Sequential Radionuclide Bone Imaging in Avascular Pediatric Hip Conditions

Radionuclide bone imaging was performed on six patients with various hip conditions. Initial bone images revealed diminished uptake of isotope 99mTc-MDP in the capital femoral epiphysis. Following therapeutic intervention, repeat bone scans revealed normal uptake of 99mTc-MDP in the capital femoral epiphysis. Subsequent radiographs revealed that avascular necrosis had not occurred. There are two types of avascularity: the potentially reversible, and the irreversible. Attempts should be made toward early recognition of the potentially reversible avascular insult. With early recognition, surgical reconstruction prior to osteophyte death may result in revascularization. If this can be accomplished, avascular necrosis can be avoided.