Ultrasound, which is coming into wider use, is helpful in assessing effusions, synovial proliferation and tendon pathology—and even obese or claustrophobic patients usually have little trouble getting an ultrasound, he said. Plus, the field of view is flexible and they can cost as little as one-fourth of what an MRI costs. But ultrasounds are very dependent on the expertise of the operator, he cautioned.
As for nuclear medicine, bone scintigraphy is very sensitive in picking up bone turnover but cannot answer why it’s happening, Dr. Omar said. PET imaging can be helpful in finding the site of active disease or in monitoring therapy, but is relatively costly, he said.
His center doesn’t put nuclear medicine to wide use, he said.
“A lot of our other modalities can provide a lot of the same information,” Dr. Omar said. “So we rarely use nuclear medicine specifically to look for a lot of these diseases.”
Thomas R. Collins is a freelance medical writer based in Florida.
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- Langston AL, Campbell MK, Fraser WD, et al. Randomized trial of intensive bisphosphonate treatment versus symptomatic management in Paget’s disease of bone. J Bone Miner Res. 2010 Jan;25(1):20–31.
