Prevalence and prognostic value of increased uptake in bone SPECT/CT in asymptomatic wrists

Maresa Allgayer,Damian Wild,Dirk Lehnick,Urs Hug,Maria Del Sol Pérez Lago,Justus Egidius Roos,Klaus Strobel

doi:10.1186/s41824-017-0020-0

Maresa Allgayer, Damian Wild + Show 5 more

Open Access

https://doi.org/10.1186/s41824-017-0020-0

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Abstract

PurposeTo evaluate the prevalence and prognostic value of increased uptake in SPECT/CT in asymptomatic wrists.MethodsForty-four patients (18 women, 26 men, median age 42.5 years, range 18–62 years) referred for bone SPECT/CT for painful symptomatic wrist (SW) were additionally imaged on their asymptomatic contralateral wrist (AW). Planar and SPECT/CT images of the SW and AW were performed between July 2014 and September 2016 and retrospectively evaluated for presence, localization, intensity and origin of uptake using a 4-point grading scale (0 = no uptake, 1 = low uptake, 2 = moderate uptake, 3 = high uptake). Fourteen patients with increased uptake in the AW were available for clinical follow-up (median follow-up: 11 months, range 3–15 months).ResultsThirty-one (70.5%, 95% confidence interval (CI): [54.8%, 83.2%]) patients showed increased uptake in the SW and 14 (31.8%, 95% CI: [18.6%, 47.6%]) in the contralateral AW. Mean maximum uptake grade in the SW was 1.48 (range 0–3) and 0.48 (range 0–2) in the AW, respectively. The SW showed significantly more locations with increased uptake (p < 0.001) and significantly higher maximum uptake grades compared to the AW (p < 0.001).Abnormal uptake in AW was due to osteoarthritis (n = 7), mechanical overload (n = 5), trauma (n = 1) and a normal variation of an ankylosis (n = 1). No patient of the follow-up group developed spontaneous pain in the primarily AW with the exception of 5 patients where wrist examination triggered local pain in the anatomical region of increased SPECT/CT uptake.ConclusionsOne third of the contralateral asymptomatic wrists demonstrate low to intermediate grade uptake in bone SPECT/CT. The majority of uptake in the contralateral asymptomatic wrist remained clinically silent in the short time follow-up.

Highlights

Wrist pain is frequent and attributable to a diversity of diseases (Ciresi and Kerley 1993; Huellner et al 2013; Pin et al 1990)
The majority of uptake in the contralateral asymptomatic wrist remained clinically silent in the short time follow-up
In patients where conventional imaging remains insufficient to depict the etiology of the complaints, MR, CT or conventional bone scintigraphy are commonly performed depending on the suspected diagnosis and availability of the different imaging modality

Summary

Introduction

Wrist pain is frequent and attributable to a diversity of diseases (Ciresi and Kerley 1993; Huellner et al 2013; Pin et al 1990). Conventional x-rays are the first line imaging modality for the evaluation of wrist pain. SPECT/CT (Single photon emission computed tomography/computed tomography) is increasingly used as a surrogate to conventional planar scintigraphic images, especially in pathologies involving complex anatomic regions like spine, wrist or foot (Buck et al 2008; Bybel et al 2008; Corre et al 2016; Huellner et al 2012; Linke et al 2010; Mariani et al 2010; Mohan et al 2010; Nathan et al 2012; Schleich et al 2012; Shirley et al 2016). The aim of this study is to evaluate the prevalence and prognostic value of abnormal uptake in bone SPECT/CT in asymptomatic wrists

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