[Skeletal scintigraphy as an addition to the roentgenological examination in traumatology (author's transl)]

Abstract

Considering various indications a review was made of 141 scintigraphic examinations for skeletal trauma. It was shown in 122 patients that bone scanning is an important method to help conventional X-ray diagnosis but that it cannot replace it. The alteration of the local metabolic bone processes is reliably indicated; and the limits and possibilities of bone scintigraphy and its use in traumatology are determined. An acute bone fracture can be proven scintigraphically. Errors are possible by the accumulation of 99mTc-activity in the soft tissue or by a negative scan in an early phase. Useful results can also be obtained when the interval from medical evaluation to the time of accident had to be evaluated. There were similarly useful results in the evaluation of fracture healing. Both those groups of cases, however, showed a high percentage of questionable results which brought no further information than the conventional X-ray findings. This is due to the irregular metabolic process at the fracture site and by much scattering in the area. Bone scanning was less informative when loosened metal plates (for osteosynthesis, however, showed a high percentage of questionable results which brought no further information than the conventional X-ray findings. This is due to the irregular metabolic process at the fracture site and by much scattering in the area. Bone scanning was less informative when loosened metal plates (for osteosynthesis, however, showed a high percentage of questionable results which brought no further information than the conventional X-ray findings. This is due to the irregular metabolic process at the fracture site and by much scattering in the area. Bone scanning was less informative when loosened metal plates (for osteosynthesis) or secondary osteomyelitis close to the fracture or the question of a recurrent fracture had to be evaluated. These groups of cases showed a higher portion of questionable results and misinterpretation. Totally, 65.9% correct results of skeletal scintigraphy brought some additional information to the roentgenological examination and were important for the surgeon. However, there were 21.3% questionable results. In 12.8% the interpretation of the bone scan was not correct.