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Anterior and posterior views of pelvis
Pelvis and right hip plain films (not shown) show no fracture
Full history/Diagnosis is available below
2. Bone scinitigraghy reveals uptake in a linear pattern in the intertrochanteric region.
Early scintigraphic change after a fracture reveals diffusely increased uptake, presumably due to hyperemia. The uptake subsequently becomes more focal. Scintigraphy becomes abnormal sooner in younger patients. Approximately 80% of fractures are scintigraphically abnormal by 24 hours, 95% by 3 days and 98% at 1 week.
The time to scintigraphic resolution is variable, depending on fracture site and degree of damage. At least 5 to 7 months is required for a fracture to scintigraphically normalize. 60 to 80% of uncomplicated fractures will become normal in one year and 90 to 95% in 3 years. Increased uptake may be seen for extended periods in cases of displaced fractures, nonunion, prominant callus / bone mass and posttraumatic arthritis.
Datz, et al. Nuclear Medicine, a Teaching File. 1992.
Laskin, et al. Intertrochanteric fractures of the hip in the elderly, a retrospective study of 236 cases. Clin Ortho and related research. 141: pp 188-195, 1979.
Thrall and Ziessman. Nuclear Medicine, the requisites. Mosby. 1995.
References and General Discussion of Bone Scintigraphy (Anatomic field:Skeletal System, Category:Effect of Trauma)
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