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Resumen Objetivo Analizar la utilidad de la fase angiogammagráfica de la gammagrafía ósea en 3 fases como posible método de cribado en el diagnóstico de infección de prótesis de cadera y de rodilla, previa a la realización de la gammagrafía con leucocitos marcados. Material y métodos Se analizaron prospectivamente 120 pacientes (70 mujeres y 50 hombres) con edad media de 71 ± 11 años y sospecha clínica de infección de prótesis de cadera (n = 63) o rodilla (n = 57), a los que se realizó gammagrafía ósea en 3 fases (angiogammagrafía, fase vascular y fase ósea) y gammagrafía con leucocitos marcados con 99m Tc-HMPAO. El diagnóstico definitivo se realizó mediante estudio microbiológico o seguimiento clínico mínimo de 12 meses. Resultados Se estableció el diagnóstico de infección de la prótesis articular en 18/120 pacientes: 10 pacientes con prótesis de cadera y 8 pacientes con prótesis de rodilla. La angiogammagrafía fue positiva en 15/18 pacientes infectados y en 21/102 pacientes no infectados, mostrando una sensibilidad del 83%, una especificidad del 79% y un valor predictivo negativo del 97%. La gammagrafía con leucocitos marcados mostró una sensibilidad y una especificidad del 72 y del 95%, respectivamente. Si se realizara la gammagrafía con leucocitos marcados exclusivamente a los pacientes con angiogammagrafía positiva, se reduciría un 70% de gammagrafías con leucocitos practicadas. No hubo ningún caso de infección con gammagrafía con leucocitos marcados positiva y angiogammagrafía negativa. Conclusiones La angiogammagrafía es una buena técnica de cribado de infección de prótesis articulares de cadera y rodilla, disminuyendo significativamente el número de gammagrafías con leucocitos marcados, sin afectar la sensibilidad de la técnica. Aim To evaluate the impact of the angioscintigrapy of the three phase bone scan as screening method to rule out infection of the hip and knee prosthesis prior to performing the 99m Tc-HMPAO leukocyte scintigraphy. Material and methods A total of 120 (70 women, 50 men; mean age 71 ± 11 years) with clinical suspicion of hip (n = 63) or knee (n = 57) infection of the prosthesis and clinical suspicion of infection were evaluated prospectively. All patients underwent three-phase bone scan (angioscintigraphy, vascular and bone phase) and 99m Tc-HMPAO-labelled white blood cell scintigraphy. Final diagnosis of infection was made by microbiological documentation or clinical follow-up for at least 12 months. Results Eighteen out of 120 patients were diagnosed of infection of hip prosthesis (n = 10) or knee prosthesis (n = 8). The angioscintigraphy was positive in 15/18 infected cases and in 21/102 of the non-infected cases with a sensitivity of 83%, specificity of 79% and negative predictive value of 97%. Sensitivity and specificity of 99m Tc-HMPAO leukocyte scintigraphy were 72% and 95%, respectively. If the leukocyte labeled scintigraphies had been used exclusively for patients with positive angioscintigraphy, this would have saved up to 70% of the 99m Tc-HMPAO leukocyte scintigraphies performed. There were no cases of infection with positive labeled leukocyte scintigraphy and negative angioscintigraphy. Conclusion Angioscintigraphy (blood flow phase of bone scan) is a useful technique for screening for hip and knee joint prosthesis infection, significantly reducing the need for 99m Tc-HMPAO leukocyte scintigraphy without affecting the sensitivity of the technique. [ABSTRACT FROM AUTHOR]

We applied three multivariate analysis techniques (principal component analysis, correspondence factor analysis and cluster analysis) to physico‐chemical data obtained by analyzing underground waters from the Majorca Island in 1987. We studied the information obtained on plotting samples and variables in the new factor space defined and found conclusions to be consistent throughout the interval studied and the occurrence of redundant information. The sample groups obtained and their relationship to the variables assayed allow hypotheses to be formulated on the geographical origin of the samples. [ABSTRACT FROM PUBLISHER]

Bone fracture is a well known possible late complication of radiation treatment. Little has been written about fractures of long bones after irradiation. We present a case of femur bone necrosis secondary to postoperative radiation for a soft tissue sarcoma of the thigh 20 years earlier. Fixation of the diaphyseal fracture and radiological evolution are described. [ABSTRACT FROM AUTHOR]