Balblanc J C, Mathieu P, Mathieu L, Tron A M, Conrozier T, Piperno M, Tournadre P, Vignon E
Claude Bernard University, Edouard Herriot Hospital, Lyon, France.
Osteoarthritis Cartilage. 1995 Sep;3(3):181-6. doi: 10.1016/s1063-4584(05)80052-4.
Hand radiographs and scintigraphy were obtained initially and at the 4-year follow-up in 15 patients with symptomatic osteoarthritis (OA) of distal and/or proximal interphalangeal joints. For each joint, a 0-15 score was obtained for the OA radiographic lesions read blind by the same observer. An abnormal isotope retention over a bone reference area was assessed and quantified. The predictive value of scintigraphy for the OA radiographic progression was confirmed and shown to be improved by a second investigation. During the study period, the percentage of radiographic OA joints increased from 66.3 to 76.6%, but joints showing an abnormal scan decreased from 40 to 22.5%. Progression of the OA radiographic score was closely related to scintigraphic changes. The mean difference between the final and initial OA score was -0.08 in joints with two normal scans (N = 115), +0.73 in joints showing a first abnormal and a second normal scan (N = 94) and +1.8 in joints with two abnormal scans (N = 14) or a scan becoming abnormal (N = 47). An abnormal scan appears to represent a transient event, and this event is associated with a period of progression of digital OA. Potentially, anti-OA therapies that suppress joint isotope retention might slow down OA progression. The magnitude of joint isotope retention was positively correlated with the OA radiographic score established at the same time (R = 0.61 and P < 0.001), but showed no predictive value for progression of the latter.
对15例有远端和/或近端指间关节症状性骨关节炎（OA）的患者，最初及在4年随访时拍摄了手部X线片并进行了闪烁扫描。对于每个关节，由同一名观察者在不知情的情况下读取OA的X线病变，获得0至15分的评分。评估并量化了骨参考区域上的异常同位素滞留情况。闪烁扫描对OA X线进展的预测价值得到证实，并且二次检查显示其预测价值有所提高。在研究期间，X线显示OA的关节百分比从66.3%增至76.6%，但扫描显示异常的关节从40%降至22.5%。OA X线评分的进展与闪烁扫描变化密切相关。两次扫描均正常的关节（N = 115），最终与初始OA评分的平均差值为-0.08；首次扫描异常而第二次扫描正常的关节（N = 94），平均差值为+0.73；两次扫描均异常的关节（N = 14）或扫描变为异常的关节（N = 47），平均差值为+1.8。异常扫描似乎代表一个短暂事件，且该事件与手指OA的进展期相关。潜在地，抑制关节同位素滞留的抗OA疗法可能会减缓OA进展。关节同位素滞留的程度与同时确定的OA X线评分呈正相关（R = 0.61，P < 0.001），但对后者的进展无预测价值。
