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Paul M Weeks - One of the best experts on this subject based on the ideXlab platform.
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the role of Bone Scintigraphy in diagnosing reflex sympathetic dystrophy
Journal of Hand Surgery (European Volume), 1995Co-Authors: Paul M WeeksAbstract:Three-phase Bone Scintigraphy is used often to diagnose reflex sympathetic dystrophy of the hand. This study presents an analysis of the literature relating three-phase Bone scanning to reflex sympathetic dystrophy in the upper extremity. The data show a wide variability in scintigraphic accuracy in patients with clinically obvious reflex sympathetic dystrophy. The results of Bone Scintigraphy correlate best with the clinical diagnosis of reflex sympathetic dystrophy within the first 20–26 weeks of onset. Even then, the sensitivity in the most recent series approximates 50%. After 26 weeks, there is a poor correlation between three-phase Bone scanning and reflex sympathetic dystrophy. Consequently, three-phase Bone Scintigraphy should not be used as a major criterion in diagnosing reflex sympathetic dystrophy. The diagnosis of reflex sympathetic dystrophy remains a clinical diagnosis made by an experienced hand surgeon.
Božidar Djordjević - One of the best experts on this subject based on the ideXlab platform.
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Diagnostic approach to reflex sympathetic dystrophy after fracture : radiography or Bone Scintigraphy ?
European journal of nuclear medicine, 1995Co-Authors: Mila Todorović-tirnanić, Vladimir B. Obradovic, R. Han, Branislav Goldner, Djordje Stanković, Dimitrije Sekulić, Tomislav Lazić, Božidar DjordjevićAbstract:The aim of this paper was to compare the value of Bone Scintigraphy and radiography in the early diagnosis of post-fracture reflex sympathetic dystrophy (RSD). Thirty-seven adult patients with post-fracture RSD (28 in the first and nine in the second clinical stage of RSD), as well as seven patients with fracture but without RSD (control group), were investigated by radiography and Bone Scintigraphy. All of them were immobilized (duration of immobilization: 4–22 weeks). In 21 persons three phase Bone Scintigraphy was performed. The best distinction between the control group and the RSD patients was achieved by delayed Bone scintigrams. The sensitivity (97%), positive predictive value (97%) and accuracy (95%) of delayed Bone Scintigraphy were very high compared to the values for radiography, which were 73%, 90% and 70% respectively. Bone Scintigraphy also displayed higher specificity (86%) and negative predictive value (86%) than radiography (57% and 29% respectively). In the first clinical stage the difference between the accuracy of Bone Scintigraphy (97%) and radiography (63%) was greater than for the whole group. In the second stage of RSD the accuracy of Bone Scintigraphy (86%) and radiography (81%) was similar. Three-phase Bone Scintigraphy is not necessary for the diagnosis of post-fracture RSD: it is sufficient to perform delayed Bone Scintigraphy. It is concluded that Bone Scintigraphy is to be preferred to radiography for the early diagnosis of post-fracture RSD in the first clinical stage. In the second stage the diagnostic capabilities of Bone Scintigraphy and radiography are more comparable.
Şebnem Korur Fincancı - One of the best experts on this subject based on the ideXlab platform.
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The Role of Bone Scintigraphy on Diagnosis of Torture
Journal of Ayurveda and Integrative Medicine, 2016Co-Authors: Ümit Ünüvar, Erenç Yasemin Dokudan, Deniz Yilmaz, Levent Kutlu, Onder Ozkalipci, Şebnem Korur FincancıAbstract:Although international human rights and humanitarian law consistently prohibit torture under any circumstance, torture that is a human crime is practiced all over the world. Torture is one of the most common forms of human rights abuse in countries with a history of military coups such as Turkey. Thousands of people were affected and the whole community from generation to generation has been deeply traumatized. Documentation of medical evidence is a very important step in the prevention of torture. Istanbul Protocol gives international standards for documentation of torture. The challenges to prove of medical evidence of torture in people who were suffered from torture many years ago, and/ or when the radiological methods failed to detect any occult injuries; some advanced methods such as Bone Scintigraphy were tested for diagnostic method. In this study, Human Rights Foundation of Turkeys applicants’ data were evaluated. The aim is to show to value of Bone Scintigraphy as a diagnostic method of torture and the results were discussed with literature. From 1991 to 2012, among of 13477 applicants of to HRFT’s Treatment and Rehabilitation Centers, totally 415 patients’ files that included Bone Scintigraphy scans were enclosed in this study. The patients files were evaluated retrospectively; and sex, age, socioeconomically status, torture methods, time since torture, duration of exposure to torture, physical and Scintigraphy findings were documented. All of the patients reported repetitive and severe beatings and various forms of torture methods. 65 were female (15.7%), 350 were male (84.3%), mean age was 30.98 ±9.67 (range 11-72 year). 232 cases (56% of 415 cases) were Scintigraphy positive and these results were consisted with the literature, and the detectable Bone lesion on Scintigraphy increased significantly with the duration of exposure to torture (7 days and more). Bone Scintigraphy should be considered as a valuable non- invasive diagnostic method to evaluate and document traumatized patients with no detectable marks upon physical examination. Key words: Torture; Bone Scintigraphy; Documentation of Torture; Diagnostic Method; Istanbul Protocol.
