Partial transient osteoporosis of the hand

Objective. To describe the radiographic and scintigraphic findings of parti al transient osteoporosis (PTO) of the hand, To discuss the relationship of PTO and other localized demineralizing diseases. Design and patients. Three patients with PTO that affected two or three dig its of the hand are reported. Two patients were middle-aged women and the t hird was a young man, All presented with a history of trauma to the hand. A ll patients experienced localized burning pain, swelling and vasomotor chan ges including redness of the skin, hyperhidrosis and signs of vasomotor ins tability of the involved fingers. Plain radiography and bone scanning were used in the diagnosis and follow-up of these cases. Results. All patients had a radial distribution of the osteoporosis that in volved adjacent rays. In all patients two rays were involved. The radiograp hic changes manifested as mini mal patchy osteoporosis involving the cortic al, cancellous, subarticular and subperiosteal bone with no articular invol vement. The increased uptake on scintigraphy coincided with the radial dist ribution of the osteoporosis. All patients improved on physical therapy and were symptom-free approximately 6 months after the initial injury. These p atients were followed Lip for more than 2 years. Conclusion. PTO of the hand is an uncommon disease with typical clinical an d radiographic findings. Bone scintigraphy confirms the partial involvement of the hand.