The Journal of Bone and Joint Surgery, Vol 62, Issue 1 90-96, Copyright © 1980 by Journal of Bone and Joint Surgery, Inc
Distribution of 99mTc-phosphate compounds in osteoarthritic femoral heads
SB Christensen and CC Arnold
In a study of the distribution of 99mTc-polyphosphate and 99mTc-methylene
diphosphonate in osteoarthritic femoral heads by macroautoradiography of
samples obtained during replacement surgery, the bone-seeking agents were
seen to accumulate in the weight-bearing, denuded areas, mainly in the cyst
walls and at the osteochondral junctions in the osteophytes. The
autoradiographic findings were substantiated by findings from
impulse-counting of different zones in the femoral heads that were done on
frozen sections. Morphological studies of sections adjacent to the cut
surface used for autoradiography showed that the accumulations of the
radionuclides were located in areas of new-bone formation, particularly
enchondral ossification. This finding was confirmed by histochemical
staining for alkaline phosphatase, a marker enzyme for bone mineralization.
The over-all distribution of alkaline phosphatase activity in cells roughly
paralleled the deposition of the bone-seeking agents. Clinical Relevance:
Scintigrams of osteoarthritic joints reflect primarily the rate of
osteogenesis in subchondral bone and osteophytes. As the scan is positive
even in very early stages in the development of the disease, a more
detailed knowledge of the mechanism responsible for an increased uptake of
99mTc-phosphate compounds may, among other things, contribute to the
elucidation of the pathogenesis.
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