SAN FRANCISCO — Traditional radiographic assessment of osteoarthritis in the medial compartment of the knee should be combined with scintigraphic data for the most accurate evaluation, according to a poster presentation at the annual meeting of the American Academy of Orthopaedic Surgeons.
By providing information on the metabolic activity of bone, scintigraphy enables degenerative changes in the knee to be detected early, before joint disease shows up in x-rays, said Dr. Scott F. Dye of the orthopedic surgery department at the University of California, San Francisco.
An anterior-posterior technetium bone scan provides a window into the metabolic activity of living bone, according to Dr. Dye and his associates. Knees can be metabolically worse or better than the x-ray results suggest. Combining the structural (x-ray) and metabolic (scintigraphy) studies provides a better assessment of the status of the knee and response to therapies.
The earliest stages of medial compartment osteoarthritis of the knee often are secondary to meniscal tears, and 80% of patients with medial meniscus tears will show loss of osseous homeostasis on scintigraphy despite normal x-ray results. This allows for identification of joints at risk of degenerative disease “at a time when the process can be fully reversed,” said Dr. Dye, who has no association with companies that make scintigraphic equipment.