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.
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.
Authors: Klaus Strobel; Isabelle Steurer-Dober; Angela J Da Silva; Martin W Huellner; Maria del Sol Pérez Lago; Elvira Bodmer; Urs von Wartburg; Patrick Veit-Haibach; Katharina Tornquist; Urs Hug Journal: Eur J Nucl Med Mol Imaging Date: 2013-11-01 Impact factor: 9.236