THE ROLE OF BONE-SCINTIGRAPHY WITH PINHOLE COLLIMATION IN THE EVALUATION OF SYMPTOMATIC PEDIATRIC HIPS

Sixty-two children with signs and symptoms of hip pathology underwent bone scintigraphy with pinhole collimation of the hip joints. Three di stinct patterns of isotope uptake were observed: a normal uptake of is otope, a focal increase or decrease of isotope uptake and a mild diffu se increase of isotope uptake. Forty-four children had normal isotope scans, an average hospital stay of 6.8 days and no significant patholo gy on follow-up. Ten children had a focal increase or decrease of isot ope uptake, an average hospital stay of 21 days and on follow-up all h ad significant pathology. Eight children had a mild diffuse increase o f isotope uptake, an average hospital stay of 8.75 days and no signifi cant pathology on follow-up. We conclude: (1) Normal isotope hip scint igrams with pinhole collimation indicate an excellent prognosis in sym ptomatic;mptomatic paediatric hips; (2) Focal scintigraphic abnormalit ies are indicative of significant pathology; (3) A mild diffuse increa se in isotope uptake on both sides of the joint is not associated with significant pathology; (4) There is a good correlation between scinti grams and the length of hospital stay; (5) Scintigraphy is at least tw ice,vice as sensitive at the time of presentation as plain radiographs in the detection of pathology.