Comparison between Scintigraphy with Polyclonal Immunoglobulin (⁹⁹Tc^m-HIG) and Physical Examination in Polyarthritic Disease

Abstract

⁹⁹Tc^m-Iabelled polyclonal human immunoglobulin ⁹⁹Tc^m-HIG scintigraphy has been suggested as a technique to detect joint inflammation in arthritic disorders. Scintigraphy was performed in fifteen patients with active polyarthritis. All joints except the hips were scored clinically for swelling and pain by a rheumatologist and scintigraphic images were obtained at 30 minutes and four hours after injection of 350MBq ⁹⁹Tc^m-HIG. The images were assessed by a nuclear medicine physician according to a four grade scale. The images were easy to assess. There was a highly significant correlation between swelling and scan score, but no correlation between pain and scan score. The mechanism for the accumulation of activity to inflamed synovial tissue remains unclear. The mean values of the scan score however increased significantly between 30 minutes and 4 hours, indicating an active binding mechanism. The method has a potential as an objective tool in monitoring rheumatic diseases.

Key Words:

• scintigraphy
• human immunoglobulin
• rheumatoid arthritis
• inflammation
• synovitis
• technetium