspecific inflammatory or rheumatic disorder of the spine clinically characterized by stiffening, pain, fi-brosis, and ankylosis. The disease typically affects the cartilaginous diskovertebral junctions and small accessory vertebral synovial joints, resulting in the bamboo spine deformity. The sacroiliac joint involvement is an essential constituent of the disease. The cause is obscure, but many recent studies have confirmed a strong association between this and...

MTcFdg Petct in Rheumatoid Arthritis

Pet Scan Rheumatoid Arthritis

The fact that 18F-FDG in inflamed joints was first reported by Yasuda et al. 1996 and, most recently, 18F-FDG PET-CT has been used for the diagnosis of early rheumatoid arthritis Beckers et al. 2004 . 18F-FDG PET-CT was systematically applied to the monitoring of disease activity by simultaneous multiarticular assessment. The knees and either the wrists and finger joints or the ankles and first metatarso-phalangeal joints were evaluated individually and globally Fig. 10.9 . Parameters derived...

Avascular Osteonecrosis and Bone Infarction

Multifocal Osteonecrosis

Pathologically, osteonecrosis may be defined as the devitalization of osteocytes and cellular bone marrow elements. A single decisive factor that may lead to osteonecrosis is vascular deprivation with resultant ischemia. The causes vary, but they can be divided into definite and probable associations Ficat and Arlet 1980 . The definite causes include trauma, fracture, irradiation, sickling, electrical damage, freezing damage, and caisson disease. Although de batable, trivial trauma, alcohol...

Slipped Capital Femoral Epiphysis

Slipped Capital Femoral Epiphysis

This condition involves the medial and posterior slippage of the capital femoral epiphysis along the physeal line. A slipped capital femoral epiphysis has been associated with a high incidence of genetic markers. In one study Mullaji et al. 1993 the HLA-B27 antigen was positive in 20 of patients with this disorder. This is a disease of childhood and adolescence, with the peak in the early second decade. Involvement is unilateral in the great majority and bilateral in about 20 . Trauma, growth...

Drug Induced Osteoporosis

Exogenous Cushing Syndrome

Steroids, heparin, and methotrexate are well-known osteoporosis-inducing drugs. Of these, steroids cause osteoporosis by decreasing bone formation through the inhibition of osteoblast formation and by increasing bone resorption through either direct stimulation of osteoclasts or increasing parathormone release Sambrook and Jones 1995 . The hypercortisonism of Cushing's disease endogenous and exogenous also causes systemic osteoporosis. The daily administration of heparin in doses larger than...

Periarticular Soft Tissue Rheumatism Syndromes

Calcification Breast Tissue

Soft-tissue rheumatism syndromes are common inflammatory conditions clinically characterized by pain. For a bone scintigraphic discussion, the syndromes are arbitrarily categorized into a the periarticular soft-tissue rheumatism syndromes, and b the muscular and musculotendinous rheumatism syndromes. The former group includes bursitis, tenosynovitis, and enthesitis and the latter includes myositis ossificans, rhabdomyolysis, musculotendinous unit injuries Baker 1984 , and distal femoral...

Behcets Syndrome

Old Man Knee Syndrome

Behcet's syndrome is a chronic relapsing disease, basically manifesting as painful oral ulceration, genital ulceration, and uveitis. Peculiarly, the prevalence is not uniform in global distribution the majority of cases have been reported from the eastern Mediterranean countries, Korea, and Japan. The mean age of onset is between 25 and 30 years with men be Fig. 12.5A, B Radiographic and scintigraphic features of acute Behcet's disease. A Lateral radiograph of the right knee in a 22-year-old...

Psoriatic Arthritis

Proximal Interphalangeal Joint Toe

The association of psoriasis with a specific type of arthritis is well established. Psoriatic arthritis may co-occur with, but is not related to, rheumatoid arthritis, and can be differentiated on the basis of asymmetrical spotty distribution, positive HLA-B27 antigen test, negative rheumatoid factor, and the radiographic and scintigraphic findings. Occasionally, however, a symmetrical polyarthritic form may be encountered, strongly mimicking rheumatoid arthritis Fig. 11.23 . Psoriatic...

