Gordon I, Peters A M, Nunn R
Skeletal Radiol. 1987;16(5):383-6. doi: 10.1007/BF00350964.
The principal causes in children of a non-acute painful hip are Perthes disease and synovitis (irritable hip). The 99mTc methylene diphosphonate (MDP) bone scan appearances in Perthes disease are well-known; in synovitis, the hip may show a diffuse increase in activity or may be normal. The significance of bone scintigraphy in the clinical setting of non-acute hip symptoms with normal skeletal radiography has been evaluated in 36 symptomatic children. The mean duration of symptoms prior to scan was 3 months (range 1 week-17 months). On the basis of final diagnosis, established by clinical findings, bone scan, X-ray and follow-up, the children were divided into two groups: synovitis or Perthes disease. Of the 33 scans in the 32 children with synovitis, 18 were normal and 15 showed diffusely increased activity on the painful side. All four patients with Perthes disease had focal femoral head abnormalities in the painful hip. Of the 18 children with normal scans, none went on to develop a skeletal disorder. In children with hip pain of over 1 week's duration, the main value of the bone scan is the early detection of Perthes disease. Diffuse increased activity on the painful side suggests synovitis. A normal scan virtually excludes significant skeletal abnormality.
儿童非急性髋关节疼痛的主要病因是佩特兹病和滑膜炎（髋关节暂时性滑膜炎）。佩特兹病的99mTc亚甲基二膦酸盐（MDP）骨扫描表现是众所周知的；在滑膜炎中，髋关节可能显示放射性活性弥漫性增加，也可能正常。对36例有症状儿童在骨骼X线摄影正常的非急性髋关节症状临床情况下骨闪烁显像的意义进行了评估。扫描前症状的平均持续时间为3个月（范围1周 - 17个月）。根据临床检查结果、骨扫描、X线检查及随访所确立的最终诊断，将这些儿童分为两组：滑膜炎组或佩特兹病组。32例滑膜炎患儿的33次扫描中，18次正常，15次显示患侧放射性活性弥漫性增加。4例佩特兹病患儿患侧髋关节股骨头均有局灶性异常。18例扫描正常的患儿均未发展为骨骼疾病。对于病程超过1周的髋关节疼痛患儿，骨扫描的主要价值在于早期发现佩特兹病。患侧放射性活性弥漫性增加提示滑膜炎。扫描正常实际上可排除明显的骨骼异常。
