Yoga & Fitness

Bone Scintigraphy: Expert Explains Its Usage In Treating Joint Injury

We may encounter diverse bone and joint injuries specific to athletes, ranging from stress fractures and inflammation to infections & traumas. Undoubtedly, early diagnosis and treatment are pivotal for treating all types of sports injuries. When there is timely identification of the condition, precise therapeutic measures can be performed, which mitigates complications and accelerates the athletes’ healing process. 

What are sports injuries?

“These are defined as injuries mainly caused by overuse, direct impact, or the application of force much greater than the human body can structurally endure. There are two kinds of sports injuries, acute and chronic,” said Dr Sanesh Vijay Tuteja, Consultant Orthopaedics, Fortis Mulund. 

“When an injury occurs suddenly, like a sprained ankle caused by a clumsy landing, it is known as an acute injury. On the other hand, chronic injuries are caused by repeated overuse of muscle groups or joints. In either case, a thorough medical examination is required to prevent long-term damage or complications,” he added. 

What is Bone Scintigraphy? 

As per Dr Tuteja, bone Scintigraphy, though less known, is a valuable diagnostic tool for assessing bone and joint injuries in athletes. This technique employs a radiopharmaceutical called Technetium coupled with Methylene Diphosphonate to obtain precise images depicting the metabolic activity of the skeletal system.

What is the role of Bone Scintigraphy in treating injuries?

Bone Scintigraphy excels in its sensitivity for detecting metabolically active bone lesions like tumours, infections, inflammation, and certain traumatic and ischemic conditions. Its unique ability to capture the physiological aspects of bone health sets it apart from other imaging modalities. However, it does have limitations owing to its lack of specificity. The specificity of a clinical test tells us how well it can correctly identify people without a particular medical condition, with high specificity meaning fewer false alarms for healthy individuals.

Enhancing treatment strategies

To fully grasp the advantages of Bone Scintigraphy, one must comprehend its underlying physiology. After the radiopharmaceutical injection, the imaging process involves three phases: perfusion, blood pool, and skeletal phases. These phases provide insights into the temporal aspects of the injury, distinguishing acute from chronic bone conditions and aiding in tailored treatment approaches.

Applications of Bone Scintigraphy

Bone Scintigraphy proves invaluable in assessing stress lesions, particularly stress fractures, which are a prevalent issue among athletes. While traditional X-rays may fail to detect these fractures in their early stages, Bone Scintigraphy’s heightened sensitivity can reveal altered bone metabolism, allowing for earlier intervention.

Tibial stress lesions

Tibial stress lesions, commonly known as ‘shin splints’, frequently trouble athletes. Bone Scintigraphy assists in grading the severity of these lesions and, importantly, excels in detecting early-stage inflammation, often surpassing MRI in sensitivity.

High-risk stress fractures

Like the tibia, there are certain other bones in the body that are at high risk of getting a stress fracture. Some examples include fractures of the hip (femoral neck), foot (5th toe and talus). Bone Scintigraphy helps to diagnose them; however, is limited by a lack of specificity and another investigation modality namely, Single-Photon Emission Computed Tomography (SPECT) is sometimes used to improve diagnostic accuracy. 

Bone Scintigraphy is a valuable tool in the orthopaedic surgeon’s armamentarium for diagnosing and managing bone and joint sports injuries. While it may not be the first choice in all situations, its unique ability to assess bone metabolism and provide early insights into injury progression makes it a valuable adjunct to traditional imaging techniques. 

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