Pinhole Collimation Of Wrist

The anterior view of the pelvis and the hip in the pediatric and juvenile age groups shows moderate tracer uptake in the acetabular fossa, triradiate growth cartilage, femoral head and neck, and trochanters, and intense uptake in the physeal plates (Fig. 4.24). The ilium, pubis, and ischium are portrayed as independent bones at this age. The ilium is indicated by horizontal "hot" plates and the ischium and pubis by vertical "hot" plates. In younger subjects the hip joint proper is totally free of tracer because the cartilaginous layers over the femoral head and acetabulum are relatively thick and the acetabular fossa is still shallow. Amazingly, pinhole scintigraphy can depict the tracer accumulated in the fovea capitis, to which the femoral capital ligament is attached (Fig. 4.24A). As bones cease to grow, tracer uptake in the fused physeal plates becomes sharply reduced and nearly completely vanishes when bones are fully mature. Thus, in adults, tracer intensely accumulates in the acetabular roof, supraace-tabular bone, and iliac crest, whereas tracer uptake diminishes in the femur. The iliac fossa is shown as a large void. At higher magnification

Mouse Bone Iliac

Fig. 4.24A, B Anterior views of the hip in children. A Higher magnification anterior pinhole scintigraph of the right hip in a 12-year-old boy reveals pronounced tracer uptake in the growth cartilage zone (gc) and slightly increased tracer uptake in the base of the greater trochanter (gt), the acetabular roof (ar), the triradiate cartilage (tc), and in the femoral head. Observe the increased uptake in the fovea where the femoral ligament inserts (arrow). B High magnification anterior pinhole scintigraph of the pelvis in a 9-year-old boy demonstrates intense tracer uptake in the growth cartilages of the ilium (il), pubis (pu), and ischium (is). Characteristically, the ilial cartilage is aligned horizontally (ho) and the pubis and ischial cartilages vertically (ve). Actually, the ischiopubic junction is shown en face as a vertically ovoid structure

Fig. 4.24A, B Anterior views of the hip in children. A Higher magnification anterior pinhole scintigraph of the right hip in a 12-year-old boy reveals pronounced tracer uptake in the growth cartilage zone (gc) and slightly increased tracer uptake in the base of the greater trochanter (gt), the acetabular roof (ar), the triradiate cartilage (tc), and in the femoral head. Observe the increased uptake in the fovea where the femoral ligament inserts (arrow). B High magnification anterior pinhole scintigraph of the pelvis in a 9-year-old boy demonstrates intense tracer uptake in the growth cartilages of the ilium (il), pubis (pu), and ischium (is). Characteristically, the ilial cartilage is aligned horizontally (ho) and the pubis and ischial cartilages vertically (ve). Actually, the ischiopubic junction is shown en face as a vertically ovoid structure

Fig. 4.25A, B Anterior view of the right hemipelvis and hip. A Anterior pinhole scintigraph of the right hemipel-vis and hip reveals increased tracer uptake in the iliac crest (ic), iliac spines (is), arcuate line (al), pecten pubis (pp), ischial body (ib), and acetabular roof. The iliac fossa (if) is demonstrated as a photopenic area. In adults, as opposed to adolescents (Fig. 4.24), tracer accumulates mainly in the acetabular bones, which are involved in articular motion, and is reduced in the remaining bones because of decelerated bone turnover. B Anteroposterior radiograph identifies the arcuate line (al), pecten pubis (pp), ischium (ib), and pubis (pb) as well as the acetabular roof levels, the anterior iliac spines, the arcuate line, the pecten pubis, and the ischial body are clearly visualized (Fig. 4.25). Unlike in younger subjects, the hip joints in adults become poorly defined because tracer uptake in the completely formed femoral head and well-deepened

Scintigraphy Symphysis

Fig. 4.26A, B Anterior view of the pubis. A Anterior pinhole scintigraph of the symphysis pubis reveals intense tracer uptake in the pubic bones about the symphysis and the articular space, which is photopenic. B Anterior pinhole scintigraph of the dorsally inclined pubis shows a drastic change in appearance. The same effect can be created by caudally tilting the long axis of pinhole collimator. Typically, tracer uptake in the pubic bone is uniform

Pubis Bone

Fig. 4.27A, B Anterior view of the elbow. A Anterior pinhole scintigraph of the left elbow reveals increased tracer uptake in the olecranon process (op), medial (me) and lateral epicondyles (le), coronoid process (cp), and head of the radius (rh). B Anteroposterior radiograph identifies the olecranon process (op), medial and lateral epicondyles (me, le), coronoid process (cp) and the head of the radius (rh)

Fig. 4.27A, B Anterior view of the elbow. A Anterior pinhole scintigraph of the left elbow reveals increased tracer uptake in the olecranon process (op), medial (me) and lateral epicondyles (le), coronoid process (cp), and head of the radius (rh). B Anteroposterior radiograph identifies the olecranon process (op), medial and lateral epicondyles (me, le), coronoid process (cp) and the head of the radius (rh)

acetabular fossa overlaps. Tracer uptake in the pubic bones about the symphysis is rather conspicuous, especially in women of childbearing age. The pubic bone uptake gradually decreases with age. Otherwise, there are no sex or age differences in the pubic bone uptake pattern (Chung et al. 1992). Dorsal inclination of the pubic bone or obliquity of the pinhole collima-tor axis may result in a drastic change in appearance (Fig. 4.26). The iliac crests and auricular surfaces are visualized to advantage in the posterior scan.

Wrist Collimination

Fig. 4.28A, B Lateral view of the elb ow. A Lateral pinhole scintigraph of the elbow demonstrates the coronoid fossa (if), head of the radius (rh), epicondyles (e) and olecranon process (op). B Mediolateral radiograph identifies the coronoid fossa (if), head of the radius (rh), epicondyles (e) and the olecranon process (op)

Fig. 4.28A, B Lateral view of the elb ow. A Lateral pinhole scintigraph of the elbow demonstrates the coronoid fossa (if), head of the radius (rh), epicondyles (e) and olecranon process (op). B Mediolateral radiograph identifies the coronoid fossa (if), head of the radius (rh), epicondyles (e) and the olecranon process (op)

Scintigraph

^ Fig. 4.29A-C Dorsal and ventral views of the wrist. A Dorsal pinhole scintigraph of the right wrist demonstrates minimally increased tracer uptake in the distal ends of the radius (r) and ulna (u) and the four proximal carpal bones: the navicular (n), lunate (I), triquetral (t) and pisiform (p). B Ventral pinhole scintigraph shows minimal tracer uptake in the distal radius (r) and ulna (u) and the four distal carpal bones: the hamatum (h), capita-tum (c), and trapezoid and trapezium (tt). The pisiform (p) is also visualized. Note the difference between the findings revealed by the dorsal and ventral views. C Dor-soventral radiograph identifies the distal radius (r) and ulna (u), the navicular (n), lunate (I), triquetral (t), pisiform (p), hamatum (h), capitatum (c) and trapezoid and trapezium (tt)

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Responses

  • abel
    How to do pelvic pinhole?
    4 years ago

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