Scintigraphic Arthrography Comparison with Contrast Arthrography and Future Applications

The knee joints of 19 patients were examined by both contrast and scintigraphic arthrography. The patients were referred because of complaints secondary to trauma. The arthrograms of nine patients were normal. Other arthrograms showed four patients to have communication with superior tibiofibular joints, three to have intact Baker's cysts, one to have a ruptured Baker's cyst, and one to have a posteromedial capsular tear with leakage in the soft tissues. One patient had recurrence after excision of hypertrophic villonodular synovitis. Five patients with total hip prosthesis and one patient with total knee prosthesis were referred so that loosening of the prosthetic devices could be ruled out. Contrast arthrography was difficult to interpret because it involved imaging of three radiopaque media, namely the bone, the metallic prosthetic device, and the contrast fluid. Radionuclide procedures, on the other hand, were easy to interpret, and depended on the collection of the injected radionuclide between the prosthetic device and the adjacent bones. Scintigraphic arthrography is to date underutilized by the medical community. Although the procedure is simple, safe, and proven to correlate well with contrast arthrography, its indications in detecting capsular tears of synovial membranes and loose prosthetic devices have yet to be further explored.