The value of early and late 99mTc-methylene diphosphonate scintigrams of hands in patients with rheumatoid arthritis and other inflammatory rheumatic diseases.

Scintigrams of hands performed immediately after injection of 555 MBq 99mTc-methylene disphosphonate (99mTc-MDP) have been found to be the same and to have the same diagnostic value as those performed with 99mTcO4 both in persons without arthritic changes and in patients with inflammatory rheumatic diseases. Increased accumulation at this point is caused by hypervascularity due to inflammation, bone accretion being still negligible. Additional exposure to radiation from 99mTcO4 scintigraphy can therefore be avoided. The late scintigrams performed 3 h after 99mTc-MDP injection in the same patient can give us additional information on the amount of bone remodeling caused by chronic inflammation. Comparison of early and late scintigrams and the radiographs of hands in the same patient can provide us with better understanding of intensity, duration, and nature of joint changes under observation.