Pretreatment bone scan in SCFE: a predictor of ischemia and avascular necrosis

Sixty-two consecutive patients with 73 slipped capital femoral epiphyses (SCFEs) underwent pretreatment planar technetium bone scan to identify the presence of ischemia of the femoral head. The relationship of pretreatment ischemia and the development of avascular necrosis (AVN) was evaluated after...

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Bibliographic Details
Published inJournal of pediatric orthopaedics Vol. 19; no. 2; p. 164
Main Authors Rhoad, R C, Davidson, R S, Heyman, S, Dormans, J P, Drummond, D S
Format Journal Article
LanguageEnglish
Published United States 01.03.1999
Subjects
Adolescent
Child
Epiphyses, Slipped - complications
Epiphyses, Slipped - diagnostic imaging
Female
Femur - diagnostic imaging
Femur Head - blood supply
Femur Head Necrosis - etiology
Humans
Ischemia - etiology
Male
Predictive Value of Tests
Radionuclide Imaging
Radiopharmaceuticals
Sensitivity and Specificity
Technetium Tc 99m Medronate
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Summary:Sixty-two consecutive patients with 73 slipped capital femoral epiphyses (SCFEs) underwent pretreatment planar technetium bone scan to identify the presence of ischemia of the femoral head. The relationship of pretreatment ischemia and the development of avascular necrosis (AVN) was evaluated after a minimum follow-up of 12 months. All patients were treated with spica casting or pinning across the physis. No forceful manipulation was performed. None of the 63 stable SCFEs demonstrated ischemia by bone scan, and none developed AVN. Of the 10 unstable SCFEs, six demonstrated ischemia by bone scan, and five of the six developed AVN. None of the four unstable SCFEs without ischemia on bone scan developed AVN. Pretreatment bone scan is a sensitive predictor for development of AVN in unstable SCFEs and may provide a method for evaluating interventional treatments for AVN associated with SCFE.
ISSN:0271-6798
DOI:10.1097/01241398-199903000-00006