BONE-SCINTIGRAPHY OF THE HANDS IN EARLY-STAGE LUPUS-ERYTHEMATOSUS ANDRHEUMATOID-ARTHRITIS

Objective. To evaluate retrospectively the discriminatory value of bon e scintigraphy, especially spot images of the hands, in differentiatin g early stage systemic lupus erythematosus (SLE) and rheumatoid arthri tis (RA), Methods. Data from 19 patients with SLE (3 men, 16 women) an d 20 patients with RA (6 men, 14 women), presenting with early stage a rticular disease (arbitrarily defined as articular complaints for no l onger than 3 mo), were reviewed, At this stage, radiographs were norma l in all patients. In all 39 patients, total body bone scintigraphy wi th spot images of the hands was performed as part of a complete diagno stic investigation. For differentiation between SLE and RA in early di sease stage, less extensive semiquantitative description in 3 categori es (normal, diffuse mildly increased, and (multi)focal moderately to m arkedly increased tracer accumulation) proved to be sufficient, Locati ons of bone scintigraphic findings were correlated to clinical finding s. Results. In RA, bone scintigraphy revealed fuci of moderate to mark edly increased tracer accumulation, corresponding to the sites of clin ical synovitis in all patients. In 10 patients with SLE, bone scintigr aphy images of the hands were normal, and in 9 patients diffuse mildly increased tracer accumulation was observed. Conclusion. The data sugg est bone scintigraphy may be useful to differentiate SLE from RA in ea rly stage disease.