[SPECT/CT in diagnostics of the hand joint]

Radiologe. 2012 Jul;52(7):621-8. doi: 10.1007/s00117-011-2269-9.
[Article in German]

Abstract

Clinical/methodical issue: Hand and wrist pain remains a diagnostic challenge, both for hand surgeons and for radiologists. Especially chronic wrist pain is often hard to localize clinically and further cross-sectional imaging is often indispensable.

Standard radiological methods: The well-established standard for non-invasive diagnostic imaging in chronic wrist pain is magnetic resonance imaging (MRI).

Methodical innovations: Recently, state-of-the-art single photon emission computed tomography/computed tomography (SPECT/CT) systems have been introduced into the diagnostic array for musculoskeletal conditions. Besides morphological data SPECT/CT also provides metabolic information.

Performance: SPECT/CT allows an exact detection and precise anatomical mapping of different pathologies of the wrist, which is often crucial for therapy.

Achievements: In patients with chronic wrist pain, SPECT/CT is more specific than MRI. It is also beneficial in patients with posttraumatic conditions and metal implants and may serve as a problem-solving tool in difficult cases.

Practical recommendations: It is considered that SPECT/CT imaging is useful if MRI results are equivocal or present no clearly leading pathology. A primary examination with SPECT/CT seems to be a reasonable option for patients with certain bone pathologies, metal implants and non-specific wrist pain.

MeSH terms

  • Hand Joints / diagnostic imaging*
  • Humans
  • Image Enhancement / methods*
  • Joint Diseases / diagnostic imaging*
  • Radiography
  • Radionuclide Imaging