Document Detail

Diagnostic evaluation using whole-body technetium bone scan in children with cerebral palsy and pain.
MedLine Citation:
PMID:  18157055     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pain in noncommunicative children can be difficult to localize and diagnose. The purpose of this study is to report our experience using a 3-phase whole-body technetium bone scan as a screening tool in identifying the source of persistent pain in children with profound disabilities who cannot communicate. METHODS: We reviewed the medical and imaging records of 45 patients who met the inclusion criteria of the study, which included a diagnosis of spastic quadriplegic cerebral palsy with severe motor and cognitive impairment, persistent pain of more than 1 week in duration with no recognizable source, and a 3-phase whole-body bone scan as part of the pain workup. RESULTS: The study group included 26 females and 19 males with an average age at presentation of 13.5 years (range, 3-20 years). A positive bone scan was seen in 24 patients (53%). The diagnosis and the source of pain were identified in all 24 patients with a positive bone scan, with the bone scan being instrumental in establishing a diagnosis or localization in 22 patients. An orthopaedic diagnosis was not established in the 21 other patients with a negative bone scan. Based on the bone scan results, additional imaging was obtained at the anatomical location indicated. The bone scan was used to establish a diagnosis of fracture in 10 of 24 patients. Other diagnoses included 3 patients with painful internal hardware, 2 with sinusitis, 2 with infections, and 1 with an obstructed kidney. CONCLUSIONS: Whole-body bone scan is a viable imaging option to identify the source of persistent pain in children who are noncommunicative. The bone scan can assist in localizing the source of pain and direct the location for further imaging as needed.
Gela Bajelidze; Mohan V Belthur; Aaron G Littleton; Kirk W Dabney; Freeman Miller
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  28     ISSN:  0271-6798     ISO Abbreviation:  J Pediatr Orthop     Publication Date:    2008 Jan-Feb
Date Detail:
Created Date:  2007-12-24     Completed Date:  2008-03-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  112-7     Citation Subset:  IM    
Department of Orthopaedics, Alfred I duPont Hospital for Children, Nemours Children's Clinic, Wilmington, DE 19899, USA.
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MeSH Terms
Bone and Bones / radionuclide imaging*
Cerebral Palsy / complications,  radionuclide imaging*
Child, Preschool
Diagnosis, Differential
Pain / etiology,  radionuclide imaging*
Pain Measurement
Reproducibility of Results
Retrospective Studies
Severity of Illness Index
Technetium / diagnostic use*
Tomography, Emission-Computed, Single-Photon / methods*
Whole Body Imaging / methods*
Reg. No./Substance:

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