The Agreement Between Blood Pool - Delayed Bone Scintigraphy and Tc-99m Human Immunoglobulin G (HIG) Scintigraphy in the Determination of the Presence and Severity of Inflammatory Arthritis

Abstract

Objective: In this study, it was aimed to investigate the agreement between early phase of bone scintigraphy – human immunoglobulin scintigraphy (EPBS-HIG) and late phase bone scintigraphy – HIG (LPBS-HIG) in the determination of the presence and also the severity of inflammatory arthritis. Material and Methods: Twenty-eight patients (23 female, 5 male; between 19 to 80 years of age) with inflammatory arthritis were included in the study. Tc-99m HIG and blood pool/late phase bone scintigraphies were performed in all patients. In scintigraphic examinations, the joints were scored with the degree of accumulation of the radiopharmaceutical by the semiquantitative analysis (0=Background activity, 1=Faint uptake, 2=Moderate uptake, 3=Marked uptake) which is called as visually active joint score as severity index of the disease. To estimate the agreement between EPBS – HIG and LPBS - HIG in the determination of the presence and severity of inflammatory arthritis, 2x2 kappa coefficients were calculated. Results: Our results showed good agreement between EPBS - HIG for the presence of inflammation (kappa: 0.72) but not for the severity of the disease (kappa: 0.29), poor agreement between LPBS - HIG for both the presence (kappa: 0.51) and severity (kappa: 0.01) of inflammatory arthritis. Conclusion: The blood pool scintigraphy could be used in the investigation of the presence of inflammatory arthritis because the good agreement with HIG and the lower cost but not for the severity of the diseaseConflict of interest:None declared.

“la synoviorthèse” can more than synovitis!

“…Increased blood pooling and intensity of the blood pool are associated with patient response to RSO [5]. However, the prerequisite of RSO response is also a homogenous intra-articular distribution and retention of the radiopharmaceutical to achieve the highest irradiation to the synovial tissue by direct irradiation or by a cross fire radiation effect [6].…”