Scan pattern of ischemia versus infarction of cold injury

Triple-phase bone scans were obtained immediately after frostbite injury in seven patients; the initial scan patterns indicated salvageable limbs. Four patients in whom tracer uptake was seen on delayed images only (improved on repeat studies 1 week later) recovered without amputation. The flow study in all these patients was abnormal, with both areas of reduced flow and hyperemia indicating ischemia. In another three patients treated by amputation of the involved extremities, there was complete and persistent absence of tracer uptake in the soft tissues and bones of the affected limbs on all images. Delayed bone imaging was more useful in estimating tissue loss