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8167239 
Journal Article 
Critical evaluation of isotopic studies in the field of rheumatology. Advantages and limitations of the scintigraphic and scintiphotographic techniques 
Ambanelli, U; Ugolotti, G; Nervetti, A; Troise, W 
1973 
16 
2 
75-93 
Spanish 
The introduction of short lived isotopes, particularly technetium, has led to the wider use of scintillography and scintillophotography in the diagnosis of rheumatic joint conditions. The aim of this study was to evaluate the possibilities of radioisotopic examination in rheumatoid arthritis and to compare, in this respect, the two methods of study, scintillography - which provides static registration - and scintillophotography, which allows the distribution of the isotope to be followed continuously. 70 patients with rheumatoid arthritis in various phases of activity were studied by both methods. As controls, normal joints (preferably the contralateral homonymous joints when unaffected) and various joints with other rheumatic conditions were also examined. In each case the patient was given a preliminary dose of 300 mg of sodium perchlorate by mouth, to prevent selective uptake of the isotope by other organs as far as possible. The joints to be studied were stabilised in standard positions and radiograms were taken. The selected isotope, technetium 90m, was then injected intravenously in a dose of 5-10 mC. The scintillograms were read by dot scan and photoscan; for scintillophotography a gamma camera was used. Results: In all cases of rheumatoid arthritis in the active phase both methods of examination showed an augmented uptake of radioactivity, i.e. the presence of inflammation, in the affected joints. In the wrist and elbow the definition was equally good with both methods. In a large joint (represented in this study by the knee), where the pathological changes may be diffuse or patchy, the corresponding variations of distribution of radioactivity were much more easily appreciable with scintillophotography than with scintillography. The isotopic results usually corresponded closely with the clinical findings, though the former were sometimes positive in clinically negative (quiescent) cases. The authors conclude that in spite of certain limitations (it cannot distinguish between different aetiological types of arthritis and is inapplicable to some joints, e.g. spine and hip), isotopic examination can make a useful contribution to the better understanding of rheumatic articular disease. (Ottley - Hove)