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Objective . To validate the ability of  99m Tc-Annexin V to visualize early stage of glucocorticoid-induced femoral head necrosis by comparing with  99m Tc-MDP bone scanning.  Methods . Femoral head necrosis was induced in adult New Zealand white rabbits by intramuscular injection of methylprednisolone.  99m Tc-Annexin scintigraphy and  99m Tc-MDP scans were performed before and 5, 6, and 8 weeks after methylprednisolone administration. Rabbits were sacrificed at various time points and conducted for TUNEL and H&E staining.  Results . All methylprednisolone treated animals developed femoral head necrosis; at 8 weeks postinjection, destruction of bone structure was evident in H&E staining, and apoptosis was confirmed by the TUNEL assay. This was matched by  99m Tc-Annexin V images, which showed a significant increase in signal over baseline. Serial  99m Tc-Annexin V scans revealed that increased  99m Tc-Annexin V uptake could be observed in 5 weeks. In contrast, there was no effect on  99m Tc-MDP signal until 8 weeks. The TUNEL assay revealed that bone cell apoptosis occurred at 5 weeks.  Conclusion .  99m Tc-Annexin V is superior to  99m Tc-MDP for the early detection of glucocorticoid-induced femoral head necrosis in the rabbit and may be a better strategy for the early detection of glucocorticoid-induced femoral head necrosis in patients.

biomed research international

The Role of<sup>99m</sup>Tc-Annexin V Apoptosis Scintigraphy in Visualizing Early Stage Glucocorticoid-Induced Femoral Head Osteonecrosis in the Rabbit

The Role of99mTc-Annexin V Apoptosis Scintigraphy in Visualizing Early Stage Glucocorticoid-Induced Femoral Head Osteonecrosis in the Rabbit

The Role of^99mTc-Annexin V Apoptosis Scintigraphy in Visualizing Early Stage Glucocorticoid-Induced Femoral Head Osteonecrosis in the Rabbit