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In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy

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Acetabular impingement on planar and SPECT bone scintigraphy.

Kevin P Banks¹, Won S Song

¹Department of Radiology, Brooke Army Medical Center, Fort Sam Houston, Texas 78234, USA. KPBanks@gmail.com

Clinical Nuclear Medicine

|November 27, 2008

Summary

This study highlights bone scintigraphy as a novel method for diagnosing bilateral femoral acetabular impingement (FAI), a condition causing hip pain. The imaging technique revealed abnormal activity consistent with FAI, aiding in diagnosis when X-rays were normal.

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Area of Science:

Orthopedics
Nuclear Medicine
Radiology

Background:

Hip pain is a common complaint, particularly in active individuals.
Femoral acetabular impingement (FAI) can cause significant hip joint pain and dysfunction.
Standard radiography may not always detect early or subtle cases of FAI.

Observation:

A 37-year-old male military trainee experienced atraumatic left hip pain exacerbated by activity.
Initial hip radiographs were normal, prompting further investigation for stress injury.
Bone scintigraphy, including planar and SPECT imaging, was performed.

Findings:

Scintigraphy showed abnormal activity in both hips, more pronounced on the left.
The pattern of activity was atypical for stress injury but suggestive of bilateral FAI.
Subsequent MRI confirmed the diagnosis of FAI.

Implications:

Bone scintigraphy offers a novel approach to evaluating the pathophysiology of FAI.
This nuclear medicine technique can aid in diagnosing FAI when conventional imaging is inconclusive.
Accurate FAI diagnosis is crucial for appropriate patient management and treatment planning.