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© 1980 British Society for Rheumatology

research-article

QUANTITATIVE SCINTIGRAPHY IN THE EARLY DIAGNOSIS OF SACRO-ILIITIS*

E. CAROLINE DUNN, R. W. EBRINGER and P. J. ELL

Department of Rheumatology Middlesex Hospital and Department of Nuclear Medicine, Middlesex Hospital Medical School London W1

Correspondence to: Requests for reprints to Dr. E. Caroline Dunn, Department of Rheumatology, Prince of Wales's Hospital, London, N15 4AW.

Bone scans were performed on 65 subjects including 13 healthy controls and 52 patients aged over 20 years with suspected sacro-iliitis. Patients were given 15 mCi of technetium-99m methylene diphosphonate (99mTcMDP) intravenously and 400 K count images were recorded two hours later from the posterior pelvis and lower lumbar spine.

Using a region of interest technique, counts were taken at three levels from each sacro-iliac joint and the central sacrum, and sacro-iliac/sacral (SI/S) ratios of uptake, and a sacro-iliac index (SI index) were calculated. High SI/S ratios and high SI indices were obtained in 15 patients with grades 0–2 sacro-iliac radiographs. Nine of these patients had clinically assessed ankylosing spondylitis (AS). Five patients with clinical AS, and grades 3 and 4 radiographs had normal SI indices.

Quantitative scintigraphy appears to be useful in the diagnosis of early sacro-iliitis prior to the appearance of definite radiographic changes.

Multilevel analysis, drug washout and background subtraction increase the sensitivity of the technique.

*Paper read at the Annual Provincial Meeting of the British Association for Rheumatology and Rehabilitation, the Royal Society of Medicine, Section of Rheumatology and Rehabilitation and the Irish Society for Rheumatology and Rehabilitation, Portsmouth, 12 and 13 October 1978. Awarded Association Prize (jointly) for 1979.


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