Technetium-99m human polyclonal immunoglobulin G studies and conventional bone scans to detect active joint inflammation in chronic rheumatoid arthritis

✍ Scribed by Lluis Berná; Gustavo Torres; César Diez; Montserrat Estorch; David Martínez-Duncker; Ignasi Carrió

• Publisher: Springer
• Year: 1992
• Tongue: English
• Weight: 683 KB
• Volume: 19
• Category: Article
• ISSN: 0340-6997
• DOI: 10.1007/bf00173277

✦ Synopsis

Rheumatoid arthritis is a chronic polyarthritis in which active inflammed joints coexist with joints in remission. We performed bone scans (99mTc-DPD) and 99mTc human polyclonal immunoglobulin G scans (99mTc-IgG) in 18 patients with rheumatoid arthritis to assess the uptake in actively inflamed joints and in joints in which remission after inflammation had occurred. A quantitative analysis of tracer uptake in each joint was performed on both scans. In 123 joints without current active inflammation, an increased 99mTc-DPD uptake was observed (2.31 ± 1.27), whereas no 99mTc-IgG uptake was noted (1.18 ± 0.32). Some 78 joints with mild pain or swelling exhibited increased 99mTc-DPD uptake (2.48 _+ 1.14) and increased 99mTc-IgG uptake (1.76 ± 0.50; P <0.001), while 21 joints with moderate to severe pain or swelling exhibited increased 99mTc-DPD uptake (2.39 _+ 0.93) and increased 99mTc-IgG uptake (1.79 ± 0.51; P <0.001). In conclusion, 99mTc-IgG scans distinguish between joints with and without active inflammation in chronic rheumatoid arthritis, whereas bone scans do not. Thus, 99mTc-IgG scans may be useful in identifying joints with current active inflammation in rheumatoid arthritis.