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Predictive value of bone scintigraphy for the detection of joint involvement in Behçet's disease: Dermatologists' perspectives

 Jimyung SEO  ;  Minseok LEE  ;  Min Ju CHO  ;  Zhenlong ZHENG  ;  Arthur CHO  ;  Dongsik BANG  ;  Do Young KIM 
 EUROPEAN JOURNAL OF DERMATOLOGY, Vol.25(5) : 477-482, 2015 
Journal Title
Issue Date
Adult ; Age Factors ; Aged ; Arthralgia/diagnostic imaging* ; Arthralgia/etiology ; Arthralgia/physiopathology ; Arthritis/diagnostic imaging* ; Arthritis/etiology ; Arthritis/physiopathology ; Behcet Syndrome/complications* ; Behcet Syndrome/diagnostic imaging* ; Bone and Bones/diagnostic imaging* ; Cartilage, Articular/diagnostic imaging ; Cartilage, Articular/physiopathology ; Cohort Studies ; Databases, Factual ; Dermatology/methods ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Radionuclide Imaging ; Republic of Korea ; Retrospective Studies ; Severity of Illness Index ; Sex Factors ; Technetium Tc 99m Medronate ; Whole Body Imaging/methods ; Young Adult
Arthritis ; Behçet's disease ; Bone scintigraphy ; Dermatologists
BACKGROUND: Behçet's disease (BD) is a multisystemic inflammatory disease with articular involvement. Non-specific arthralgia without objective signs of arthritis, such as swelling or effusion, is common in such patients. Thus, an accurate diagnosis of joint involvement may be challenging for dermatologists.

OBJECTIVES: To evaluate the validity of (99m)Tc-methylene diphosphonate (Tc-99m-MDP) bone scintigraphy for joint involvement assessment in patients with BD.

MATERIALS AND METHODS: In 211 patients with BD who had scintigraphic evaluations due to joint symptoms, agreement between bone scintigraphy findings and clinically evaluated joint complaints was retrospectively assessed using Cohen's kappa (κ) statistic. A patient subset (n = 104) showing agreement between joint complaints and scintigraphy results was re-evaluated by a rheumatologist to determine the level of diagnostic specificity attained by combining bone scintigraphy with clinical examinations of dermatologists.

RESULTS: The total kappa value (211 patients) was 0.604, indicating fair agreement between joint complaints and scintigraphy results. Individual analysis of eleven joint categories revealed statistically significant correlations for wrist (κ = 0.677), shoulder (κ = 0.661), and foot joints (κ = 0.618). Of the 104 referrals to a rheumatologist, 95 (91.34%) were confirmed as having BD-associated articular involvement. Joint acral areas (e.g., foot, hand, wrist and shoulder) that had the highest kappa value correlations also ranked highest in diagnostic specificity.

CONCLUSION: Bone scintigraphy presents a simple and useful option for dermatologists to assess joint involvement in BD patients, especially for specific anatomic sites.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영) ORCID logo https://orcid.org/0000-0002-0194-9854
Bang, Dong Sik(방동식)
Seo, Jimyung(서지명)
Lee, Min Seok(이민석)
Zheng, Zhen Long(정진룡)
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
Choi, Min Ju(최민주)
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