Development of a Protocol for SPECT/CT in the Assessment of Wrist Disorders
Identifieur interne : 002104 ( Main/Exploration ); précédent : 002103; suivant : 002105Development of a Protocol for SPECT/CT in the Assessment of Wrist Disorders
Auteurs : Aude Le Corre ; Kym Phuong Huynh ; Rasmeet Singh Dhaliwal ; Gregory Ian BainSource :
- Journal of Wrist Surgery [ 2163-3916 ] ; 2016.
Abstract
Url:
DOI: 10.1055/s-0036-1583314
PubMed: 27777821
PubMed Central: 5074841
Affiliations:
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<author><name sortKey="Dhaliwal, Rasmeet Singh" sort="Dhaliwal, Rasmeet Singh" uniqKey="Dhaliwal R" first="Rasmeet Singh" last="Dhaliwal">Rasmeet Singh Dhaliwal</name>
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<series><title level="j">Journal of Wrist Surgery</title>
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<front><div type="abstract" xml:lang="en"><p><bold>Background</bold>
Single-photon emission computed tomography and computed tomography (SPECT/CT) is a hybrid diagnostic imaging modality that allows clinicians to integrate their diagnostic evaluations and deliver a definitive diagnosis in musculoskeletal disorders. Specifically, in identification of osseous pathology, the conventional bone scan delivers greater specificity compared with magnetic resonance imaging (MRI). However, use of SPECT/CT enhances the sensitivity and specificity. Use of this modality denotes the possibility to specify the lesion more accurately and precisely while grading the activity according to osseous structural changes.</p>
<p><bold>Purpose</bold>
This study aimed to evaluate the clinical utility of SPECT/CT in the diagnoses and management of osseous wrist disorders. The objectives were to examine the value of SPECT/CT in the diagnosis of osseous-related wrist pain and whether the findings altered management.</p>
<p><bold>Patients and Methods</bold>
A retrospective cohort study of 20 patients with such wrist pain was conducted. SPECT/CT was used in the diagnostic process for these patients.</p>
<p><bold>Results</bold>
Following SPECT/CT imaging, the common final diagnoses were osteoarthritis (10; 50%) and avascular necrosis (5; 25%). Less common diagnoses included ulnar carpal impact syndrome, infection, malunion, complex regional pain syndrome, and carpal boss. Some presented with multiple pathologies. SPECT/CT changed the final diagnosis in 11 cases, resulting in nonoperative treatment (7; 63%) or surgery (4; 37%).</p>
<p><bold>Conclusion</bold>
Findings from this study and the literature demonstrate the clinical utility of SPECT/CT in the assessment of osseous-related wrist disorders. We present an algorithm for the assessment of wrist pain with osseous pathology. This commences with clinical assessment and plane radiographs (first-line investigation). Some cases will require a second-line investigation (ultrasound, CT, and/or MRI). If the diagnosis remains unclear, SPECT/CT is recommended as a third-line investigation.</p>
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</front>
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<tree><noCountry><name sortKey="Bain, Gregory Ian" sort="Bain, Gregory Ian" uniqKey="Bain G" first="Gregory Ian" last="Bain">Gregory Ian Bain</name>
<name sortKey="Corre, Aude Le" sort="Corre, Aude Le" uniqKey="Corre A" first="Aude Le" last="Corre">Aude Le Corre</name>
<name sortKey="Dhaliwal, Rasmeet Singh" sort="Dhaliwal, Rasmeet Singh" uniqKey="Dhaliwal R" first="Rasmeet Singh" last="Dhaliwal">Rasmeet Singh Dhaliwal</name>
<name sortKey="Huynh, Kym Phuong" sort="Huynh, Kym Phuong" uniqKey="Huynh K" first="Kym Phuong" last="Huynh">Kym Phuong Huynh</name>
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