Different modalities for evaluation of whole-body in diagnos
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This study aimed to investigate the ability of whole-body bone scintigraphy (WB-BS) in the detection of multifocal osteonecrosis (ON) compared to whole-body magnetic resonance imaging (WB-MRI) and to clarify the characteristics of patients with multifocal ON among those with ON of the femoral head (ONFH) using WB-MRI.

46 patients who had symptomatic ONFH were included in the study. Data on patient demographics, including age, sex, body mass index (BMI), history of corticosteroid intake, alcohol abuse, smoking, and symptomatic joints, were collected from their medical records. All patients underwent WB-MRI and WB-BS before surgery.

Results:
--The agreement in the detection of ON by WB-MRI vs the uptake lesions by WB-BS in the hip joints was moderate, while that in other joints was low.

--Among the 152 joints with ON detected by WB-MRI, 92 joints were symptomatic, and 60 joints were asymptomatic.

--12 out of the 46 patients had multifocal (three or more distinct anatomical sites) ON.

--Nonetheless, while WB-BS detected symptomatic ON detected by WB-MRI as uptake lesions in 82.6% of the joints, asymptomatic ON detected by WB-MRI was detected as uptake lesions in 21.7% of the joints.

--All patients with multifocal ON had a history of steroid therapy, which was significantly higher than that in patients with oligofocal ON.

--The patients with a hematologic disease had multifocal ON at a higher rate.

Finally, asymptomatic Osteonecrosis detected by WB-MRI could be more difficult for WB-BS to detect than symptomatic Osteonecrosis. WB-MRI may be useful for evaluating multifocal ON, given the cost, examination time, and radiation exposure.

Source: https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-021-02473-3
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