Radionuclide bonescanning infemales withchronic lowbackpain

SUMMARY Sixty female patients withchronic lowbackpainhavebeenstudied clinically, radiographically, andbyradionuclide bonescanning forevidence ofsacroiliac disease. Twenty-four patients hadquantitative sacroiliac scintigraphy (QSS) results suggesting sacroiliitis. Inonly oneof these patients was theradiograph abnormal. Clinical andlaboratory examinations failed toreveal anypossible associated aetiological factors. Six-month follow-up of18patients showedthatsubjective improvement ofpainisassociated with areturn tonormalofQSSresults, oftensecondary to anti-inflammatory medication. Itisconcluded thatsacroiliac disease maybea common causefor chronic lowbackpaininwomen andthat its presence maybemissedifradiographs arerelied upon toconfirm thediagnosis. Itsaetiology remains obscure. Lowbackache isacommoncomplaint inwomen presenting notonlytofamily practitioners butalso togynecologists, orthopedic surgeons, andrheumatologists. Although manydiscrete entities, including sacroiliac disease, canbeidentified asthesource of lowbackpain, alarge groupofpatients exist whose vaguesymptoms, minimal signs, and normal laboratory studies generate suchdiagnoses as mechanical backache, lumbar strain, orpsychogenic rheumatism. Radiographic change canconfirm a diagnosis ofsacroiliac disease, buttheabsence ofchange does notrule outdisease activity inthese joints. Recently, theuseof99mTcstannous pyrophosphate bone scanning andquantitative sacroiliac scintigraphy (QSS) hasbeenadvocated asauseful adjunct to radiography intheassessment ofsacroiliac disease.'-3 Consequently, theproblemof chronic low backache inwomenwasstudied withscanning techniques irn thisrheumatic disease unit.4 This study showed that QSSisauseful meansfordetectingsacroiliac disease whenradiographs arenormal andthatdisorders ofthese joints areacommon cause oflowbackache inwomen. Inthis paper wehaveundertaken toassess possible clinical, laboratory, andradiographic correlates of sacroiliac disease asmeasured byquantitative sacro