The Role of the Three Phase Bone Scintigraphy in the Management of the Patients with Costochondral Pain

Abstract

Aim: The bone scintigraphy is indicated in patients with costochondral pain in order to identify the organic etiology. We aimed to investigate the local and projecting pain, or incidental findings in the three phase bone scintigraphy of the patients referred for costochondral pain.Methods: We included 50 patients (36F, 24M; mean: 41±18 years-old) referred to our department for three phase bone scintigraphy for costochondral pain between January 2009-July 2012.Results: Among the 50 patients 22 had normal scintigraphy. An increased activity accumulation in the sternoclavicular joint was observed in 12 patients (right in 4, left in 4 and bilateral in 4) only in late phase and in 9 patients (right in 2, left in 1 and bilateral in 6) with increased vascularity. Among projecting pain causes, activity was present on sternum in 4 patients, on humerus in 2 patients and on the first costae in 2 patients. For the characterization of inflammatory pathology, the three phase bone scintigraphy showed sensitivity, specificity, accuracy, positive and negative predictive values of 43%, 94%, 78%, 77% and 78% respectively.Conclusion: Bone scintigraphy is an effective diagnostic method for the identification of local or projecting pain, and additionally unexpected incidental pathologies ssociated with costochondral pain. However regarding the characterization of inflammatory process false negatives should be considered.Conflict of interest:None declared.

Refractory Tietze’s Syndrome Occurring after Lumbar Spine Surgery in Prone Position

“…Ultrasound of the area may be useful in visualizing the edema. Bone scintigraphy is an effective diagnostic tool for localizing the pathology in cases of costochondral pain 18. CT is also useful in these cases where the findings are chondral enlargement and destruction with/without calcification of costal cartilage 19.…”