%0 Journal Article
%T SPECT versus Planar Scintigraphy as a Clinical Aid in Evaluation of the Elderly with Knee Pain
%A Amir Oron
%A Izhar Arieli
%A Tamir Pritsch
%A Einat Even-Sapir
%A Nahum Halperin
%A Gabriel Agar
%J ISRN Orthopedics
%D 2013
%R 10.1155/2013/842852
%X Chronic knee pain is a common complaint among the elderly and appears in 30%¨C40% of the population over the age of 65. This study was performed in order to evaluate correlation between clinical presentation of chronic knee pain and the imaging findings of SPECT and planar bone scintigraphy. Methods. We prospectively recruited 116 patients over the age of 50 who had neither knee surgery nor trauma. Patients were divided into symptomatic and asymptomatic groups. All patients were examined by an experienced orthopedic surgeon; on the same day imaging was performed. Statistical analysis was performed to correlate physical examination findings with planar scintigraphy and SPECT findings and blood pool images. Results. In symptomatic patients, planar scintigraphy correlated significantly ( ) with the presence of excessive joint fluid, synovial condensation, and decrease in range of motion as measured in extension and flexion and patellar grinding test. SPECT findings correlated with all of the above tests as well as with medial and patellofemoral joint tenderness. Conclusions. We believe a finding of tenderness at the medial articular crease or of the patellofemoral compartment of the knee should be considered an indication for the use of SPECT scintigraphy rather than planar scintigraphy. 1. Introduction Bone scans have become a key tool in assessing musculoskeletal pathology [1, 2]. Use of Single Photon Emission Computerized Tomography (SPECT) is becoming more common over the years as well [3]. Use of SPECT allows a three-dimensional assessment of the isotope dispersed in the subjects body, as compared with a two-dimensional assessment with planar ˇ°regularˇ± scintigraphy. Bone scintigraphy is divided into three consecutive phases. The Perfusion phase, assessed at 30 to 60 seconds following injection, the Blood-Pool phase assessed at 2 to 5 minutes following injection, and the late phase at 2 to 5 hours following injection [4]. The use of Polyphosphate compounds with the isotope and mainly Tc-MDP allows differentiating between pathologies within soft tissues surrounding the bone and those within the bone in the perfusion phase and that found in the late phase which is attributed to the chemical reaction of the polyphosphate compounds and the hydroxyappetite crystals within bone [5]. Planar scintigraphy of complex or large structures within the skeletal system does not relay an accurate three-dimensional anatomic image, while use of SPECT mapping allows for spatial localization of the pathology in the mapped organ [3]. The differential diagnosis of knee pain
%U http://www.hindawi.com/journals/isrn.orthopedics/2013/842852/