ORTHOPHEADICS, Lima MCL

Abstracts XIX Brazilian Congress of Nuclear Medicine

8. ORTHOPHEADICS

8.1 - THE UTILITY OF SCINTIGRAPHY IN THE DIAGNOSIS OF REPETITIVE STRAIN INJURIES OF THE UPPER EXTREMITIES.

Lima MCL; Etchebehere ECSC; Oliveira JI; Maules F; Ramos CD; Camargo EE. Division of Nuclear Medicine, Department of Radiology and Department of Internal Medicine, Campinas State University ( UNICAMP), Campinas, Brazil

elba@mn-d.com

Repetitive strain injuries (RSI) are characterized by lesions to the soft tissue after strainful work. RSI require rapid diagnosis and treatment since it may lead to temporary or permanent functional impairment. Diagnosis is based mainly on clinical complaints, physical examination and radiographs. The purpose of this study was to verify the utility of bone, [Tc-99m] sestamibi and gallium-67 scintigraphies in the diagnosis of RSI. Five patients (pts) (4 male, 1 female), mean age 38.8 years with an 8 hour daily work schedule, mean service time of 116.8 months and different jobs, were studied. RSI was graded I – IV, based on clinical findings and complemented by ultra-sound (US) and x-rays. Pts were then submitted to three-phase bone scan (TPBS) with [Tc-99m] MDP and to [Tc–99m] sestamibi (SS) and gallium-67 (GS) scintigraphies, with a maximum time interval of 2 months between all three studies. Findings were graded as mild, moderate and severe. TPBS was normal in 2 pts and revealed mild uptake in the shoulder of the other 3 pts. SS revealed mild uptake in the shoulder of 1 pt. GS demonstrated mild uptake in 3 pts (2 in the right shoulder and 1 on both shoulders) and moderate in 2 (1 on both shoulders and the other in the superior third of the right arm). X-rays were normal in all pts and US was abnormal in the right shoulder of 2 pts. TPBS and SS were not effective in the early diagnosis of RSI, detecting changes only in grade IV lesions. GS was abnormal in the earlier stages of the disease, but the abnormalities and grades were not always in agreement (one grade II pt showed greater uptake than a grade III pt). Scintigraphies were useful only in the advanced stages of RSI.