Estudios isotópicos en patología reumatológica. Patrones gammagráficos característicos

Nuclear medicine plays a major role in the diagnosis of osteoarticular diseases and especially in rheumatic disease, in which bone scintigraphy is the most widely used technique due to its high sensitivity and ability to identify alterations early, before changes become apparent in conventional radiology or magnetic resonance imaging. There are several characteristic scintigraphic patterns that are diagnostic in rheumatologic diseases, such as the bullhead sign in SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) or the V or pencil end images in Paget's disease, among others. However, there are other conventional nuclear medicine techniques that also show typical patterns such as the panda or lambda signs in the study of sarcoidosis with gallium scintigraphy. Although classical nuclear medicine has been the most extensively used technique in this type of pathology, the development of new techniques such as PET, hybrid equipment such as SPECT-CT and the use of anatomical and functional image fusion are demonstrating their utility in benign and malignant tumoral bone disease, degenerative joint disease, infections and even in the study of large vessel vasculitis.