Hand images: normal and abnormal

Supplemental hand scintigrams with abnormal features were obtained from 29% of patients (134 of 463) who were referred for routine, minified bone imaging with /sup 99m/Tc-Sn-polyphosphate. A wide spectrum of normal activity distribution ranging from well-defined to ''wash-out'' images is described in 329 cases (71%). In the abnormal images of the joints and individual bones, the changes, although not always characteristic of some particular disease, may often suggest a diagnosis and/or its pathophysiologic status. The joints with heavy uptake correlate well with the presence of active clinical findings, e.g., in the arthritides. The bone features associated with metabolic disease, especially when full-blown, may be fairly characteristic. A potential application is in the assessment of digital circulation, particularly in obliterative vascular diseases such as scleroderma, Buerger's disease, chronic neuropathies, and possibly other collagen or vascular diseases that involve the hands. Interesting images, probably of somewhat limited usefulness, are observed in some congenital anomalies, fractures, camptodactyly, contracture deformities, unilateral lymphedema after mastectomy, etc