Bone scan as a screening tool in children and adolescents with back pain
Child; Female; Humans; Male; Magnetic Resonance Imaging; adolescent; Preschool; PedPal Lit; infant; retrospective studies; Bone and Bones/radionuclide imaging; Back Pain/etiology/radionuclide imaging; Bone Neoplasms/complications/epidemiology/radionuclide imaging; Radiopharmaceuticals/diagnostic use; Spondylolysis/complications/epidemiology/radionuclide imaging; Technetium/diagnostic use
Retrospective review of 142 patients from 2 teaching hospitals, investigated for persistent backache. The inclusion criteria were to be up to 18 years, to have no known associated diseases, and to have had a bone scan as a part of their work up. Other tests were also used to reach the final diagnosis. The utility of the bone scan to detect underlying pathology was assessed. On the whole, 75 patients were found to have pathology while only 52 children had a positive bone scan. We also looked for associated findings that could indicate the presence of pathology. The age of the patients, the duration of symptoms, and the presence of night pain seemed to be irrelevant on predicting underlying pathology. The sensitivity of the bone scan was low, 0.613 (95% CI: 0.549-0.654), although it proved to be highly specific, 0.91 (95% CI: 0.83-0.95). A careful analysis of the data and the different diagnosis suggests that Technetium bone scan still holds a place in the study of these patients; however, there is a big concern by the fact that some primary malignancies went undetected on the scan.
2006
Sanpera I; Beguiristain-Gurpide JL
Journal of Pediatric Orthopaedics
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
Diagnostic evaluation using whole-body technetium bone scan in children with cerebral palsy and pain.
Child; Female; Humans; Male; Pain Measurement; Adult; Severity of Illness Index; Reproducibility of Results; adolescent; Preschool; retrospective studies; Emission-Computed; Tomography; Diagnosis; Differential; Bone and Bones/radionuclide imaging; Cerebral Palsy/complications/radionuclide imaging; Pain/etiology/radionuclide imaging; Single-Photon/methods; Technetium/diagnostic use; Whole Body Imaging/methods
BACKGROUND: Pain in noncommunicative children can be difficult to localize and diagnose. The purpose of this study is to report our experience using a 3-phase whole-body technetium bone scan as a screening tool in identifying the source of persistent pain in children with profound disabilities who cannot communicate. METHODS: We reviewed the medical and imaging records of 45 patients who met the inclusion criteria of the study, which included a diagnosis of spastic quadriplegic cerebral palsy with severe motor and cognitive impairment, persistent pain of more than 1 week in duration with no recognizable source, and a 3-phase whole-body bone scan as part of the pain workup. RESULTS: The study group included 26 females and 19 males with an average age at presentation of 13.5 years (range, 3-20 years). A positive bone scan was seen in 24 patients (53%). The diagnosis and the source of pain were identified in all 24 patients with a positive bone scan, with the bone scan being instrumental in establishing a diagnosis or localization in 22 patients. An orthopaedic diagnosis was not established in the 21 other patients with a negative bone scan. Based on the bone scan results, additional imaging was obtained at the anatomical location indicated. The bone scan was used to establish a diagnosis of fracture in 10 of 24 patients. Other diagnoses included 3 patients with painful internal hardware, 2 with sinusitis, 2 with infections, and 1 with an obstructed kidney. CONCLUSIONS: Whole-body bone scan is a viable imaging option to identify the source of persistent pain in children who are noncommunicative. The bone scan can assist in localizing the source of pain and direct the location for further imaging as needed.
2008-02
Bajelidze G; Belthur MV; Littleton AG; Dabney Kirk W; Miller F
Journal Of Pediatric Orthopedics
2008
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1097/BPO.0b013e3181558bc1" target="_blank" rel="noreferrer">10.1097/BPO.0b013e3181558bc1</a>