RESUMEN
The purpose of this study was to evaluate whether intraoperative nidus detection with a hand-held gamma probe was efficient enough for use as a routine procedure. Thirty-seven patients with osteoid-osteomas were submitted to surgical treatment. The first group consisted of 19 patients submitted to open nidus resection using a hand-held gamma probe as guide. The control group consisted of 18 patients operated on by conventional technique. The procedures were classified as successful if nidus resection could be confirmed by histology or postoperative imaging studies. Patients in the gamma group were followed for a mean of 13 months; patients in the control group for a mean of 39 months. In the gamma group, 17/19 procedures were successful; in the control group, only 12/18 procedures were successful. The gamma probe helped to locate the osteoid-osteoma nidus, and the same probe could be used in various hospitals.
Asunto(s)
Neoplasias Óseas/diagnóstico por imagen , Osteoma Osteoide/diagnóstico por imagen , Adolescente , Adulto , Neoplasias Óseas/cirugía , Niño , Preescolar , Femenino , Humanos , Periodo Intraoperatorio , Masculino , Persona de Mediana Edad , Osteoma Osteoide/cirugía , CintigrafíaRESUMEN
Radionuclide imaging (RI) of the osseous and nonosseous structures of the thigh, knee, and leg provide important diagnostic and prognostic information upon which the orthopedic surgeon can base treatment planning and management decisions. 99mTc-MDP scintigraphy is essential in overuse injuries such as stress fractures and shin splints. RI is important in assessing complications of trauma. It is the only imaging modality able to assess the magnitude of physeal stimulus caused by femoral fractures and to predict a favorable or unfavorable outcome of leg length by semiquantitative analysis; SPECT imaging can detect and locate decreased metabolism associated with posttraumatic closure of the physeal plate to predict growth arrest and deformities. Three-phase bone imaging (TPBI) is essential to differentiate hypervascular from avascular nonunions and follow delayed union. In osteonecrosis of the knee, bone scintigraphy precedes radiography changes even in stage l of the disease. 99mTc-MDP and 99mTc-HIG imaging are powerful tools in determining the outcomes of osteoarthritis and rheumatoid arthritis, respectively. Bone scintigraphy can also detect chronic ligament and acute and chronic meniscal lesions. The combined use of TPBI, gallium-67 citrate imaging, and indium-111 or 99mTc-HMPAO labeled leukocytes is important to diagnose and differentiate acute from chronic osteomyelitis, and to detect infected knee prostheses. Thallium-201 chloride imaging and 99mTc-sestamibi imaging have an important role in the assessment of tumor response to chemotherapy and in the quantification of tumor viability.
Asunto(s)
Rodilla/diagnóstico por imagen , Pierna/diagnóstico por imagen , Muslo/diagnóstico por imagen , Enfermedades Óseas/diagnóstico por imagen , Neoplasias Óseas/diagnóstico por imagen , Trastornos de Traumas Acumulados/diagnóstico por imagen , Femenino , Fracturas por Estrés/diagnóstico por imagen , Humanos , Traumatismos de la Rodilla/diagnóstico por imagen , Prótesis de la Rodilla , Traumatismos de la Pierna/diagnóstico por imagen , Masculino , Radiofármacos , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
The authors study 24 patients with the histologic diagnosis of osteoblastoma treated from 1953 to 1996, with a mean follow-up of 33.4 months. Two were considered as a malignant osteoblastoma. Twenty-two cases were operated, and in 2 of these was performed only a selective embolization to pelvic and spine localization. It was discussed clinical and radiographic aspects and the response to treatment. It was obtained 20 good and 4 poor results.