^99m-Technetium-labelled human immunoglobulin G scintigraphy in peripheral enteropathic arthropathy

Rheumatic manifestations are the most common extraintestinal features in the inflammatory bowel disease. The aim of this study was to determine the effectiveness of ^99mtechnetium-labelled polyclonal human immunoglobulin G (^99mTc-IgG) scintigraphy, to detect peripheral joint inflammation in patients with enteropathic arthropathy. Nineteen patients (Crohn disease: 4, colitis ulcerosa: 15) with either pain and/or swelling of peripheral joints, underwent ^99mTc-IgG scintigraphy. The results were correlated with clinical, and laboratory activity parameters, as well as with radiological findings. The mean duration of bowel disease was 7.55±6.11 years. In 19 patients 17 peripheral joints were swollen and 58 were tender. Taking tenderness as a potential indicator of joint involvement; 31 (53%) of the joints revealed abnormality on ^99mTc-IgG scintigraphy. The most frequently affected sites were the knees, ankles and tarsals. The total scintigraphic scores were significantly correlated with tenderness and swelling scores. No correlation was observed between the scores of ^99mTc-IgG scintigraphy and radiological findings. In conclusion ^99mTc-IgG scintigraphy can be appropriate for detecting inflammation of peripheral joints and can be used to establish the extent of arthritis in patients with inflammatory bowel disease.