We tried to evaluate the possibility that the radionuclide imaging of the knee with 99mTc-pyrophosphate be the diagnostic tool for the patients with the suspected tear of the meniscus of the knee. Among the 142 cases in which 99mTc-pyrophosphate scan was performed, both arthrogram and knee scintigraphy were performed in 60 cases, but only 25 cases were done arthroscopy & arthrotomy for identification to intraarticular legion. We observed 4 types of abnormally increased uptake in the scintigraphy from 16 cases of 19 cases that identified to the meniscus tear. These patterns were seen with 1) diffuse increased uptake, 2) focal increased uptake, 3) plate-like increased uptake in or near the joint space, 4) diffuse increased uptake with plate-like accentuation. Among the 25 cases, 18 cases were found to have consistent scintigraphy & operative findings, 3 cases were observed not tear of meniscus but other legions in the knee joint. And only 4 cases were seen differented to findings of arthrotomy & scintigraphy. We could conclude that the knee scintigraphy with 99mTc-pyrophosphate could be used as a helpful method of the initial evaluation of the internal derangement of the knee in the patients with the suspected tear of the meniscus of the knee.
Arthroscopy ; Humans ; Joints ; Knee Joint ; Knee ; Methods ; Radionuclide Imaging ; Tears ; Technetium Tc 99m Pyrophosphate

Gallium-67 scintigraphy is helpful in the assessment of active extrapulmonary sarcoidosis. Muscular involvement of sarcoidosis is often asymptomatic or nonspecific, and laboratory examinations do not provide convincing evidence of muscular involvement. We report a case of muscular sarcoidosis, which was detected by gallium-67 scintigraphy. In a patient who was suffering from fever and arthralgia of knee joint, gallium-67 scintigraphy showed mediastinal and hilar involvement of sarcoidosis with unexpected extensive muscular uptake. Magenetic resonance imaging revealed the detailed depiction of intramuscular infiltration of sarcoid granuloma. Gallium-67 scintigraphy is useful in detecting inflammatory muscular involvement of sarcoidosis as well as other multiorgan involvement.
Arthralgia ; Fever ; Granuloma ; Humans ; Knee Joint ; Magnetic Resonance Imaging* ; Radionuclide Imaging* ; Sarcoidosis*

Colloidal gold 198Au were injected into 40 knee joints of rabbits for the study of the change of synovial membrane. We verified even distribution of Colloidal gold 198Au about knee joints by use of scintigraphy. After then, histopathological examinations were performed by periodic intervals. The following results are obtained form this study. l. Intra-articular injection of Colloidal gold 198Au into rabbit's knee joints resulted in a mild resctive inflammation at synovium. In was charscterized by an infiltration of eosinophils and by sclerotic changes in the subsynovium and by fibrosis of synovial vessels. 2. From this study, intra-articular injection of Colloidal gold 198Au may by benefit to treat the chronic synovial effusion in human.
Colloids ; Eosinophils ; Fibrosis ; Gold Colloid ; Humans ; Inflammation ; Injections, Intra-Articular ; Knee Joint ; Rabbits ; Radionuclide Imaging ; Synovial Membrane

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare form of seronegative polyarthritis which is characterized by sudden onset of a symmetrical and peripheral polysynovitis, prominent pitting edema of both hands in elderly patient. It has a benign course and remits completely after steroid treatment. We describe a 77-year-old Korean man of RS3PE syndrome He presented with sudden onset polyarthritis and pitting edema of the dorsum of both hands and both feet. Rheumatoid factor was negative and erythrocyte sedimentation rate was high. Bone scintigraphy showed increased uptake in both wrist, knee, and ankle joints. His synovitis and pitting edema completely disappeared after steroid treatment.
Aged ; Ankle Joint ; Arthritis ; Blood Sedimentation ; Edema* ; Foot ; Hand ; Humans ; Knee ; Radionuclide Imaging ; Rheumatoid Factor ; Synovitis* ; Wrist

The common causes of rhabdomyolysis include trauma, hypoxia, drugs, toxins, infections and hyperthermia. Operative insults, including direct trauma and ischemia, have the potential to cause the development of rhabdomyolysis. Pneumatic tourniquets used during arthroscopic knee surgery to prevent blood loss have led to many complications such as nerve paralysis and vascular injuries. Rhabdomyolysis can also be caused by prolonged pneumatic tourniquet application without a midapplication release, and also from an increased application pressure, but the actual incidence of this is low. In order to prevent rhabdomyolysis, the clinicians must be aware of such risks and follow strict guidelines for the application time, the midapplication release and also the inflation pressure. Vigorous hydration and postoperative patient surveillance are helpful to prevent rhabdomyolysis. We have recently experienced a case of rhabdomyolysis after the arthroscopic knee surgery, and the rhabdomyolysis could have been associated with the use of a pneumatic tourniquet.
Adult ; Anterior Cruciate Ligament/injuries/surgery ; *Arthroscopy/statistics & numerical data ; Humans ; Kidney Failure/etiology/radionuclide imaging/ultrasonography ; Knee Joint/*surgery ; Male ; Postoperative Complications/etiology/radionuclide imaging/ultrasonography ; Rhabdomyolysis/*etiology/radionuclide imaging/ultrasonography ; Tourniquets/*adverse effects

