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Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Combined Tc-99m MDP skeletal imaging and Tc-99m(V) DMSA whole body scans to detect metastases were performed during the follow-up of 30 patients who underwent surgery for breast carcinoma. Eight patients had normal Tc-99m MDP and Tc-99m(V) DMSA scans and were declared free of metastatic disease, further confirmed by no change in symptomatology over a 1-year follow-up period. Twenty-two patients had positive Tc-99m MDP scans with varied skeletal involvement. Tc-99m(V) DMSA scans showed matched areas of increased radiotracer concentration in bony metastases in 20 of these patients. Tc-99m(V) DMSA concentration was not seen in traumatic vertebral collapse or in coexistent osteoarthritic disease in vertebral metastatic involvement. Interestingly, Tc-99m(V) DMSA showed increased concentration in brain and liver metastases. Pentavalent Tc-99m(V) DMSA appears useful for detecting skeletal and soft-tissue metastases in breast carcinoma, and can improve the specificity of Tc-99m MDP bone scans in screening for bone metastases.
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PMID:Tc-99m(V) DMSA imaging. A new approach to studying metastases from breast carcinoma. 131 48

Predictive clinical value of scintigraphical classification of the femoral head in intracapsular fracture of the femoral neck, as classified by Hirano, et al. in 1987, was investigated by long-term follow-up (mean; 4 years and 7 months). Normal healing was achieved in 21 of 24 patients. In those cases, early 99mTc-MDP scintigraphy revealed an over-all increase of radionuclide uptake (Type A) and band-like decrease along the fracture (Type B1). Late segmental collapse of the femoral head was found in 3 patients who showed either a decrease in the weight-bearing area (Type B2) or over-all decrease of radionuclide uptake (Type C). The results of fracture healing were well correlated to each type of scintigraphical classification. The changes of radionuclide uptake in the fracture site were also followed by serial 99mTc-MDP scintigraphy.
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PMID:Scintigraphical observation to predict fracture healing in intracapsular fracture of the femoral neck. 322 87

A 2-year follow-up regarding healing complications, such as redisplacement, nonunion, and segmental collapse of the femoral head, was performed in 306 patients operated on for femoral neck fracture and examined with 99mTechnetium-MDP scintimetry within 2 weeks postoperatively. Scintimetric evaluation was performed by selecting regions of interest over the femoral head on the fracture side and the intact side and by comparing the uptake. A femoral head ratio fractured/intact side thus was obtained. Of 199 patients with an intact femoral head uptake (ratio greater than or equal to 1.0), 181 showed no signs of healing complications at 2 years, whereas 18 had developed healing complications. Of 107 cases with a deficient femoral-head uptake (ratio less than 1.0), 96 had developed healing complications within 2 years from the operation, while 11 cases had no signs of radiographic complications. We conclude that 99mTc-MDP scintimetry performed within 2 weeks from femoral neck fracture can predict the outcome of the healing course with a prognostic accuracy of 91 per cent.
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PMID:Prognostic precision in postoperative 99mTc-MDP scintimetry after femoral neck fracture. 342 76

Nine patients with nondisplaced femoral neck fracture were evaluated with preoperative Tc-MDP-scintimetry, ultrasonography, and measurement of the intracapsular pressure. The intracapsular pressure in straight neutral position of the hip exceeded normal hip pressure in all cases. Patients with an intracapsular pressure greater than 80 mm Hg had a low scintimetric rate, indicating a risk for segmental collapse of the femoral head. Intracapsular tamponade may contribute to the development of segmental collapse in some patients with nondisplaced femoral neck fracture, but further investigations are needed to determine whether evacuation of the hemarthrosis should be recommended.
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PMID:Intracapsular pressure and caput circulation in nondisplaced femoral neck fractures. 355 24

Thirty-nine patients with femoral neck fractures were followed up clinically and radiographically by technetium-99m-methylenediphosphonate (99mTc-MDP) scintimetry two to 20 days and four, eight, 12, 24, and 36 months after surgery or until redisplacement, pseudarthrosis, or segmental collapse occurred. The scintimetric data were calculated by selecting regions of interest on the fractured and intact sides over the femoral head, neck, greater trochanter, and shaft; ratios of fractured/intact side were obtained for each region. Bone metabolism after femoral neck fracture was expressed and analyzed numerically. Prognosis regarding the course of healing could be made with precision by studying femoral head isotope activity shortly after surgery, preferably one to three weeks after operation. Intact femoral head uptake (ratio greater than 1.0) was connected with uneventful healing, while defective uptake (ratio less than 1.0) was observed with healing complications. The vast majority of femoral heads with primary uptake defects showed increased uptake (greater than 1.0) after four months, often as early as six to eight weeks, indicating revascularization. Segmental collapse, as well as redisplacement and pseudarthrosis, appear to be related to femoral head vascular injury. Femoral head uptake in patients in whom healing complications developed secondary to avascularity differed significantly from that in patients with normal healing, except at investigations performed four to eight months after operation. 99mTc-MDP uptake in the femoral neck, trochanter, and shaft areas was increased for all femoral neck fractures. Subsequent normalization was considerably slower in patients with healing complications. A significant difference from normal healing did not occur until 12-24 months after operation. For patients with contralateral hip disease affecting the femoral head ratio, the prognosis regarding complications was made with the aid of the femoral head/shaft ratio on the fracture side.
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PMID:Technetium-99m-methylenediphosphonate scintimetry after femoral neck fracture. A three-year follow-up study. 622 81