Faint Tracer In L2 Vertebra

Reiter Syndrome

Fig. 11.8 Spotty asymmetrical polyarthritis and spondylitis in Reiter's syndrome. Composite whole-body spot scintigraph in a 26-year-old man with Reiter's syndrome panoramically delineates the lesions in the lower lumbar spin, both proximal tibiae, the right forefoot, and the left hind- and midfoot arrows with diarrheal disorder or a postvenereal complication. The prevalence of Reiter's syndrome is not easy to assess because of the difficulty in making a definite diagnosis. This is due mainly...

Temporomandibular Joint

Median Atlantoaxial Joints

Fig. 10.41A, B Rheumatoid apophysitis in the lumbar spine. A Right posterior oblique radiograph of the lower lumbar spine in a 63-year-old woman with rheumatoid apophysitis of L3 and L4 vertebrae shows articular blurring and periarticular bone erosions open arrows . B Posterior pinhole scintigraph reveals moderately increased tracer uptake in L3 and L4 apophyseal joint on the right arrows . Note the typical astride position of the apophyseal joint at this level The temporomandibular joints are...

Osteoporosis Of Elbow

Inferomedial Aspect Humeral Head

The shoulder has three different joints the gle-nohumeral joint, the acromioclavicular joint, and the coracoclavicular joint. The last of these is a variant joint between the coracoid process and conoid process of the clavicle. Furnished with a bursa it is the site of coracoclavicular ligament attachment, and its prevalence is 0.8 Gumina et al. 2002 . Rheumatoid arthritis is common in the first two joints, but is rare in the last whose existence itself is rare Lehtinen et al. 1999 ....

B

Osteo Artritis Radiography

Fig. 9.34A, B Osteoarthritis in the ulnar side of the wrist. A Dorsopalmar radiograph of the right wrist in a 41-year-old female shows sclerosis in the distal radial epiphysis with narrowing of the radiocarpal joint and the lunate -triquetral joint R radius, L lunate, T triquetrum . B Dorsal pinhole scan reveals intense tracer uptake in the radiocarpal joint lower arrow and the lunate-triquetral joint upper arrow uptake in the joints with severer pathological change and vice versa Fig. 9.35B ....

Tuberculous Arthritis of Peripheral Joints

Soft Tissue Dissolving Hip Area

Tuberculosis in the peripheral joints runs an insidious, chronic course as tuberculosis elsewhere. For the most part, the mode of infection of tuberculous arthritis is blood-borne with a primary focus usually in the lung. It may also arise from direct contamination with tuberculosis in the neighboring bone. Granulomatous tissue and pannus erode and dissolve articular cartilages and subchondral bones, causing irregular narrowing and disfiguring. Tuberculosis affects any joint Enarson et al. 1979...

Rheumatoid Arthritis

Images Whole Body Arthritis

Rheumatoid arthritis is a fairly common systemic disease of multifarious and obscure etiologies, affecting primarily the synovial membranes of the joints in the appendicular and axial skeleton. It has a notorious predilection for the small joints of the hands and feet although the large joints of the wrists, knees, elbows, shoulders, and sternum are not exempted. The involvement is typically polyarticular and symmetrical. In the spine, the cervical vertebrae, particularly the atlantoaxial...

Loose Bodies In

Hip Loose Bodies

The hip is a ball-and-socket joint that permits multiaxial movement. It is surrounded by a dense, strong, fibrous capsule. Along with the knee, the hip joint is the most typical site of os-teoarthritis. Clinical symptoms are rotation or extension difficulty and pain that may be referred to the buttock, thigh, groin, greater tro-chanteric region, and knee. The radiographic features, as in all other joints, include articular narrowing, osteoscle-rosis, osteophytosis, subchondral cystic change,...

Manubriosternal Joint

Osteoarthritis also affects the manubriosternal joint, which is one of the largest fibrocartilagi-nous articulations. Degenerative arthritis mainly involves the central portion of the articular fibrocartilage with resultant articular narrowing and periarticular eburnation. Radiographically, the manubriosternal joint shows diffuse or partial narrowing with irregular sclerosis of the subchondral bones. Occasionally, the joint may be totally closed Fig. 9.30A . Conventional or computed tomography...

Radioulnar Susp Ra Adalah

Rheumatoid Arthritis Left Hand

The involvement of the radiocarpal, distal radioulnar, and prestyloid compartments Resn-ick 1974 and the pisiform-triquetral compartment Resnick 1976 is characteristic of rheumatoid arthritis of the wrist in early stages. While pinhole scans demonstrate significant tracer uptake in the radiocarpal, distal radioul-nar, and pisiform-triquetral compartments Fig. 10.12A radiographic alterations are subtle and occasionally doubtful Fig. 10.12B . The Fig. 10.11A, B Extremely intense tracer uptake in...

