April 24, 2019
Paper of the Month May 2019
This month: A Preliminary Study of Ankle Single Photon Emission Computed Tomography/Computed Tomography in Patients With Bony Impingement Syndrome: Association With the Visual Analogue Scale Pain Score.
Both osteoarthritis and impingement syndrome are commonly observed in sports and orthopedic medicine. Ankle impingement is a painful mechanical limitation of full ankle movement secondary to osseous/soft-tissue abnormality and accurate diagnosis is important for planning surgical treatment. Data on the role of bone SPECT/CT in ankle and foot conditions is still scarce, in particular on how imaging findings relate to symptoms and outcome.
While limited in sample size (n=50), this retrospective study by Zhang et al is of interest because all patients had surgical confirmation of the diagnosis and adequate duration of follow-up (median 2.5 years). The main finding of the study is that the intensity of lesions on bone SPECT/CT is associated with pain severity, supporting this technique to identify culprit lesions that are targets for intervention. Also, impingement may represent the higher end of the OA disease spectrum, with a trend towards multifocal uptake, even though the pattern/site of uptake was not associated with symptom intensity. In conclusion, the results of this study support bone SPECT/CT as a problem solving tool in patients with unexplained ankle pain.
Enjoy the reading,
your BELNUC Board
Zhang XY, et al. J Foot Ankle Surg. 2019. [Epub ahead of print]