Radionuclide imaging in internal derangements of the knee

Mooar, Pekka A.; Gregg, John R.; Jacobstein, Jerome G.

doi:10.1177/036354658701500207

Cited by 22 publications

(14 citation statements)

References 18 publications

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“…Using the modified Takakura scoring system, 18 we confirmed a significant correlation between the stage of osteoarthritis and conventional bone scan findings, as suggested previously. 25,27 Unexpectedly, we did not observe a similar correlation between the degree of hindfoot and ankle deformity (i.e., the coronal plane deviation and/or talar tilt in the ankle mortise) and the level of activation on bone scans.…”

Section: Discussioncontrasting

confidence: 54%

“…In particular, the diagnostic sensitivity of bone scans can be attributed to their ability to detect increased subchondral metabolic osseous activity, which can suggest arthrosis even before the appearance of clinical symptoms, plain radiographic findings, or arthoscopic changes. 20,[23][24][25][26][27] However, conventional bone scintigraphy cannot be used to determine the exact site of abnormal bone turnover, especially in certain anatomical regions such as the relatively small joints of the foot and ankle. Second only to cardiac studies, examination of the bone is the most frequent application of SPECT performed in routine nuclear medicine practice.…”

Section: Discussionmentioning

confidence: 99%

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SPECT‐CT compared with conventional imaging modalities for the assessment of the varus and valgus malaligned hindfoot

Knupp

Pagenstert

Barg

et al. 2009

Journal Orthopaedic Research

112

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The combined single-photon emission computed tomography and conventional computed tomography (SPECT/CT) technique has increased the sensitivity and specificity of bone scans. We examined the value of using SPECT/CT for the assessment of coronal plane hindfoot deformities. Twenty-seven patients with varus (11 patients) or valgus (16 patients) malalignment of the hindfoot were assessed using radiography, conventional CT, bone scintigraphy, and SPECT/CT. The amount of deformity, stage of osteoarthritis, and level of activation on bone scans and SPECT/CT were measured. Activation was assessed in 12 regions of interest. The stage of osteoarthritis seen on plain radiographs correlated significantly with the level of activation detected on bone scans (p < 0.05). No correlation was observed between the amount of deformation and activity, and between bone scan activation and signs of osteoarthritis on CT scans. The varus malaligned ankles showed higher radioisotope uptake in the medial areas, while the valgus malaligned ankles showed increased uptake in the lateral areas (p < 0.05). SPECT/CT may be a valuable tool for the assessment and staging of osteoarthritis. Our findings underline the adverse effects of coronal plane deformity of the hindfoot. In addition, results from this study provide useful information for future basic research on coronal plane deformity of the hindfoot and for determining appropriate surgical approaches. ß

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

SPECT‐CT compared with conventional imaging modalities for the assessment of the varus and valgus malaligned hindfoot

Knupp

Pagenstert

Barg

et al. 2009

Journal Orthopaedic Research

112

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“…Meniscal pathology also alters bone metabolism (Mooar et al 1987, Dorchak et al 1993. We assumed that resections of the menisci would result in abnormal wear in the corresponding joint compartment, because of increased uptake in the lateral joint compartment in patients with lateral meniscus resection.…”

Section: Discussionmentioning

confidence: 99%

Positive pivot shift after ACL reconstruction predicts later osteoarthrosis63 patients followed 5–9 years after surgery

Jonsson

Riklund

Lind

2004

Acta Orthopaedica Scandinavica

266

208

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Background Rupture of the anterior cruciate ligament (ACL) may cause osteoarthrosis (OA) and functional impairment. We wanted to find out whether the degree of knee stability obtained after ACL reconstruction correlates with radiographic and clinical outcome.Patients and methods We examined 63 patients 2 and 5-9 years after anterior cruciate ligament (ACL) reconstruction. Knee stability was assessed 2 years after surgery by recording AP laxity using radiostereometric technique (RSA) and by performing the pivot shift test. Degeneration of the knee joint was evaluated with bone scintigraphy, and radiographically. Functional outcome was assessed with Lysholm score, Tegner activity scale and with the one-leg hop test.Results Radiographic signs of osteoarthrosis at the most recent follow-up (5-9 years) did not correlate with knee stability. Patients with positive pivot shift test 2 years after surgery showed increased scintigraphic activity of the subchondral bone at the most recent follow-up, and inferior subjective functional outcome 2 years after surgery. Knees having had meniscus resections had more often OA. Radiographical signs of OA were associated with higher scintigraphic uptake in the operated knee relative to the contralateral knee.Interpretation The ability to obliterate the pivoting by ACL reconstruction appears to be more important than normalizing the AP laxity in order to prevent later OA.

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“…without knowledge of the operative findings. The patterns as described by Mooar et al [22] were used for classification ( Table 1). Intensity of uptake was graded 2 for a marked increase, 1 for a slight increase, and 0 when it was not increased compared to the contralateral knee.…”

Section: Methodsmentioning

confidence: 99%

Abnormal bone scans in anterior cruciate ligament deficiency indicate structural and functional abnormalities

et al. 2000

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Many patients with anterior cruciate ligament (ACL) deficiency have an abnormal bone scan. This finding has not yet been explained. Suggested explanations include intra-articular (structural) or kinematic (functional) abnormalities. We examined the relationship between bone scintigraphy and cartilage degeneration or meniscal lesions in the ACL-deficient knee in 95 consecutive patients who had bone scintigraphy 1-3 days prior to arthroscopic ACL reconstruction. Intra-articular abnormalities of the knee did not explain all scintigraphic patterns of this study. We did not find clinically useful positive predictive values for scintigraphic patterns considered to indicate cartilage degeneration or a lateral meniscus lesion. A clinically useful positive predictive value was found only for medial meniscus lesions when time since ACL rupture was more than 18 months, and for local cartilage degeneration when markedly increased uptake was seen when time since ACL rupture was more than 4 months. Considering these findings, alternative explanations are discussed, based on specific aspects of abnormal kinematics and adaptive bone metabolism of the ACL-deficient knee.

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Radionuclide imaging in internal derangements of the knee

Cited by 22 publications

References 18 publications

SPECT‐CT compared with conventional imaging modalities for the assessment of the varus and valgus malaligned hindfoot

SPECT‐CT compared with conventional imaging modalities for the assessment of the varus and valgus malaligned hindfoot

Positive pivot shift after ACL reconstruction predicts later osteoarthrosis63 patients followed 5–9 years after surgery

Abnormal bone scans in anterior cruciate ligament deficiency indicate structural and functional abnormalities

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