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Radionuclide imaging in internal derangements of the knee

Division of Orthopaedics, Medical College of Pennsylvania, Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania

John Gregg, MD

Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania

Jerome Jacobstein

Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania

The clinical specificity and sensitivity of imaging with ^99mTC was evaluated prospectively in 104 consecutive patients admitted to the hospital for diagnostic/surgical arthroscopy. Four distinct patterns of radionuclide ac tivity were seen that correlated with observed arthros copic findings. These patterns of activity were seen with 1 ) degenerative joint disease (DJD) or severe ro tational instability, 2) meniscal pathology, 3) fracture of the subchondral plate or full thickness cartilaginous ulceration, and 4) synovitis. Radionuclide imaging was seen to be extremely sensitive and highly specific for all four patterns of activity.

The observed association of subchondral plate injury with meniscal pathology may present an explanation for the observed poor outcome in a limited number of patients following meniscectomy.

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