Assessment of the clinical significance of asymptomatic lower extremity uptake abnormality in young athletes

This study was undertaken to evaluate our hypothesis that most asymptomatic lower extremity uptake abnormalities are of no clinical consequence and to assess whether these findings should affect patient care. Methods: One hun dred consecutive young athletes referred for bone scintigraphy by a sports medicine clinic because of low back pain were evaluated for the presence of asymptomatic bone scan abnormalities in the lower extremities. The patient s were then reexamined by the referring sports medicine physician, who had full knowledge of the bone scan results. Scintigraphic findings were correl ated with the clinical evaluation at the time of scintigraphy and on follow -up evaluations ranging from 8 to 14 mo later. Results: Asymptomatic lower extremity abnormalities were present in 34% of patients. There were abnorma lities of the feet in 30 patients (focal uptake in 26 patients, diffuse upt ake in 10 patients), the tibia in 13 patients (2 focal uptake, 11 diffuse u ptake), and the femur in 2 patients (both with diffuse uptake). None of the regions of abnormal lower extremity uptake was symptomatic at the time of initial evaluation, There was no change in the clinical management of any p atient because of the scan findings. None of the patients was advised to re strict the activity level because of the asymptomatic scan findings. None o f the regions of scan abnormality became symptomatic on follow-up evaluatio n. Conclusion: This study shows that asymptomatic bone scintigraphic abnorm alities of the feet, as well as diffuse abnormalities of the tibia, are com mon in young athletes. These findings are most likely of no clinical conseq uence and do not require a change in the activity level. Focal abnormalitie s of the femur or tibia are not commonly seen in asymptomatic young athlete s.