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A significant diagnostic method in torture investigation: Bone Scintigraphy
Forensic Science International, 2013Co-Authors: Onder Ozkalipci, Ümit Ünüvar, Umit Sahin, Sukran Irencin, Şebnem Korur FincancıAbstract:Torture appears to be a permanent feature in countries, which have experienced military coups or ruled by oppressive governments in the past, such as Turkey. The Human Rights Foundation of Turkey (HRFT) was established in 1990 to serve torture victims, mainly those who were the victims of the 1980 military regime. Since then the HRFT has been providing rehabilitation and documentation for torture survivors. Bone Scintigraphy can be one of the diagnostic methods to reveal trauma, particularly after several years when it is challenging to find any physical or radiological evidence. The HRFT's Istanbul Branch referred 97 of their applicants for Bone Scintigraphy between 1992 and 2010. In this retrospective survey of 97 cases, 17 of them were female and 80 of them were male. Several aspects were evaluated, including working conditions, change of torture methods practiced in certain time periods, time since torture and duration of exposure to torture in comparison with findings of Bone scintigraphies. The torture methods varied from beating to falanga, electric shock, suspension and several other types of torture within the period of practice, although beating was a common denominator among all. The findings were classified according to time since torture and duration of exposure to torture. More than half of the cases (59%) had a detectable Bone lesion on Bone Scintigraphy, and the detectable Bone lesion on Scintigraphy increased significantly with the duration of exposure to torture, particularly among cases who had been subjected to torture for a longer period (8 days and more). Bone Scintigraphy should be considered as a valuable non-invasive diagnostic method to assess and document long term torture practices and/or cases with no detectable marks upon physical examination.
Alex Maes - One of the best experts on this subject based on the ideXlab platform.
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Bone Scintigraphy in testicular tumors.
Clinical nuclear medicine, 2001Co-Authors: F. J. H. N. Braga, Marcos Abdo Arbex, Jorge Haddad, Alex MaesAbstract:Purpose: Testicular tumors do not occur frequently. Primary treatment is surgical, and radiotherapy and chemotherapy can play important roles in cases of metastatic disease. Bone Scintigraphy is used largely for early detection of skeletal metastases from several tumors, and conventional radiographic studies are less sensitive than the nuclear technique for such a purpose. The aim of this study was to identify the role of Bone Scintigraphy in cases of testicular tumors, regardless of the grade. Materials and Methods: The authors examined 28 patients (8 to 52 years old) with proved testicular tumors using Tc-99m MDP (750 MBq; 20 mCi) injected intravenously. Whole-body images were obtained 2 hours later, at 500,000 counts per image. Radiographic studies were obtained to investigate abnormal areas noted on Scintigraphy. Results: The results of Bone Scintigraphy were abnormal in seven cases, consisting of variable but diffuse uptake in the iliac Bone on the same side as the affected testicle. MDP uptake was substantial in five of these patients (four seminomas, one nonseminoma; only two radiographic studies were abnormal), and the two other patients had moderate uptake of the radiopharmaceutical (two seminomas; radiographic studies were normal). Metastases were confirmed by biopsy in three cases. Discussion: Early metastases from seminomas can occur through the lymphatic drainage toward the iliac lymph node chain. This could explain these findings. The scintigraphic aspects of the affected iliac Bones seem characteristic. Conclusions: Early detection of metastases is very important to ensure the efficacy of radiotherapy and chemotherapy. Bone Scintigraphy may play an important role in such cases and seems to be more sensitive than conventional radiography. Testicular tumor metastases should be considered when iliac involvement is observed. Paget's disease should be included in a differential diagnosis.
Mila Todorović-tirnanić - One of the best experts on this subject based on the ideXlab platform.
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Diagnostic approach to reflex sympathetic dystrophy after fracture : radiography or Bone Scintigraphy ?
European journal of nuclear medicine, 1995Co-Authors: Mila Todorović-tirnanić, Vladimir B. Obradovic, R. Han, Branislav Goldner, Djordje Stanković, Dimitrije Sekulić, Tomislav Lazić, Božidar DjordjevićAbstract:The aim of this paper was to compare the value of Bone Scintigraphy and radiography in the early diagnosis of post-fracture reflex sympathetic dystrophy (RSD). Thirty-seven adult patients with post-fracture RSD (28 in the first and nine in the second clinical stage of RSD), as well as seven patients with fracture but without RSD (control group), were investigated by radiography and Bone Scintigraphy. All of them were immobilized (duration of immobilization: 4–22 weeks). In 21 persons three phase Bone Scintigraphy was performed. The best distinction between the control group and the RSD patients was achieved by delayed Bone scintigrams. The sensitivity (97%), positive predictive value (97%) and accuracy (95%) of delayed Bone Scintigraphy were very high compared to the values for radiography, which were 73%, 90% and 70% respectively. Bone Scintigraphy also displayed higher specificity (86%) and negative predictive value (86%) than radiography (57% and 29% respectively). In the first clinical stage the difference between the accuracy of Bone Scintigraphy (97%) and radiography (63%) was greater than for the whole group. In the second stage of RSD the accuracy of Bone Scintigraphy (86%) and radiography (81%) was similar. Three-phase Bone Scintigraphy is not necessary for the diagnosis of post-fracture RSD: it is sufficient to perform delayed Bone Scintigraphy. It is concluded that Bone Scintigraphy is to be preferred to radiography for the early diagnosis of post-fracture RSD in the first clinical stage. In the second stage the diagnostic capabilities of Bone Scintigraphy and radiography are more comparable.