Bone Scintigraphy in Early Diagnosis of Perthes' Disease

Abstract

99mTc-pyrophosphate bone scintigraphy was performed in patients with Perthes' disease in the radiological initial stage and within 4 months after the onset of symptoms, and in patients with transient synovitis of the hip joint. In Perthes' disease there was decreased activity in the capital femoral epiphysis. In cases with synovitis a diffusely increased activity was found. A correct diagnosis of Perthes' disease was possible at a time when the radiological findings were minimal or even prior to any radiological findings. Increased activity might have been expected if the aetiology of the disease was an aseptic coxitis, or if the increased radiological density was due to new bone formation. Also in abortive forms of Perthes' disease a decreased activity was found. This indicates that a period of decreased blood flow to the epiphysis is not bound to be followed by the typical radiological course of the disease.