Comparative role of scintigraphy in sporting injuries in the new millennium

Abstract

Exercise for good health and as a prerequisite for most sporting endeavours is both an aspirational and necessary requirement at a time when obesity plagues much of the well-developed world. It has led to great advances in the science of exercise and a medical specialty devoted to sporting injuries. Epidemiology of sporting injury is crucial in this process in order to prevent injury and to focus attention on dangerous practices in some sports. The bone scan was historically considered a mainstay for the diagnosis of sporting injuries involving stress fractures, acute fractures and some soft tissue injuries. However, the role of scintigraphy has been supplanted by magnetic resonance imaging (MRI) in many of these settings, largely due to its high contrast resolution for soft tissues, spatial resolution of the relevant anatomy and the absence of radiation exposure. Nevertheless, there remains a valuable contribution from scintigraphy with the development of single photon emission computed tomography (SPECT) co-located with x-ray computed tomography (CT) in the same instrument. The place of scintigraphy in the evaluation of sporting injuries needs to be critically evaluated against the competing modalities of CT, MRI and high-resolution ultrasound. It is no longer appropriate or critically acceptable to examine scintigraphy in isolation from the other available imaging modalities.