Importance of quantitative 3-phase bone scintigraphy(QTPBS) at complex regional pain syndrome(CRPS) type 1 in lower extremity

Abstract

In this study, we aimed to assess the effect of quantitative 3-phase bone scintigraphy (QTPBS) in patients with musculoskeletal patologies at lower extremity regarding early diagnosis and clinical outcomes. 42 patients having musculoskeletal pathologies at lower extremity who were prediagnosed as complex regional pain syndrome (CRPS) were evaluated. Roentgenograms, SPECT and 3- phase bone scintigraphy were obtained for all patients. Patients who had trauma history to the intact side and patients with microfractures according to SPECT were excluded from the study. The affected limb of patients is compared with patients' intact side. There were no statistical significance for Phase 1 and Phase 2 related areas when we compared the intact side and effected site of the extremity. However, 14 of 16 areas for Phase 3 showed statistical signifance while only two of the areas (P3-PP1 and P3-MPJ) did not show any difference. Specifically, P3-L Tibia related area show strong statistical significance of p=0.0001. Quantitative analysis of 3-phase bone scintigraphy(QTPBS) supports early diagnoses and treatment in CRPS. Beside this, it contributes to eliminate arthritis and metbaolic diseases in differential diagnosis. Among the other existing techniques, QTPBS is the most sensitive and reliable one for now.