Two patients with femoral neck fractures, one displaced and one undisplaced, are presented. Preoperative intravital staining with tetracycline and Tc-MDP scintimetry both showed intact femoral head circulation while Tc-MDP-scintimetry 1 week after operation showed pronounced circulatory deficiency. Sr85-scintimetry performed at the same time was inconclusive. Segmental collapse was observed radiographically, 8 and 12 months postoperatively. The major vascular injury resulting in avascularity most probably occurred during the procedure of osteosynthesis, and Tc-MDP-scintimetry was found suitable for early postoperative recognition of avascular necrosis in both fractures.
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PMID:Avascular necrosis associated with nailing of femoral neck fracture. Two cases examined pre- and postoperatively by tetracycline and radionuclide tracer techniques. 623 Aug 56

In seven patients suffering redisplacement, nonunion or segmental collapse after nailing of femoral neck fractures, subsequent changes in the vitality of the femoral head were studied with tetracycline labeling and 99mTc-MDP scintimetry. At reoperation (total hip arthroplasty), the femoral heads were extracted and sawn into slices which were then analyzed. Vitality before nailing was totally lacking (tetracycline labeling) in one case (nonunion), and in the remaining cases moderate reduction was seen, most pronounced in the apical part of the head. In all cases, scintimetry 1-2 weeks after nailing showed reduced femoral head uptake of 99mTc-MDP, but scintimetry some hours before reoperation showed increased femoral head uptake. Isotope analysis of the slices from the extracted femoral heads showed marked reduction of uptake in the apical part of the head, moderate reduction in the distal and anterior parts, and satisfactory uptake in the posterior part of the head and the foveal region, though with individual variations. It was concluded that there is a genuine increase in uptake (revascularization) later in the course in postoperatively avascular heads, and that the apical part of the femoral head sustains the most pronounced vascular damage in femoral neck fracture and is probably the slowest to revascularize.
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PMID:Femoral head vitality at reoperation for femoral neck fracture complications. 623 5

A scintimetric study using Tc-99m MDP was made of 54 patients with delayed union, nonunion, or late segmental collapse of the femoral head, 4-92 months after femoral neck fracture. In radiographically verified collapse, the radionuclide uptake ratio between the femoral head on the fractured and on the intact side (HHR) was significantly higher than in fractures resulting in delayed union or nonunion. On the basis of scintimetric and radiographic findings, the patients with healing disturbances could be divided into three groups, characterized by the following features: Satisfactory post-reduction position of the fracture without subsequent redisplacement and a high HHR, which as a rule turned out to be delayed union; The same radiographic pattern but with a lower HHR, which in most cases resulted in nonunion; Inadequate reduction or early redisplacement of the fracture with a high HHR, which resulted in nonunion. The fractional precision in discriminating between different types of disturbed fracture healing by means of skeletal scintimetry was 0.86 in this study. This non-invasive and technically simple method would therefore be a valuable complement to radiography in the assessment of healing, more than 4 months after fracture of the femoral neck.
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PMID:Radionuclide scintimetry for diagnosis of complications following femoral neck fracture. 624 Aug 86

A prospective study of the development of necrosis of the femoral head was performed in 34 patients with fractures of the femoral neck. Technetium-99m MDP images of the hip regions were obtained immediately after nailing of the hip and at four, eight and 12 months. There was a good correlation between qualitative and numeric evaluation of isotope uptake in the femoral heads. Comparison of the activity level in the femoral head on the fracture side with that in the contralateral control site showed activity ratios to vary between < 1.0 for those heads showing a general reduction in activity on conventional images to > 1.4 with a mean of 2.0 for those showing increased activity. The initial postoperative images in 2/7 undislocated fractures showed a marked depression in femoral head activity on the fracture side; 13/21 dislocated fractures showed a similar defect suggesting a significant loss of bone remodeling. Normal Tc-99m activity in the femoral head (category 2) was observed in two fracture cases imaged within 24 hours of fracture, just prior to nailing. Repeat studies within one week of fracture and nailing demonstrated a marked depression in activity (category 0). Radiographic evidence of collapse later developed in both patients. The perfusion and blood pool images were useful for identifying femoral heads with deficient circulation. This investigation has demonstrated that the nailing procedure may threaten the vascular condition of the femoral head in hip fracture, that a dead head may be radiographically normal and clinically asymptomatic, and that the metabolic condition of the femoral head may be expressed in numeric terms suitable for statistical analysis.
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PMID:Dynamics of Technetium-99m methylenediphosphonate imaging of the femoral head after hip fracture. 644 42

A follow-up study regarding the occurrence of segmental collapse of femoral head has been done in 53 patients of united femoral neck fracture including a periodic examination by 99mTc-MDP scintimetry. The results showed that the sequential variations in the nuclide uptake ratio of the femoral heads could reflect the histological repairing process and metabolic level in the femoral head. A sustainedly high nuclide uptake in 12 months after operation often denotes that there are defects in the repairing process of the ischemic femoral head, and that the segmental collapse of the femoral head will ensue.
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PMID:[Prediction of segmental collapse of femoral head after femoral neck fracture by scintimetry]. 772 Apr 19


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