• Ori Elkayam, Daphna Paran, Einat Even-Sapir, Irena Litinsky, Irena Wigler, Michael Yaron, and Dan Caspi.
• Department of Rheumatology, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel. oribe14@netvision.net.il
• Semin. Arthritis Rheum. 2002 Jun 1; 31 (6): 406-12.

ObjectiveTo assess the potential benefits of technetium Tc 99m hexylmethylpropylene amine oxime (Tc 99m HMPAO)-labeled leukocyte scintigraphy in a group of patients with spondyloarthropathies (SpAs), overt gastrointestinal symptoms, and negative extensive endoscopic/radiologic test results.Patients And MethodsTen patients with SpAs and overt gastrointestinal symptoms were included in this study. All patients underwent colonoscopy and small bowel barium studies, and results were negative. Abdominal scintigraphy with Tc 99m HMPAO-labeled leukocytes was performed in all the patients. Clinical and laboratory data and response to treatment was recorded.ResultsThe Tc 99m HMPAO-labeled leukocyte scintigraphy was positive in 5 of 10 patients, demonstrating uptake at the terminal ileum which is very suggestive of Crohn disease. The 5 scintigraphically positive patients were treated with sulfasalazine (SSZ). Four patients responded to SSZ with significant improvement of both gastrointestinal and joint symptoms.ConclusionsIn 5 of 10 patients with SpA and suspected inflammatory bowel disease on clinical grounds, evidence of inflammatory bowel disease was shown by scintigraphic studies in which conventional invasive procedures failed. Tc 99m HMPAO-labeled leukocyte scintigraphy should be considered in the evaluation of patients with SpA.Copyright 2002, Elsevier Science (USA). All rights reserved.

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