What Is Tracer Uptake Of The Knee

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Staph Infection The Knee Pictures

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 arrowheads), and the narrowing of the joint. The proximal tibiofibular joint also shows periarticular sclerosis and articular obliteration (arrows)

The knee is the most common site of osteoarthritis. The anatomy of the knee is compound, having two condylar joints between the femur and tibia, and the sellar joint between the patella and femur. The joint is provided internally with the menisci and the cruciate ligaments and externally with the bursae above, in front of, and below the patella. The causes for osteo-arthritis in the femorotibial compartment (knee) and the patellofemoral compartment (patella) are many and varied. For example,

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 arrowheads), and the narrowing of the joint. The proximal tibiofibular joint also shows periarticular sclerosis and articular obliteration (arrows)

Osteoarthritis The Knee Osteophytes

Fig. 9.14A, B Patellar involvement in osteoarthritis. A Medial pinhole scintigraph of the left knee in a 61-year-old woman shows a spotty "hot" area in the infero-posterior aspect of the patella (arrow) with associated spotty intense tracer uptake in the other periarticular bones. B Mediolateral radiograph demonstrates a small osteophyte in the inferoposterior aspect of the patella (arrow) and suspicious erosion in the apposing femoral cortex

Fig. 9.14A, B Patellar involvement in osteoarthritis. A Medial pinhole scintigraph of the left knee in a 61-year-old woman shows a spotty "hot" area in the infero-posterior aspect of the patella (arrow) with associated spotty intense tracer uptake in the other periarticular bones. B Mediolateral radiograph demonstrates a small osteophyte in the inferoposterior aspect of the patella (arrow) and suspicious erosion in the apposing femoral cortex

Fig. 9.15A, B Patellar osteoarthritis. A Lateral pinhole scan of the right patella in a 63-year-old male shows increased tracer uptake localized to the upper edge of the retropatellar facet (arrow). B Lateral radiograph reveals a small spur with sclerosis (arrow)

Chondromalacia Knee Radiograph

femorotibial osteoarthritis has been related to trauma, meniscus surgery, osteonecrosis, deformity and obesity, and femoropatellar osteo-arthritis to trauma, deformity and chondroma-lacia patellae (Bahk et al. 1994; Resnick 2002). Symptoms may be surprisingly lacking during the early stage despite the presence of radiographic spurs or scintigraphic change, or con

Condromalacia Selar Grado

Fig. 9.16A-C Scintigraphic manifestation of chondromalacia patellae. A Mediolateral radiograph of the right knee in a 61-year-old man with painful, "surface-type" chondromalacia patellae reveals suspicious pointing of the upper patellar pole and osteopenia in the upper aspect of the patella (?). B Axial measure-set CT section through the upper patella reveals the denudation of the cartilaginous layer with subchondral bone elevation in the lateral facet (arrows). With a different CT window setting a small cystic change is apparent just beneath the elevated bone (arrow). C Medial pinhole scan shows spotty intense tracer uptake that is characteristically localized in the central zone of the retropatellar facet (arrow). The other articular compartments are normal versely pain and limited motion may antedate the appearance of the radiographic or scinti-graphic abnormality. Sooner or later, however, instability, awkward gait, limb deformity and subluxation may ensue with severe disablement. Radiographic features include articular narrowing of various grades, subchondral os-teosclerosis, eburnation, cystic change, and periarticular osteophytosis or spur formation. When acute synovitis supervenes the para-articular soft tissue becomes bulged due to effusion and synovial edema, and it occurs typically in the medial femorotibial compartment (Fig. 9.2A). Occasionally, vacuum shadow and loose bodies may be seen. Except for marginal spurs, most changes occur in the contact joint surfaces. In advanced cases, the joint becomes subluxed and sealed due to osseous ankylosis.

Pinhole scintigraphy in the earliest stage of osteoarthritis demonstrates spotty "hot" area(s) in the subchondral zones of the femorotibial compartment that is in close contact and weight bearing (Fig. 9.6). The degree of uptake varies widely from subtle to extreme, and the appearance may be spotty, mottled, patchy, or segmental. Tracer uptake and radiographic changes do not necessarily match each other, and a hot area may be seen where there is no radiographic change (Fig. 9.6). As the disease progresses focal uptake appears in the eburna-tion and spurs formed in the tibial plateaus, femoral condylar undersurfaces, and tibial tubercles (Fig. 9.13). The uptake is discrete and asymmetrical, mainly involving the medial and central femorotibial compartments (Figs. 9.49.6). When cystic change supervenes, uptake becomes markedly intensified. Cystic change is commonly observed in the medial tibial con-dylar edge, giving rise to the "hot edge" sign (Fig. 9.4). In occasional cases the whole knee joint compartments including the medial and lateral femorotibial compartments, the proximal tibiofibular compartment, and the patello-femoral compartment are involved (Fig. 9.13). The involvement of the tibial tubercles is indicated by uptake localized in the central elevation of the tibial head (Fig. 9.13).

In summary, unlike in infective arthritis and rheumatoid arthritis, the lesions in osteoarth-ritis are discrete and the joint is not completely affected. When acute synovitis supervenes uptake becomes diffuse, but is still confined to one side of the knee, more commonly the medial side. Subchondral cysts accumulate tracer most intensely, presenting the "hotter spot within hot area" sign. In contrast, mature osteophytes accumulate little or no tracer. Their location in the nonstress area keeps metabolism as inert and stable as that in the normal long bones (Fig. 9.5).

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Responses

  • Tony
    What is tracer uptake of the knee?
    7 years ago
  • ESSI
    What is tracet uptake?
    7 years ago
  • carola
    What is intense uptake in the proximal left tibia?
    7 years ago
  • madihah
    What is intense uptake in the left tibia and left femur image?
    6 years ago
  • Costantino
    What is uptake in the patella?
    2 years ago
  • MIREILLE ELLIS
    What does intense uptake of the patella mean?
    1 year ago
  • kristian mcintyre
    What is done for focal increase of radiotracer uptake?
    7 months ago

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