Hand Fingers

Rheumatism Arthritis Static Bone Scan

The early alteration of rheumatoid arthritis has been described to initiate from the second and third metacarpophalangeal joints and the third proximal interphalangeal joint Fig. 10.10A . As shown in this case, however, the synchronous involvement of the wrist is common. Indeed, wrist involvement is as characteristic and heralding as digital involvement, or is even predominant during the early stages of the disease Hendrix et al. 1987 . Radiography reveals erosion, articular narrowing, and...

Sternum

Arthritis The Breastbone

The sternum is provided with three articulations the paired sternoclavicular joints and the single manubriosternal joint. The former joints consist of the medial end of the clavicle and the clavicular notch along with the superior surface of the first costal cartilage and articular disk. The manubriosternal joint is mostly symphysis and partly synovial with cavitation created by disk absorption. The periarticular bony surfaces are covered by hyaline cartilage and connected by a fibrocartilage...

Transient Synovitis of the

Transitory Hip Synovitis

Transient synovitis is a self-limited, nonspecific, inflammatory disease, typically affecting the hips in children aged between 3 and 10 years. Boys are affected much more commonly than girls. It occurs frequently after a respiratory tract infection. Erythrocyte sedimentation rate and white blood cell count are mostly normal. Other terms for the condition include irritable hip syndrome, observation hip, transitory arthritis, transitory coxitis, and simple serous coxitis. The etiology is not yet...

Pyarthrosis and Abscess of the Sacroiliac Joint

Staph Infection Toe Pictures

The sacroiliac joint may be infected through the hematogenous route, from a contiguous focus, or by direct bacterial implantation from Fig. 8.16A, B Acute infective arthritis of the elbow. A Lateral pinhole scan of the right elbow in a 31-year-old male shows intense tracer uptake in the radial head rh , olecranon base ob , and olecranon fossa of . B Lateral radiograph reveals diffuse blurring of the joint with thickening of the cubital soft tissue overlying the olecranon arrowheads Fig. 8.16A,...

Acromioclavicular Joint

Acromioclavicular Joint Space Widening

Degenerative change of this joint is primarily related to aging. The disease may start as early as the second decade of life, becoming severe by the fifth decade de Palma 1957 . The disease causes discomfort or pain that may be aggravated by motion, radiating to the upper arm. Radiography in the early stage shows mild cortical thickening and subcortical osteopenia in the para-articular bones, giving rise to a pencil-line appearance and apparent articular widening Fig. 9.22A . With the progress...

Glenohumeral Joint

Bone Scan Showing Female Lower Parts

Osteoarthritis of the glenohumeral joint may be associated with aging, occupation, sports, or accidental trauma. Bone diseases such as epiphyseal dysplasia, crystal deposition, hemophilia, or alkaptonuria may also cause osteoarthritis in this joint. The usual pathological sequence is chondrolysis with articular narrowing, hypertrophy with eburnation and osteophyto-sis, and cystic formation. Radiography shows eburnation, marginal sclerosis, and cystic change with articular nar rowing most...

Ankle and Tarsal Joints

Ankle And Tarsus Joints

Articular cartilage of the patella may be categorized as the surface type or the basal type. The former is age-dependent, and its incidence increases precipitously with age, predisposing to osteoarthritis in later years, and the latter is a disease of young adults with more or less self-limited symptoms and clinical course. Conventional radiography is of limited value in diagnosing this condition Lund and Nilsson 1980 , but arthrography and CT and MRI play a decisive role. Occasionally, simple...

Intervertebral Osteochondrosis

Lower Lumbar Spondylotic

The spine has five different articulations the diskovertebral and apophyseal joints in throughout the spine, the costotransverse and costocorporeal joints in the thoracic spine, and the uncovertebral joints in the cervical spine. Of these, the diskovertebral joint is fibrocarti-laginous in type and others are synovial except for the uncovertebral joint that is mixed in type. Based on the principal site of involvement, diskovertebral degeneration can be divided into diskovertebral osteoarthritis...

