• Bárbara Juarez Amorim, Elba Cristina Sá de Camargo Etchebehere, Graciella Dalla Torre, Mariana da Cunha Lopes de Lima, SantosAllan de OliveiraAde O, Celso Darío Ramos, Luiz Ricardo Gonzalez, José Inácio Oliveira, and Edwaldo Eduardo Camargo.
• Division of Nuclear Medicine, Department of Radiology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, CEP 13083-888 Campinas, São Paulo, Brazil. juarezbarbara@hotmail.com
• Sao Paulo Med J. 2006 May 4; 124 (3): 145149145-9.

Context And ObjectiveThe diagnosis of repetitive strain injury (RSI) is subjective and solely based on clinical signs and physical examination. The aim of this paper was to assess the usefulness of three-phase bone scintigraphy (TPBS) in diagnosing RSI.Design And SettingProspective study at the Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP).MethodsSeventy-three patients (mean age 31.2 years; 47 males) with clinical suspicion of RSI in the upper limbs were studied. A total of 127 joints with suspicion of RSI were studied. The shoulders, elbows and wrists were analyzed semi-quantitatively, using the shafts of the humeri and ulnae as references. The results were compared with a control group of 40 normal individuals. The patients signs and symptoms were used as the "gold standard" for calculating the probabilities.ResultsFrom visual analysis, abnormalities were observed in the flow phase for four joints, in the blood pool phase for 11 joints and in the delayed images for 26 joints. Visual analysis of the joints of the control group did not show any abnormalities. Semi-quantitative analysis showed that most of the patients joint ratios were normal. The exceptions were the wrists of patients with left-sided RSI (p = 0.0216). However, the sensitivity (9%) and accuracy (41%) were very low.ConclusionTPBS with semi-quantitative analysis has very low sensitivity and accuracy in the detection of RSI abnormalities in the upper limbs.

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