Foot pain: specific indications for scintigraphy

O'duffy, E. K.; Clunie, Gavin; Gaćinović, S; Edwards, J. C. W.; Bomanji, Jamshed; Ell, Peter J.

doi:10.1093/rheumatology/37.4.442

Cited by 28 publications

(17 citation statements)

References 2 publications

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“…Nevertheless, the case presented herein is unique because the patient not only had no clubbing but also bilateral calcaneal periostitis was the only manifestation of HOA. The scintigraphic appearance was different from focal or diffuse tracer uptake patterns of the calcaneus, which have been recorded in various other disorders [7,22]. In addition, clinical assessment was unremarkable and supported our scan interpretation.…”

Section: Discussionsupporting

confidence: 76%

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Hypertrophic osteoarthropathy manifested with isolated calcaneal periostitis in bone scintigraphy

et al. 2010

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Hypertrophic osteoarthropathy (HOA) is an incompletely understood syndrome characterized by digital clubbing and periosteal proliferation of long bones and it is commonly associated with primary lung tumors. Bone scintigraphy is a sensitive method in detecting HOA and characteristic findings have been reported. We present the case of a man with newly diagnosed non-small cell lung cancer, unremarkable clinical examination and blood tests and no digital clubbing. During disease staging, however, bone scintigraphy showed intense calcaneal cortical proliferation bilaterally without involvement of other parts of the skeleton. Cortical reaction of both calcanei resolved significantly after chemotherapy. This case indicates that HOA may manifest with isolated calcaneal periostitis bilaterally, which is a new addition to the literature.

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Section: Discussionsupporting

confidence: 76%

“…There was also a barely visible cortical radionuclide uptake in the tibiae, which in our experience does not deviate from normal variants. Other minor abnormalities in the feet were considered non-significant, given the age of the patient and suboptimal positioning in acquisition [7]. Radiographs of both calcanei were judged normal (Fig.…”

Section: Case Reportmentioning

confidence: 99%

Hypertrophic osteoarthropathy manifested with isolated calcaneal periostitis in bone scintigraphy

et al. 2010

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“…In the second assessment of each area the amount of pathological activity was graded as proposed by O'Duffy et al, 10 with grade 0 showing normal activity in the late bone phase related to the background taken as an area over the distal third of the ipsilateral tibia, grade 1 indicating a target-tobackground ratio of between 1 and 2 and grade 2 a targetto-background ratio of more than 2. In the third and fourth …”

Section: Methodsmentioning

confidence: 99%

SPECT-CT imaging in degenerative joint disease of the foot and ankle

Pagenstert¹,

Barg

Leumann³

et al. 2009

The Journal of Bone and Joint Surgery. British volume

138

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The precise localisation of osteoarthritic changes is crucial for selective surgical treatment. Single photon-emission CT-CT (SPECT-CT) combines both morphological and biological information. We hypothesised that SPECT-CT increased the intra- and interobserver reliability to localise increased uptake compared with traditional evaluation of CT and bone scanning together. We evaluated 20 consecutive patients with pain of uncertain origin in the foot and ankle by radiography and SPECT-CT, available as fused SPECT-CT, and by separate bone scanning and CT. Five observers assessed the presence or absence of arthritis. The images were blinded and randomly ordered. They were evaluated twice at an interval of six weeks. Kappa and multirater kappa values were calculated. The mean intraobserver reliability for SPECT-CT was excellent (kappa = 0.86; 95% CI 0.81 to 0.88) and significantly higher than that for CT and bone scanning together. SPECT-CT had significantly higher interobserver agreement, especially when evaluating the naviculocuneiform and tarsometatarsal joints. SPECT-CT is useful in localising active arthritis especially in areas where the number and configuration of joints are complex.

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“…39.4 ). One should be aware of the fact that tracer uptake in the fi rst metatarsophalangeal joint is frequently observed in asymptomatic patients with beginning, age-related arthrosis (O'Duffy et al 1998 ). Although the intensity of uptake in such cases is usually mild, the specifi city of the bone SPECT abnormalities in this area needs to be further elucidated.…”

Section: Injuries Involving the First Metatarsophalangeal Joint And Hmentioning

confidence: 99%

“…They concluded that SPECT-CT is useful in localizing active arthritis, especially in complex bony structures (Pagenstert et al 2009 ). One should keep in mind though that especially in the midfoot and fi rst metatarsophalangeal joint, functional abnormalities can be found in asymptomatic patients (O'Duffy et al 1998 ), and their presence in the setting of the symptomatic patient should be interpreted with caution.…”

Section: (Secondary) Degenerative Joint Diseasementioning

confidence: 99%

Nuclear Medicine Imaging of Foot Injuries

Arias-Bouda

Smit

2015

Nuclear Medicine and Radiologic Imaging in Sports Injuries

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In sports medicine, foot disorders present a signifi cant clinical challenge due to the complex anatomy and function of the foot. Injuries are complex involving soft tissue as well as bony structures. Bone scintigraphy is a sensitive technique, which provides essential functional information which correlates better with clinical symptoms and treatment response than anatomical abnormalities. It is a useful tool to detect conditions affecting the bony structures of the foot in an early phase, but can also be helpful in the initial evaluation of soft tissue injuries. MRI though remains better in delineating most soft tissue injuries. The emergence of SPECT-CT has increased the accuracy of bone scintigraphy. This is particularly true for the recently developed hybrid systems, which are capable of

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Foot pain: specific indications for scintigraphy

Cited by 28 publications

References 2 publications

Hypertrophic osteoarthropathy manifested with isolated calcaneal periostitis in bone scintigraphy

Hypertrophic osteoarthropathy manifested with isolated calcaneal periostitis in bone scintigraphy

SPECT-CT imaging in degenerative joint disease of the foot and ankle

Nuclear Medicine Imaging of Foot Injuries

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