Establishing a diagnostic scale of subacute thyroiditis without radioisotope scanning

Background: Radioisotope scanning is important to diagnose subacute thyroiditis(SAT), but it’s not always available. So we aim to establish a diagnostic scale for SAT without radioisotope scanning.Methods: The suspected SAT patients hospitalized in Yuebei people's Hospital from January 2012 to December 2016 were selected and divided into study group and control group according to whether they were diagnosed as SAT. The clinical indexes of two groups were collected and the diagnostic scale of SAT was established by using binary logistic regression analysis. The effectiveness of the scale was evaluated by ROC curve. Results: Of 309 patients, 58.25% of patients were confirmed with SAT and the remaining 41.75% of patients were not diagnosed with SAT. After univariate analysis, variables which were considered statistically different(P<0. 05) between the two groups were selected as independent variables and the diagnosis of SAT was taken as dependent variable in the binary logistic regression model. The logistic regression model consisted of 4 variables, each was thyroid tenderness, firm on palpation, increased ESR and elevated thyroid hormone level. The P value of Omnibus tests was≤0. 001 and the Nagelkerke R Square was 0. 915. The diagnostic scoring scale was established with these four variables according to their regression coeffient. The area under the ROC curve for this diagnostic scale was 0. 991(95% confidence interval, 0. 982-0.999). The highest Youden index was 0. 912, the corresponding cut-off point was 7. Internally validation shows a sensitivity of 92. 78% and a specificity of 98.45% of our scale. Conclusions: We established and validated a diagnostic scale for SAT without the need for radioisotope scanning for the first time. It has good application in institutions that do not have radioisotope machines or among pregnant and lactating women.

Establishing a diagnostic scale of subacute thyroiditis without radioisotope scanning

Background: Radioisotope scanning is important to diagnose subacute thyroiditis(SAT),but it’s not always available.So we aim to establish a diagnostic scale for SAT without radioisotope scanning. Methods: The suspected SAT patients hospitalized in Yuebei people's Hospital from January 2012 to December 2016 were selected and divided into study group and control group according to whether they were diagnosed as SAT. The clinical indexes of two groups were collected and the diagnostic scale of SAT was established by using binary logistic regression analysis.The effectiveness of the scale was evaluated by ROC curve. Results: Of 261 patients,69% of patients were confirmed with SAT and the remaining 31% of patients were not diagnosed with SAT. After univariate analysis,variables which were considered statistically different( P <0.05) between the two groups were selected as independent variables and the diagnosis of SAT was taken as dependent variable in the binary logistic regression model. The logistic regression model consisted of 4 variables, each was thyroid tenderness,firm on palpation, increased ESR and hyperthyroidism.The P value of Omnibus tests was ≤0.001 and the Nagelkerke R Square was 0.894. The diagnostic scoring scale was established with these four variables according to their regression coeffient.The area under the ROC curve for this diagnostic scale was 0.989(95% confidence interval, 0.978-1.0).The highest Youden index was 0.908,the corresponding cut-off point was 5.5.Internally validation shows a sensitivity of 93.33% and a specificity of 97.53% of our scale. Conclusions: We established and validated a diagnostic scale for SAT without the need for radioisotope scanning for the first time.It has good application in institutions that do not have radioisotope machines or among pregnant and lactating women.

Quantitative Radio-Isotope Scanning of the Sacroiliac Joints in Ankylosing Spondylitis

A method for applying 99mTc-MDP for dynamic and static quantitative radioisotope scanning (QRS) of the sacroiliac joints (SI) in early progressive sacroiliitis in ankylosing spondylitis (AS) is described. In a prospective study, 2 groups of male AS patients were investigated, one with increased elevated erythrocytic sedimentation rate (ESR) (group A, n = 7) and one with normal ESR (group B, n = 8). In both groups an increased uptake of the radiotracer was found in the static part of the study versus a control group C (n = 9). An increased uptake versus group C was also found for group A in the dynamic part of the study (p = 0.01) while there was no significant difference dynamically between groups B and C. The results of the dynamic study in group A indicate ESR to be a parameter of inflammatory activity in the SI joints. The study also seems to indicate QRS to be a valuable diagnostic method in early AS without definite radiographic changes in the SI joints.