Degenerative Joint Diseases

Subcortical Cyst Knee

Osteoarthritis Degenerative joint diseases include osteoarthritis, osteoarthrosis, osteochondrosis and others, and are the most common joint disorders that gradually disable patients. These recently receive greater attention because of the unprecedented prolongation of life expectancy and the availability of efficient prosthetic therapy. The terms describing degenerative joint diseases are many and used more or less loosely and even interchangeably. Osteoarthritis and osteoarthosis designate...

Wrist and Carpal Joints

Cystic Change Carpal Bones Rheumatoid

The wrist radiocarpal joint is a biaxial and ellipsoid articulation formed between the distal end of the radius and the scaphoid, lunate, and triquetrum with triangular cartilage on the ul-nar side. The joint is lined by synovium and surrounded by fibrous capsule and radiocarpal ligaments. In addition, there are complex inter-carpal joints, interconnecting a the proximal carpal bones, b the distal carpal bones, and c the two carpal bone rows. Osteoarthritis of the wrist predominantly affects...

Navicular Accessory Joint

Bone Scan Foot And Tibia Hot Spots

The characteristic radiographic features of osteoarthritis of the navicular accessory bone include irregular narrowing of the navicular and navicular-accessory synchondrosis or joint with the condensation of the accessory bone, mimicking avascular necrosis Fig. 9.50A . The accessory bone avidly accumulates tracer, attesting to the fact that dense accessory bone is not due to necrosis but stimulated bone Fig. 9.48A, B Osteoarthritis in the sesamoidal articulation of the first metatarsal head. A...

Pyogenic Arthritis Pyarthrosis

Pyogenic Arthritis The Shoulder

Pyogenic arthritis is a septic condition of a joint. As in acute osteomyelitis, acute pyarthrosis may result from a hematogenous spread of bacteria with direct synovial lodgment, b transphyseal across the growth cartilage spread of a primary infective focus in the long-bone metaphysis, c contiguity, or d penetration or operation. The most common offenders are micrococci and gram-negative bacilli. In children, pyarthrosis has a predisposition for the large joints of the limbs, whereas bacterial...

Sternoclavicular Joint

Medial Sternoclavicular Joint

The sternoclavicular joint is the synovial articulation between the medial end of the clavicle and the sternal clavicular notch, together with the upper part of the subjacent first costal cartilage. The movements and structures including the articular disk are much like those of the acromioclavicular joint. The fibrocartilaginous layer is much thicker on the clavicular surface than the sternal notch. This joint is also a common seat of osteoarthritis. Men are more frequently affected than...

Chondromalacia Patellae

Chondromalacia Patella

Chondromalacia of the patella is a condition characterized by a series of degenerative changes that involve the cartilage and subchondral bone in the retropatellar facet. Clinically, two different types have been described on the basis Fig. 9.17A, B Chondromalacia patellae associated with osteoarthritis. A Medial pinhole scan of the right knee in a 70-year-old woman shows spotty intense tracer uptake typically localized in the upper posterior aspect of the patella surrounded by less intense...

What Is Tracer Uptake Of The Knee

Osteoarthritis The Knee Osteophytes

Fig. 9.13A, B Multicompartmental involvement in osteoarthritis in the knee. A Anterior pinhole scan of the right knee in a 35-year-old man shows multiple, asymmetrical areas of segmental, spotty, and patchy tracer uptake in the femorotibial compartments including the tibial tubercles and the proximal tibiofibular joint arrows with narrowed articular space arrowheads . B Anteroposterior radiograph reveals minimal marginal osteophytes arrowheads , the pointing of the tibial tubercles middle...

Osteitis Condensans Ilii

Iliac Condensans

Osteitis condensans ilii is a nonspecific, self-limited inflammatory disease of the iliac bone in women more typically of childbearing age. This condition may be seen in older women, and even in men although rarely. One study revealed its incidence to be 1.6 Numaguchi 1971 . It is mostly bilateral and symmetrical, although unilateral cases are not rare. The cause is unknown, but, as with osteitis pubis, it has been related to abnormal stress of pregnancy and delivery, which cannot explain its...

Clinical Applications

Understandably, the clinical use of bone scan was much restricted when first introduced in the early 1960s Fleming et al. 1961 . At that time bone scintigraphy was applied to the diagnosis of cancer metastasis Fig. 1.2 and fracture Fig. 3.1 . Since then, its scope has been enormously expanded, indeed far beyond the scope originally envisaged. This expansion has been made possible basically by the availability of high-technology gamma camera systems and excellent radiopharmaceuticals, and...