IMAGING

PINHOLE BONE SCINTIGRAPHY FOR EVALUATION OF HEAD CIRCULATION AFTER REVASCULARIZATION PROCEDURE IN OSTEONECROSIS OF FEMORAL HEAD

Taek Rim Yoon, Jae Yoon Chung, Eun Kyoo Song, Sang Jin Park
Chonnam University Hospital, Kwangju, Korea (tryoon@chonnam.ac.kr)

Introduction: The purpose of this study was to evaluate the efficacy of anteroposterior and lateral pinhole images in the evaluation of head circulation after vascularized iliac graft for osteonecrosis of femoral head.

Materials and Methods: Thirteen patients who underwent vascularized iliac graft for Ficat stage III osteonecrosis were followed postoperatively by anteroposterior and lateral pinhole images of bone scintigraphy. We performed pinhole bone scintigraphy preoperatively, at 2 weeks, 3 months, 6 months and 12 months postoperatively. The circulation of the anterosuperior portion of femoral head was evaluated in the anteroposterior and lateral pinhole images as good if there was hot uptake, fair if hot and cold uptake were mixed, and poor If there was cold uptake.

Result: Preoperatively, the circulation was rated as poor in 10 cases, fair in 2 cases and good in 1 case. At postoperative one year, good circulation was found in 8 cases, fair in3 cases and poor in 2 cases, Pinhole bone scintigraphy in lateral view was very informative to evaluate the exact site of the lesion.

Discussion and Conclusion: Anteroposterior and lateral pinhole bone scintigraphy was very useful for evaluation of healing process after revascularization procedure.