Nucl Med Mol Imaging.  2019 Aug;53(4):278-286. 10.1007/s13139-019-00596-9.

The Correlation Between Tenosynovitis Pattern on Two-Phase Bone Scintigraphy and Clinical Manifestation in Patients with Suspected Rheumatoid Arthritis

• Choi HJ
• Lee SJ
• Kim JY
• Sung YK
• Choi YY

• KMID: 2455523
• DOI: http://doi.org/10.1007/s13139-019-00596-9

Abstract

PURPOSE
To investigate the correlation between the tenosynovitis pattern on two-phase bone scintigraphy (2P-BS) and clinical manifestation in patients with suspected rheumatoid arthritis (RA). METHOD: 2P-BS including technetium-99m-methylene diphosphonate blood pool and bone phase imaging in 402 consecutive patients with clinically suspected RAwere retrospectively reviewed. According to 2010 RA Classification Criteria, patients were grouped as RA and non-RA. Visual assessment of all fingers, toes, wrists, and ankles on 2P-BS was performed. Clinical suspected tenosynovitis was evaluated on physical examination. Rheumatoid factor, anti-cyclic citrullinated protein antibody, C-reactive protein, and estimated sedimentation rate were obtained. Radiographic findings were also used to define early and established arthritis.
RESULTS
Tenosynovitis pattern was detected in 12.7%(51/402 patients) on 2P-BS.A total of 94.1%(48/51) were diagnosed as RA vs. 5.9% (3/51) as non-RA. Of the 48 RA patients with positive 2P-BS finding, 85.4% (41/48) had early arthritis and 14.6% (7/48) had established arthritis. On physical examination, tenosynovitis was suspected in 21.9% (88/402). A total of 56.8% (50/88) belonged to the RA group and 43.2% (38/88) to the non-RA group. The tenosynovitis pattern of 2P-BS and physical examination showed statistical difference and moderate agreement. The positive tenosynovitis pattern on 2P-BS represented up to 26.408 of odds ratio which was highest among the RA-associated factors.
CONCLUSION
Tenosynovitis pattern on 2P-BS was more commonly detected in the RA group and was more frequently associated with early arthritis pattern. Therefore, 2P-BS could give additional information for the detection of subclinical tenosynovitis in early or preclinical RA patients.

Keyword

Tenosynovitis; Bone scintigraphy; MDP; Rheumatoid arthritis

MeSH Terms

Ankle
Arthritis
Arthritis, Rheumatoid*
C-Reactive Protein
Classification
Fingers
Humans
Methods
Odds Ratio
Physical Examination
Radionuclide Imaging*
Retrospective Studies
Rheumatoid Factor
Tenosynovitis*
Toes
Wrist
C-Reactive Protein
Rheumatoid Factor