The effect of intermittent pneumatic compression on the bone uptake of (99m)Tc-labelled methylene diphosphonate in the lower limb

Venous compression of the lower limbs will obstruct outflow through the deep and superficial veins, yet inflow will continue, without continual swelling of the limb. It is hypothesised that venous channels in the long bones act as collateral channels to restore outflow, and therefore general blood f...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2005-06, Vol.125 (5), p.348-354
Main Authors: Morris, R J, Elsaid, M, Elgazzar, A H, Zaid, T M, Evans, W D, Woodcock, J P
Format: Article
Language:English
Subjects:
Adult
Bandages
Female
Femur - blood supply
Femur - diagnostic imaging
Femur - drug effects
Humans
Lower Extremity
Male
Pressure
Radionuclide Imaging
Radiopharmaceuticals - pharmacokinetics
Regional Blood Flow - physiology
Technetium Tc 99m Medronate - pharmacokinetics
Tibia - blood supply
Tibia - diagnostic imaging
Tibia - drug effects
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Summary:Venous compression of the lower limbs will obstruct outflow through the deep and superficial veins, yet inflow will continue, without continual swelling of the limb. It is hypothesised that venous channels in the long bones act as collateral channels to restore outflow, and therefore general blood flow through bone will increase. Such a hemodynamic change should affect the uptake of radiopharmaceuticals by the bone, though uptake changes in themselves would not definitely indicate flow changes. The purpose of this study, therefore, was to determine whether bone uptake in the lower limb is affected by intermittent venous compression, irrespective of the mechanism involved. The effect of intermittent pneumatic compression of the thigh and calf on the uptake of (99m)Tc-methylene diphosphonate (MDP) was studied in 24 patients. All were undergoing routine bone imaging for medical conditions that were not focused on their lower limbs, and received 1 h of the therapy at 60 mmHg on one limb only, after injection of the radiopharmaceutical. Three hours after injection the relative difference in uptake (net counts per pixel) between the two limbs was calculated. The standard imaging protocol was otherwise unchanged. The median differences in uptake in the intermittently compressed limb compared with the contralateral limb were +7.6% (interquartile range +3.9% to +16.0%, p
ISSN:0936-8051
DOI:10.1007/s00402-005-0811-9