To the Editor.—
Dr Griffith's article on the early diagnosis of ischemic necrosis of the hip (1981;246:2615) states that, "In practice it appears that only two specific types of osteonecrosis can be demonstrated with any degree of accuracy using nuclear techniques. These are necrosis occurring in Legg-Perthes disease and after fractures of the femoral head." While this may have been the case in 1975,I do not believe that it is true in 1981. In addition to the technetium phosphate compounds for evaluating ischemic necrosis of the hip, technetium Tc 99m sulfur colloid marrow scanning is another useful nuclear technique for the determination of femoral head vascularity. In cases where the bone scan with technetium phosphate compounds demonstrates increased uptake secondary to reactive bone formation, the technetium Tc 99m sulfur colloid marrow scan may be of great help in pinpointing avascular areas that are otherwise obscured. Meyers et al1 found
Easton EJ. Diagnosis of Ischemic Necrosis of the Hip. JAMA. 1982;247(24):3313–3314. doi:10.1001/jama.1982.03320490017017
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