Bone scintigraphy in children with persistent pain in an extremity, suggesting algoneurodystrophy.

In this retrospective study, the data of bone scintigraphy performed in 21 children suspected of reflex sympathetic dystrophy (RSD) were analyzed. All of them had persistent pain in an extremity or a clinical suspicion of RSD. All children with strong suspicion of RSD showed diffuse hypoactivity at the level of the involved area on bone scintigraphy.

Pediatric nuclear medicine: a practical approach.

This paper is devoted to the practical aspects of pediatric nuclear medicine, particularly the controversy about drug sedation. The authors conclude that drug sedation should be exceptionally used. There is an alternative way, consisting in an adequate approach of the patient: good information to the parents and the child; taking care of the child's environment, starting from the first contacts in the waiting room; specific education of technologists: this includes injections and blood sampling, but also proper handling of the child during the procedure and adequate psychological attitudes toward child and parents.

Paediatric nuclear medicine procedures: routine sedation or management of anxiety?

In our department, examinations of long duration are performed without sedation. It is exceptional that a test has to be postponed because of lack of cooperation by the patient. Good quality images, taking into account the recommended paediatric amounts of radioactivity, are achieved for procedures such as MIBG whole body scanning (10 min frame-1), gastro-oesophageal reflux studies (60 min acquisition), renography and furosemide challenge (45 min) or pinhole views for bone or renal DMSA studies (20-30 min).

Estimation of normal chromium-51 ethylene diamine tetra-acetic acid clearance in children.

In order to estimate the normal range of chromium-51 ethylene diamine tetra-acetic acid (EDTA) clearance in children, we selected a series of 256 patients with past or present urinary tract infection who showed, at the time of the clearance determination, normal technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy and normal left to right DMSA relative uptake. The clearance was calculated by means of either the simplified second exponential method or the 120-min single blood sample; Chantler's correction was used in order to correct for having neglected the first exponential. There was a progressive increase in clearance from the first weeks of life (mean value around 1 month: 55 ml/min/1.

Replacing 99Tcm-DMSA for renal imaging?

We have tried to evaluate the usefulness of an early 99Tcm-MAG3 image, obtained during the second minute after injection of the tracer, in predicting the renal alterations seen on a 99Tcm-DMSA scintigraph, in children clinically suspected of pyelonephritis. It appears that the accuracy of the MAG3 image is population dependent: when, in most of the patients of a study group, DMSA scintigraphy is either normal or very abnormal, the MAG3 image will correctly reflect the DMSA scintigraph. However, when the DMSA alterations are less pronounced, the early MAG3 image will miss the lesions in about 50% of the cases.