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Diffusely increased bone scintigraphic uptake in patellofemoral pain syndrome

¹ Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
² Department of Orthopaedics, Hässleholm-Kristianstads Hospitals, Hässleholm, Sweden
³ Näslunds Sjukgymnastik AB, Kristianstad, Sweden
⁴ Department of Rehabilitation Medicine, Karolinska Hospital, Stockholm, Sweden

Correspondence to:
Correspondence to:
Jan E Näslund
Karolinska Institutet, Department of Physiology and Pharmacology, Eldarevagen 5, Kristianstad 29144, Sweden; j.naslund{at}mailbox.calypso.net

Objectives: Painful disorders of the patellofemoral joint are one of the most frequent complaints in orthopaedic and sports medicine. The aims of this study were to determine whether bone scintigrams of patients suffering from patellofemoral pain syndrome (PFPS) show diffuse uptake and in what bony compartment of the knee uptake, if any, was localised.

Methods: Fifty eight patients with chronic PFPS were examined. All patients underwent a detailed clinical history and a thorough physical examination of the knee. Anterior and lateral static images of both knees were made using a gamma camera 3 h after injection of 550 MBq of ^99mTc-HMDP. Two experienced radiologists visually evaluated the scans blindly and separately. As 51 patients had bilateral pain, 109 painful knees are included in the results.

Results: Diffuse uptake on bone scintigrams was found in 48 knees in 30 of the patients. In 33 knees the uptake was localised to only one bone compartment, in 10 knees diffuse uptake was found in two of the bones forming the knee joint, and in six knees all three bone compartments (the distal femur, the patella, and the proximal tibia) exhibited diffuse uptake.

Conclusions: Scintigrams of approximately half of the patients with PFPS will show diffuse uptake in one or more of the bony compartments of the knee joint and radioactive tracer accumulation will occur as often in the proximal tibia as in the patella.

Abbreviations: AKP, anterior knee pain; BMD, bone mineral density; MTSS, medial tibial stress syndrome; PFPS, patellofemoral pain syndrome

Keywords: diffuse uptake; patellofemoral pain; scintigraphy; tibia

This article has been cited by other articles:

				J. Naslund, M. Walden, and L.-G. Lindberg Decreased Pulsatile Blood Flow in the Patella in Patellofemoral Pain Syndrome Am. J. Sports Med., October 1, 2007; 35(10): 1668 - 1673. [Abstract] [Full Text] [PDF]