Bone Scintigraphy in Slipped Capital Femoral Epiphysis

Abstract

99mTc-diphosphonate bone scans were performed on 11 children with slipped capital femoral epiphysis. On pinhole hip images, 7 hips in 7 patients had increased radionuclide uptake in the physis and adjacent proximal femoral metaphysis where the slip had occurred. Three hips in 3 patients had decreased radionuclide uptake in the femoral head on the side of the slipped epiphysis, indicating compromise of the femoral head blood supply. Three or more mo. following internal fixation 3 children had scintigraphy that showed loss of the usual focal uptake in the physis and adjacent proximal femoral metaphysis. Bone scintigraphy in pediatric patients with slipped capital femoral epiphysis is valuable in defining the metabolic status of the femoral head. Absence of radiopharmaceutical uptake in the affected femoral head indicates that the femoral head is at risk for development of radiographic changes associated with aseptic necrosis.