The role of scintigraphy with technetium-99m nanocolloid in patients with peripheral joint pain.

We studied 51 patients with peripheral joint pain to assess the ability of technetium-99m-nanocolloid (99mTc NC) scintigraphy to distinguish patients with active joint disease from those without, irrespective of their underlying aetiology. Patients with peripheral joint pain due to various causes were clinically categorised as either having objective signs of active joint disease or not. Their clinical diagnoses were not made known to the nuclear physician until after scanning. Each patient was given an intravenous injection of 555 MBq of 99mTc NC 1 h prior to taking spot views of the peripheral joints. Seventeen patients with low backache but without peripheral joint pain were imaged in an identical manner to exclude peripheral joint involvement. The latter formed a control group. 99mTc NC scintigraphy demonstrated a sensitivity of 89% for identifying at least one affected joint per patient, a specificity of 87.5%, a negative predictive value (npv) of 87.5%, a positive predictive value (ppv) of 89%, and overall accuracy of 88%. There were three false negative and three false positive cases. The scan was negative in all control subjects. 99mTc NC scintigraphy proved to be sensitive in patients with active joint disease and demonstrated a good correlation with clinical assessment. The value of the high specificity, npv and negative controls together made the test highly discriminatory in excluding patients without active peripheral joint disease.

99Tc(m) nanocolloid scintigraphy: a reliable way to detect active joint disease in patients with peripheral joint pain.

We evaluated 99Tc(m) nanocolloid (NC) scintigraphy as a method for identifying patients with active joint disease in a group with peripheral joint pain of varying aetiology. Fifty-nine patients with peripheral joint pain were divided into two groups: those with clinical signs of active joint inflammation and those without objective signs. Thirty-four patients clinically diagnosed as having active joint disease had a total of 117 joints (95 large and 22 small) involved. 99Tc(m) NC identified 96 (79 large and 17 small) of these joints. Twenty-five patients were negative clinically. Twenty-two of these were scan negative. The other three had a total of 11 scan positive joints. The correlation coefficient between clinical and scan findings was 0.79. There was no significant difference shown between clinical evaluation and scintigraphy (z=-1.64, P = 0.1004). 99Tc(m) NC proved to be an effective method for identifying patients with active peripheral joint disease from among a group with arthralgia.

Tc-99m erythrocyte localization of an intramuscular hemangioma of the arm.

An unusual case of intramuscular hemangioma of the left triceps muscle is presented. This tumor may infiltrate the muscle and be misdiagnosed as a malignant neoplasm.