[Value of thallium-technetium scintigraphy in the preoperative localization of parathyroid adenoma. Apropos of 30 cases].
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Biomedical subjects
Publications and source records attributed to R Granier.
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The authors report 5 observations of young adults, 3 teen-agers and 2 children suffering from algodystrophy, and in whom isotopic exploration of the skeleton disclosed a clear bony hypofixation during the entire evolution. These observations confirm their 1981 work concerning a young adult suffering from algodystrophy with isotopic bony hypofixation. Recent Canadian and American studies emphasize also the frequency of isotopic hypofixation in children algodystrophy. It seems, therefore, that isotopic bony hypofixation (linked perhaps to a decreased blood flow), is rather specific of algodystrophy in young subjects.
Bone scintigraphy with technetium 99m pyrophosphates was used to study a series of 74 cases of algodystrophies. Though non-specific, this investigation was the determining factor for confirming the diagnosis in more than 48% of cases, by demonstrating early bone hyperfixation, its topographical characteristics, and the return to normal conditions after 3 to 12 months. Bone hyperfixation has to be exaluated together with clinical, biological, and radiological signs when considering the diagnosis, and though in half the cases it is not indispensable for diagnosis, it is always of value for determining the amount of extension of the algodystrophic process.
The authors describe, on the basis of 7 cases, a special form of decalcifying algodystrophy not described in the literature, characterized by a very localized pain beginning gradually, or more often suddenly. It is of mechanical or mixed type, accompanied by local, pseudo-inflammatory signs being either apparent or discrete, very elective and very sharp pain upon palpation of a very limited area of a condyle or a tibial plate, with hyperfixation located through scintigraphy with technetium 99m polyphosphates, and regressing either spontaneously, or more quickly under treatment, of which thyrocalcitone is the essential part, without undergoing a phase of intense loco-regional demineralization. This form of algodystrophy, that they propose to call partial algodystrophy, can, like the other forms of algodystrophy, appear in monofocal or plurifocal form, either straight off or at a distance from the first incidence, which leads this new radioclinical type to be considered a simple form of algodystrophy of the limbs, midway between the types without radiological anomaly during development and the complete and extensive ones with major radiological signs. Finally, they underline the great value or scintigraphy in diagnosing this form of algodystrophy and algodystrophy without radiologic anomaly.
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