Evaluation of the Articular Involvement of Behcet's Disease Via Bone Scintigraphy

Han, Eun Chun; Oh, Sang Ho; Bang, Dongsik

Abstract

BACKGROUND
Behcet's disease (BD) is a chronic relapsing inflammatory disease that involves various organ systems. Articular involvement was reported to be present in approximately 50% of Korean BD patients. The joint symptoms of BD patients have usually been described as intermittent, self-limiting and non-erosive, and they are mostly monoarticular and oligoarticular arthritis.
OBJECTIVE
The purpose of our investigations was to evaluate the usefulness of bone scintigraphy for detecting the articular involvement of BD.
METHODS
We reviewed the medical records, laboratory findings and bone scintigraphy findings of 89 patients who were diagnosed with BD from January 2005 to June 2007.
RESULTS
Of the 89 BD patients, 14 patients were male and 75 patients were female with a mean age of 43.92+/-8.49 yr. The most frequently involved site on bone scintigraphy was the wrist (44.9%) with the decreasing order of frequency as follows: the feet (39.3%), the hands (25.8%), the knee (24.7%), the sacroiliac joint (22.4%), the shoulder (18%), the ankle (16.9%), the hip (12.6%), the spine (10%) and the elbow (3%). The pattern of involvement, which was defined as the number of joints showing hot uptake on the bone scintigraphy at one episode of arthropathy, was monoarticular in 5.6%, oligoarticular in 44.9%, polyarticular in 38.2% and there was no uptake in 11.2%. Among 130 joints, 63.1% of the joints showed close correlation between the clinical symptoms and the bone scintigraphy uptake.
CONCLUSION
We suggest that bone scintigraphy can be a useful tool to determine the presence and site of articular involvement. However, more studies are needed to exclude non-specific bone scintigraphy uptake and to determine the correlation between clinical symptoms and the bone scintigraphy findings.