99mTechnetium pyrophosphate scintigraphy in the detection of skeletal muscle disease |
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Authors: | U. A. Walker K. Garve I. Brink N. Miehle H. H. Peter T. Kelly |
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Affiliation: | (1) Department of Rheumatology and Clinical Immunology, Albert-Ludwigs University Medical School, Hugstetterstr. 55, 79106 Freiburg, Germany;(2) Nuclear Medicine, Albert-Ludwigs University Medical School, Freiburg, Germany |
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Abstract: | We aimed to assess the specificity and sensitivity of 99mtechnetium pyrophosphate muscle scintigraphy in the diagnostic workup of patients with suspected myopathy. We reviewed the charts of 166 patients; 52% of the subjects had myalgias, 36% had muscle weakness, 45% had an elevated serum creatine kinase (CK), and 49% had an increased C reactive protein (CRP). Scintigraphy was positive in 34 patients (20%). The test was more sensitive in the presence of muscle weakness, elevated CK, or increased CRP. The presence of myalgias did not influence the odds. Sensitivity was 60% in patients with the final diagnosis of polymyositis, dermatomyositis, or inclusion body myositis, and 70% in noninflammatory myopathies. Eight percent had false positive scintigrams. In individuals with biopsy-proven myopathy (51 subjects), the diagnostic sensitivity was 43%, and its specificity was 60%. Low positive and high negative likelihood ratios (5.0 and 0.65, respectively) document an only limited diagnostic efficiency of 99mTc-PYP scintigraphy in the evaluation of inflammatory and noninflammatory myopathies and suggest that the test is not helpful in the routine diagnostic workup of muscle complaints, even after a priori selection of patients for CK plus CRP abnormalities. |
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Keywords: | Myopathy Myositis Radionuclide imaging Skeletal muscle 99mTechnetium pyrophosphate |
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