A comparison of radiography and radioisotope scanning in the detection of Paget's disease and in the assessment of response to human calcitonin

Abstract

In 8 patients with symptomatic Paget''s disease, radiographs and radioisotope bone scans were compared before treatment by high dose synthetic human calcitonin (CIBA 47175-Ba) and 3 mo. and 12 mo. later. In 6 patients quantitative radioisotope scans allowed calculation of relative radioactivity in normal bone, Paget''s disease and bone adjacent to osteoarthritic joints. Comparison of radiographs and scans showed 69 sites diagnosed as Paget''s disease on both examinations; 9 sites showed radiographic changes of Paget''s disease but had negative radioisotope scans, and 2 sites were abnormal on the scan but radiologically normal. One of these 2 reverted towards normal during treatment with calcitonin. Comparison of analog scands done at 3 mo. and 12 mo. with initial scans showed diminished uptake in Paget''s disease compared with normal bone, and quantitation showed this was due to decreased absolute uptake in Paget''s disease and a slight increase in normal bone. Osteoarthritic bone showed no significant response to calcitonin.