OBJECTIVE: To evaluate the potential and correlation between near-infrared fluorescence (NIRF) imaging using cyanine 5.5 conjugated with hydrophobically modified glycol chitosan nanoparticles (HGC-Cy5.5) and 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) imaging of collagen-induced arthritis (CIA). MATERIALS AND METHODS: We used 10 CIA and 3 normal mice. Nine days after the injecting collagen twice, microPET imaging was performed 40 minutes after the intravenous injection of 9.3 MBq 18F-FDG in 200 microL PBS. One day later, NIRF imaging was performed two hours after the intravenous injection of HGC-cy5.5 (5 mg/kg). We assessed the correlation between these two modalities in the knees and ankles of CIA mice. RESULTS: The mean standardized uptake values of 18F-FDG for knees and ankles were 1.68 +/- 0.76 and 0.79 +/- 0.71, respectively, for CIA mice; and 0.57 +/- 0.17 and 0.54 +/- 0.20 respectively for control mice. From the NIRF images, the total photon counts per 30 mm2 for knees and ankles were 2.32 +/- 1.54 x 10(5) and 2.75 +/- 1.51 x 10(5), respectively, for CIA mice, and 1.22 +/- 0.27 x 10(5) and 0.88 +/- 0.24 x 10(5), respectively, for control mice. These two modalities showed a moderate correlation for knees (r = 0.604, p = 0.005) and ankles (r = 0.464, p = 0.039). Moreover, both HGC-Cy5.5 (p = 0.002) and 18F-FDG-PET (p = 0.005) imaging also showed statistically significant differences between CIA and normal mice. CONCLUSION: NIRF imaging using HGC-Cy5.5 was moderately correlated with 18F-FDG-PET imaging in the CIA model. As such, HGC-Cy5.5 imaging can be used for the early detection of rheumatoid arthritis.
Animals ; Ankle Joint/radionuclide imaging ; Arthritis, Experimental/*radionuclide imaging ; Carbocyanines/administration & dosage/*diagnostic use ; Chitosan/administration & dosage/*diagnostic use ; Fluorodeoxyglucose F18/administration & dosage/diagnostic use ; Injections, Intravenous ; Knee Joint/radionuclide imaging ; Male ; Mice ; Microscopy, Confocal ; Nanoparticles ; Positron-Emission Tomography/*methods ; Radiopharmaceuticals/administration & dosage/diagnostic use ; Statistics, Nonparametric

OBJECTIVE: Insufficiency fracture (IF) occurs when normal or physiological muscular activity stresses a bone that is deficient in mineral or elastic resistance. We studied clinical characteristics of IF in patients with chronic inflammatory joint diseases in Korea. METHODS: Between Aug. 1997 and Feb. 2003, thirty five patients with 77 fractures were studied at the authors' institution when they were being treated for their rheumatic diseases. The clinical and laboratory data were collected by review of medical record retrospectively. RESULTS: All patients except four were postmenopausal women (mean age 63.0+/-10.0 years) with long disease duration (mean 14.2+/-11.6 years). Thirty three patients had rheumatoid arthritis, 1 ankylosing spondylitis and 1 systemic lupus erythematosus. Twenty nine patients (85.7%) were receiving regular steroid treatment (mean dose 4.0+/-2.3 mg/day, mean duration 6.1+/-4.2 years). Twenty four patients were treated with methotrexate. The significant reduction in their bone mineral density was found 27 patients based on BMD or QCT. Eight patients without osteoporosis were treated with steroid or MTX. Twenty three patients were ever used for osteoporosis treatment. Most patients except four presented with pain in the low back, groin, hip, pelvic, leg and knee. Initial simple radiography was positive in only 7 patients, with vertebral compression fracture in 11 patients and no effect on mobility except ten. Diagnosis was delayed (mean duration of symptom until diagnosis was 45.6+/-64.5 days). IF was confirmed using the bone scan. Sacrum and pelvic bone was most frequently affected site. The other sites were SI joint, iliac wing, symphysis pubis, acetabulum and femur neck. Twenty nine patients required in-patient stay (mean 17.4 days). All but one patient showed an uneventful recovery with conservative treatment. CONCLUSION: The low grade nature of symptoms, minimal effect on mobility, absence of significant trauma and missed on initial plain radiography make diagnosis difficult and delayed. IF should be suspected in cases of unexplained pain with local tenderness in patients of chronic inflammatory joint diseases. The technetium-99m diphosphonate bone scintigraphy was valuable diagnostic tool in the early recognition of IF.
Acetabulum ; Arthritis, Rheumatoid ; Bone Density ; Diagnosis ; Female ; Femur Neck ; Fractures, Compression ; Fractures, Stress* ; Groin ; Hip ; Humans ; Joint Diseases* ; Joints* ; Knee ; Korea ; Leg ; Lupus Erythematosus, Systemic ; Medical Records ; Methotrexate ; Osteoporosis ; Pelvic Bones ; Radiography ; Radionuclide Imaging ; Retrospective Studies ; Rheumatic Diseases ; Sacrum ; Spondylitis, Ankylosing