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The Journal of Bone and Joint Surgery 78:473-4 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Jean Francis Maillefert, M.D., Christian Tavernier, M.D., Michel Toubeau, M.D., François Brunotte, M.D., Michael A. Mont, M.D. and David S. Hungerford, M.D.

TO THE EDITOR:

We read with interest "Current Concepts Review. Non-Traumatic Avascular Necrosis of the Femoral Head" (77-A: 459–474, March 1995), by Mont and Hungerford. We agree that bone-scanning is a useful technique for the detection of avascular necrosis of the femoral head. We would like to point out that, with such a technique, a gamma camera equipped with a pinhole collimator, rather than a classic large field-of-view gamma camera, should be used. When a classic large field-of-view gamma camera is used, the photon-deficient defect in the femoral head, which is scintigraphic evidence of avascular necrosis, is often obliterated by the perinecrotic zone of increased scintigraphic activity. Consequently, avascular necrosis cannot be distinguished from other causes of increased activity. The pinhole collimator is a conical collimator with a small circular aperture, . . . [Full Text of this Article]


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