Abstract
Pienimäki TT, Takalo RJ, Ahonen AK, Karppinen JI. Three-phase bone scintigraphy in chronic epicondylitis. Objective To assess the utility of 3-phase bone scintigraphy as a complementary diagnostic method in chronic epicondylitis. Design A cross-sectional study. Setting Hospital outpatient clinic admitting patients with musculoskeletal disorders. Participants Patients (N=59; 68% women) with unilateral chronic epicondylitis. Interventions Not applicable. Main Outcome Measures Three-phase bone scintigraphy was performed after an intravenous injection of 550MBq 99mtechnetium-labeled hydroxymethyline diphosphonate ( 99mTc-HDP) in the patients. Blood flow and blood pool phases were graded visually as normative or abnormal. In the bone metabolic phase, the scintigraphic radiograph images were evaluated using a transmission densitometer. The ratio between maximal bone uptake of 99mTc-HDP in each epicondyle and the mean of that in the adjacent humerus was used as a bone uptake measure, which was compared with clinical data (pain questionnaire, pain drawing, cubital pain thresholds, muscle strength) and with work ability and lifestyle factors. Results The bone uptake of 99mTc-HDP of the affected epicondyle was 33% and 17% higher in men and women, respectively, compared with the corresponding healthy epicondyle ( P<.001 and P=.007). High bone uptake of 99mTc-HDP was associated with better work ability, grip strength, and muscle performance in both sexes but was not correlated with the pain measures. Blood flow phases had a positive correlation with the duration of symptoms and a negative correlation with the bone uptake of 99mTc-HDP, grip strength, and work ability. Conclusions High bone uptake of 99mTc-HDP among patients with chronic epicondylitis was associated with better muscle strength, work ability, and arm function. In chronic cases, a higher degree of bone uptake of 99mTc-HDP may thus indicate a healing response in the bone tissue.
Published Version
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