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Journal of the Korean Academy of Rehabilitation Medicine 2007;31(6):735-741.
Clinical Efficacy of Quantitative Bone Scintigraphy in Shoulder Adhesive Capsulitis.
Lee, Yong Taek , Park, Jung Mi , Chung, Seung Hyun
1Department of Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea.
2Department of Nuclear Medicine, Bucheon Hospital, Soonchunhyang University College of Medicine, Korea. jmipark@schbc.ac.kr
3Department of Rehabilitation Medicine, National Cancer Center, Korea.
유착성 견관절낭염에서 정량적 골 신티그라피의 임상적 유용성
이용택, 박정미1, 정승현2
성균관대학교 의과대학 강북삼성병원 재활의학교실, 1순천향대학교 의과대학 부천병원 핵의학과, 2국립암센터 재활의학과
Abstract
Objective
To evaluate the clinical efficacy of the quantitative bone scintigraphy in shoulder adhesive capsulitis (AC).
Method
Twenty-six AC patients and age-matched 18 healthy controls underwent bone scintigraphy. For the quantitative analysis, region of interest (ROI) was drawn over each gleno-humeral joint area, excluding coracoid process, acromion and acromio-clavicular joint. We obtained the uptake ratios of affected side to unaffected side from anterior and posterior image respectively. Additionally, mean uptake ratios were calculated from both anterior and posterior ROI count. Reference values for each uptake ratio were obtained from 18 healthy controls. Clinical stages of the patients were determined according to the history and physical examination including range of motion under sonographically guided intra-articular anesthesia (Hannafin's stage). Quantitative measurements were analyzed according to Hannafin's stage and clinical findings.
Results
Uptake ratios for the patients were significantly higher than the controls (p<0.05). Sensitivities of the anterior image and mean uptake ratio were 81 % and 62% respectively. All 7 patients with abnormal findings in posterior image were stage II. Ninety-four percent in stage I and II showed abnormal mean uptake ratio. Nocturnal pain was associated with increased uptake ratio, particularly mean uptake ratio (p<0.05).
Conclusion
The findings of quantitative bone scintigraphy correlated with the clinical diagnosis, nocturnal pain and Hannafin's stage. Thus, the quantitative bone scintigraphy may be helpful in the diagnosis of shoulder AC. Additionally, mean uptake ratio and posterior image may contribute to clinical staging of AC (i.e. stage I, II and stage II respectively). (J Korean Acad Rehab Med 2007; 31: 735-741)
Key Words: Adhesive capsulitis, Bone scintigraphy, Quantitative, Sonography, Intra-articular anesthesia


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