Oron Amir, Arieli Izhar, Pritsch Tamir, Even-Sapir Einat, Halperin Nahum, Agar Gabriel
Department of Hand Surgery, Kaplan Medical Center, Hebrew University, P.O. Box 100, Rehovot, Israel.
Department of Orthopedic Surgery, Kaplan Medical Center, Hebrew University, P.O. Box 100, Rehovot, Israel.
ISRN Orthop. 2013 Jan 22;2013:842852. doi: 10.1155/2013/842852. eCollection 2013.
Chronic knee pain is a common complaint among the elderly and appears in 30%-40% of the population over the age of 65. This study was performed in order to evaluate correlation between clinical presentation of chronic knee pain and the imaging findings of SPECT and planar bone scintigraphy. Methods. We prospectively recruited 116 patients over the age of 50 who had neither knee surgery nor trauma. Patients were divided into symptomatic and asymptomatic groups. All patients were examined by an experienced orthopedic surgeon; on the same day imaging was performed. Statistical analysis was performed to correlate physical examination findings with planar scintigraphy and SPECT findings and blood pool images. Results. In symptomatic patients, planar scintigraphy correlated significantly (P < 0.01) with the presence of excessive joint fluid, synovial condensation, and decrease in range of motion as measured in extension and flexion and patellar grinding test. SPECT findings correlated with all of the above tests as well as with medial and patellofemoral joint tenderness. Conclusions. We believe a finding of tenderness at the medial articular crease or of the patellofemoral compartment of the knee should be considered an indication for the use of SPECT scintigraphy rather than planar scintigraphy.
慢性膝关节疼痛是老年人常见的主诉，在65岁以上人群中发病率为30%-40%。本研究旨在评估慢性膝关节疼痛的临床表现与单光子发射计算机断层扫描（SPECT）及平面骨闪烁显像成像结果之间的相关性。方法：前瞻性招募116例50岁以上、未曾接受过膝关节手术或受过外伤的患者。将患者分为有症状组和无症状组。所有患者均由经验丰富的骨科医生进行检查，并于同日进行成像检查。进行统计分析以关联体格检查结果与平面闪烁显像、SPECT检查结果及血池图像。结果：在有症状的患者中，平面闪烁显像与关节积液过多、滑膜增厚以及屈伸活动范围减小和髌股研磨试验之间存在显著相关性（P < 0.01）。SPECT检查结果与上述所有检查以及内侧和髌股关节压痛均相关。结论：我们认为，膝关节内侧关节皱襞或髌股关节间隙压痛应被视为使用SPECT闪烁显像而非平面闪烁显像的指征。
