Näslund J E, Odenbring S, Näslund U-B, Lundeberg T
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Br J Sports Med. 2005 Mar;39(3):162-5. doi: 10.1136/bjsm.2004.012336.
Painful disorders of the patellofemoral joint are one of the most frequent complaints in orthopaedic and sports medicine. The aims of this study were to determine whether bone scintigrams of patients suffering from patellofemoral pain syndrome (PFPS) show diffuse uptake and in what bony compartment of the knee uptake, if any, was localised.
Fifty eight patients with chronic PFPS were examined. All patients underwent a detailed clinical history and a thorough physical examination of the knee. Anterior and lateral static images of both knees were made using a gamma camera 3 h after injection of 550 MBq of (99m)Tc-HMDP. Two experienced radiologists visually evaluated the scans blindly and separately. As 51 patients had bilateral pain, 109 painful knees are included in the results.
Diffuse uptake on bone scintigrams was found in 48 knees in 30 of the patients. In 33 knees the uptake was localised to only one bone compartment, in 10 knees diffuse uptake was found in two of the bones forming the knee joint, and in six knees all three bone compartments (the distal femur, the patella, and the proximal tibia) exhibited diffuse uptake.
Scintigrams of approximately half of the patients with PFPS will show diffuse uptake in one or more of the bony compartments of the knee joint and radioactive tracer accumulation will occur as often in the proximal tibia as in the patella.
髌股关节疼痛性疾病是骨科和运动医学中最常见的病症之一。本研究的目的是确定髌股疼痛综合征（PFPS）患者的骨闪烁扫描是否显示弥漫性摄取，以及如果有摄取，摄取位于膝关节的哪个骨腔室。
对58例慢性PFPS患者进行检查。所有患者均接受了详细的临床病史询问和膝关节的全面体格检查。在注射550MBq的（99m）Tc-HMDP后3小时，使用γ相机对双膝进行前后位和侧位静态图像采集。两名经验丰富的放射科医生分别对扫描结果进行盲法评估。由于51例患者双侧疼痛，结果纳入109个疼痛膝关节。
30例患者的48个膝关节在骨闪烁扫描中发现弥漫性摄取。33个膝关节的摄取仅局限于一个骨腔室，10个膝关节在构成膝关节的两块骨头中的两块出现弥漫性摄取，6个膝关节的所有三个骨腔室（股骨远端、髌骨和胫骨近端）均表现为弥漫性摄取。
约一半的PFPS患者的闪烁扫描将显示膝关节一个或多个骨腔室的弥漫性摄取，放射性示踪剂在胫骨近端和髌骨中的积聚频率相同。
