Evaluation of the articular involvement of Behçet's disease via bone scintigraphy

Background: Behçet's disease (BD) is a chronic relapsing inflammatory disease that involves various organ systems. Articular involvement was reported to be present in approximately 50% of Korean BD patients. The joint symptoms of BD patients have usually been described as intermittent, self-limiting and non-erosive, and they are mostly monoarticular and oligoarticular arthritis. Objective: The purpose of our investigations was to evaluate the usefulness of bone scintigraphy for detecting the articular involvement of BD. Methods: We reviewed the medical records, laboratory findings and bone scintigraphy findings of 89 patients who were diagnosed with BD from January 2005 to June 2007. Results: Of the 89 BD patients, 14 patients were male and 75 patients were female with a mean age of 43.92+8.49 yr. The most frequently involved site on bone scintigraphy was die wrist (44.9%) with the decreasing order of frequency as follows: me feet (39.3%), the hands (25.8%), the knee (24.7%), the sacroiliac joint (22.4%), the shoulder (18%), the ankle (16.9%), the hip (12.6%), the spine (10%) and the elbow (3%). The pattern of involvement, which was defined as me number of joints showing hot uptake on the bone scintigraphy at one episode of arthropathy, was monoarticular in 5.6%, oligoarticular in 44.9%, polyarticular in 38.2% and there was no uptake in 11.2%. Among 130 joints, 63.1% of the joints showed close correlation between me clinical symptoms and the bone scintigraphy uptake. Conclusion: We suggest mat bone scintigraphy can be a useful tool to determine the presence and site of articular involvement. However, more studies are needed to exclude non-specific bone scintigraphy uptake and to determine the correlation between clinical symptoms and me bone scintigraphy findings.