SPECT-CT as a diagnostic tool in foot and ankle surgery. Preliminary experience in 6 cases

Abstract

Objective: To present our preliminary experience with the use of SPECT-CT as a tool for differential diagnosis in foot and ankle pain. Methods: Six patients (Medium age: 47 y-o, 3 males and 3 females) were evaluated with SPECT-CT between April and October of 2009. All patients had hindfoot or midfoot pain with no clear diagnosis. Most of them had pain as a complication of hindfoot trauma. All the cases were evaluated with plain radiographs, and some with MRI or ultrasound. Results: The previous diagnosis to SPECT-CT were arthritis, hindfoot pain in study, osteochondral lesion, and oligoartralgia under study. The SPECT-CT ruled out joint involvement in four of the six cases, determined the diagnosis in four of the six cases, and in two of the six cases led to a surgical treatment. Conclusions: The SPECT-CT imaging test is a complement to the history and physical examination in diagnostic evaluation for foot and ankle pain. Its usefulness is mainly seen in cases of chronic posttraumatic hindfoot pain, in multiple joints involvement, and in the presence of metallic hardware from previous surgery. It helps in improving accuracy of diagnosis in cases of difficult evaluation with traditional imaging tests.