Institutional members access full text with Ovid®

Share this article on:

Use of radioisotope bone scans in children with obscure foot pain

Hazany, Salar J.a; Bader, Semon R.b; Hazany, Davidd; Ly, Nancy T.a; Otsuka, Norman Y.c

Journal of Pediatric Orthopaedics B: July 2011 - Volume 20 - Issue 4 - p 252–256
doi: 10.1097/BPB.0b013e328344c4c6
Leg, Ankle and Foot

Foot pain in pediatric patients often presents as a diagnostic challenge. Studies in adults with foot pain have shown that bone scans are valuable diagnostic tools, especially in instances in which clinical evaluation and conventional radiography have failed to provide a clear answer. To our knowledge, no similar investigation has ever been conducted in the pediatric population. The objective of this study was to determine the utility of bone scans as a diagnostic tool for children with foot pain of unclear etiology. Our secondary objective was to determine whether obtaining a bone scan, in fact, alters the treatment plan of such patients. Chart review was done, documenting the prebone scan versus post bone scan diagnosis and treatment plans. We found that bone scans were diagnostically useful in 38 of 49 [77.6%, 66–87, 90% confidence interval (CI)] cases, helping to establish new diagnoses in 31 of 49 (63%, 51–75, 90% CI) cases, and directing the treatment of children with clinically unclear foot pain in 31 of 49 (63%, 51–75, 90% CI) cases. We conclude that children between the age of 2 and 11 years who present with unilateral or bilateral foot pain of unclear clinical etiology, with a normal or inconclusive radiograph and physical examination, and who had no previous magnetic resonance imaging and/or computed tomography scan, may benefit from the use of a bone scan to guide diagnosis and treatment.

aDavid Geffen School of Medicine, University of California, Los Angeles

bDepartment of Orthopaedic Surgery, Harbor UCLA Medical Center

cShriners Hospital for Children, Los Angeles

dUniversity of California, Santa Barbara, California, USA

Correspondence to Salar J. Hazany, MD, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA Tel: +1 310 571 8435; fax: +1 805 498 1411; e-mail: shazany@ucla.edu

© 2011 Lippincott Williams & Wilkins, Inc.