Abstract |
Acute transient synovitis of the hip presents
clinically pain and limping. But in the majority of the
cases, definite positive findings are not manifest in
roentgenogram in its early phase. However radionuclide
bone imaging combines with the assessment of
vascularization and bone tracer uptake Is of great
value in solving this diagnostic problem. The materials
for this study consisted of 29 children with acute
transient synovitis of the hip, characterized by
symptoms and physical signs of an arthritis, negative
X-ray findings and disappearance of all symptoms and
signs within a short period of time. They were twenty
males and 9 females and age ranged from 1 to 12 years.
We took pelvic reontgenogram in AP and frog-leg views.
After intravenous bolus injection of 10 to 15 mCi of
Tc-99m-methylene diphosphonate, 24 sequential image of
the pelvis was taken at 2-second interval for blood
flow study. The scintigrams were made using a gamma
camera with high resolution parallel hole collimator.
Blood pool imaging was obtained at 2 minutes after
tracer administration. After 3 hours, static images
were taken and then close-up image of the hip using
pin-hole collimator was followed. The results were as
follows: 1) Bone scintigram was much more sensitive
than conventional roentgenogram in diagnosis of acute
transient synovitis of the hip. 2) Three-phase imagings
showed increased vascular activities in blood pool
scintigrams in 96%. 3) Pin-hole imaging showed
increased tracer uptake in the regional bones of the
hip, particularly in the medial aspect of femoral head
and acetabulum. 4) We confirmed that three-phase
imaging reinforced with pin-hale technique were very
useful in diagnose of acute transient synovitis of the
hip. |