Diagnostic evaluation using whole-body technetium bone scan in children with cerebral palsy and pain.

Title

Diagnostic evaluation using whole-body technetium bone scan in children with cerebral palsy and pain.

Creator

Bajelidze G; Belthur MV; Littleton AG; Dabney Kirk W; Miller F

Publisher

Journal Of Pediatric Orthopedics

Date

2008

Subject

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

Description

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

Rights

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).

Type

Journal Article

Citation List Month

Backlog

Pages

112-117

Issue

1

Volume

28

Citation

Bajelidze G; Belthur MV; Littleton AG; Dabney Kirk W; Miller F, “Diagnostic evaluation using whole-body technetium bone scan in children with cerebral palsy and pain.,” Pediatric Palliative Care Library, accessed August 3, 2021, https://pedpalascnetlibrary.omeka.net/items/show/14201.

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