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KMID : 1148920160500040322
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Nuclear Medicine and Molecular Imaging
2016 Volume.50 No. 4 p.322 ~ p.328
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Clinical Meaning of Hot Uptake on Bone Scan in Symptomatic Accessory Navicular Bones
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Chong A-Ri
Ha Jung-Min
Lee Jun-Young
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Abstract
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Introduction: We analyzed clinical factors related to uptake on a Tc-99 m HDP bone scan of the accessory navicular (AN).
Materials and Methods: We retrospectively reviewed patients who had been examined by an orthopedic surgeon and underwent bone scan due to suspected symptomatic AN. A three-point grading system was used to evaluate uptake on bone scan. Relationships between grade, symptoms, age, gender, symptom duration, and bone size were analyzed.
Results: In total, 73 ANs (30 asymptomatic, 43 symptomatic) were enrolled. The majority of asymptomatic ANs had no uptake but some had grade 1 (n?=?8) or 2 (n?=?2) uptake. All asymptomatic ANs with uptake remained asymptomatic during follow-up. For the asymptomatic ANs, larger bones showed a higher grade. With a cut-off value of size ≤6.8 mm, there is no chance of uptake. All symptomatic ANs showed uptake on bone scan. For symptomatic ANs, larger size and shorter pain duration were related to a higher grade. Age, gender, and left-/right-sideness were not related to grade. Multiple regressions revealed that only uptake grade, not size or symptom duration, was the significant risk factor for a symptomatic AN. With a cut-off value of grade <1, a symptomatic AN could be ruled out with a negative predictive value of 100 %.
Conclusion: Bone scanning is useful for symptomatic ANs with a high negative predictive value. Higher grade is related to larger size and shorter pain duration. For asymptomatic ANs, grade was related to size but did not predict symptom development.
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KEYWORD
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Accessory navicular bone, Introduction Emission-computed, Radionuclide imaging, Tomography
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