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      Technetium-99-Labelled Methylene Diphosphonate Uptake Scans in Patients with Dialysis Arthropathy

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          Patients on long-term haemodialysis suffer from dialysis arthropathy due to the deposition of dialysis amyloid. We investigated the use of <sup>99</sup>Tc-labelled methylene diphosphonate bone scans in 17 patients as a possible in vivo diagnostic technique. In most clinically affected joints, with the exception of shoulders and hands, there was increased radioisotope uptake consistent with uptake by periarticular bone. In addition, we describe intense soft-tissue uptake around some clinically affected large joints. In contrast, control groups of patients on haemodialysis without arthropathy and patients without renal failure did not have increased uptake. A semi-quantitative scale of uptake was devised, and the following correlations were significant: pain perception and isotope uptake score in the ankles and feet, and the number of radiological lesions and isotope uptake scores in the wrists and knees. The following sites where the radioisotope might bind in the affected joints are proposed: amyloid deposits, areas of soft-tissue calcification, or areas of increased bone turnover. It is concluded that whereas the scanning technique cannot make a definite diagnosis of amyloid and, therefore, cannot be expected to supersede histological diagnosis, it is a useful adjuvant investigation, of particular importance in those patients unable or unwilling to undergo biopsy.

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          Author and article information

          S. Karger AG
          10 December 2008
          : 54
          : 3
          : 202-207
          Departments of aMedicine and bNuclear Medicine, Charing Cross Hospital, and cDepartment of Radiology, West Middlesex Hospital, London, UK
          185855 Nephron 1990;54:202–207
          © 1990 S. Karger AG, Basel

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          Pages: 6
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