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Accuracy of bonescan diagnosing osteoarthritis?

Osteoarthritis, previously referred to as the degenerative joint disease of the temporomandibular joint (TMJ), is a physical response to increased force on the TMJ and refers to the degenerative state associated with secondary inflammation. Osteoarthritis occurs in most people, but is nonetheless more prevalent in females than in males and has been shown to be highly associated with increasing age According to Dworkin and LeResche,criteria for the diagnosis of osteoarthritis include the presence of pain, both subjective and palpatory, and auscultation of crepitus. Radiological characteristics such as structural changes, including erosion of the cortical bone of the condyle or mandibular fossa, sclerosis and flattening of the condyle, and osteophytes could also indicate a diagnosis of osteoarthritis.

For the diagnosis of TMJ diseases, useful imaging techniques include plain radiological tests such as panoramic and transcranial radiography, tomography, arthrography, CT and MRI.Nuclear medical test methods include bone scan and single photon emission CT (SPECT).However, plain radiography has some limitations, including the fact that it cannot evaluate the centre and medial side of the condyle and that a difference in bone mineral content of at least 30–50% is required for the detection of a bone lesion. Bone scans show positive detectable signals even with the increase in osteoblast activity of approximately 10%, and their sensitivity is very high, making bone scans advantageous for the early diagnosis of lesions. However, the specificity of bone scans is relatively low

Standard radiography has several limitations for the evaluation of the bone structure of the TMJ. Nonetheless, after the diagnosis of osteoarthritis based on previous clinical assessment and radiography, if bone scan results are applied as an additional diagnostic tool, an accurate and rapid diagnosis can be made and treatment could be initiated more quickly. In our study, the association of diagnosis based on clinical symptoms and general radiographs with the results of bone scan was examined.