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Bone scintigraphy in femoroacetabular impingement: a preliminary report
Wadih Y Matar1, Olivier May, François Raymond
1Division of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital-General Campus, Critical Care Wing 1646, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6.
Clinical Orthopaedics and Related Research
|December 18, 2008
Summary
Bone scans, specifically SPECT imaging, show high sensitivity in diagnosing femoroacetabular impingement (FAI), a common cause of hip pain in young adults. This nuclear imaging technique helps identify characteristic uptake patterns associated with FAI.
Area of Science:
- Orthopedics
- Radiology
- Nuclear Medicine
Background:
- Femoroacetabular impingement (FAI) is increasingly recognized as a cause of hip pain, labral tears, and cartilage damage in young adults.
- Accurate diagnosis of FAI is crucial for timely intervention and management.
Purpose of the Study:
- To determine the sensitivity and specificity of bone scans, particularly SPECT imaging, in diagnosing FAI.
- To describe the characteristic findings of FAI on nuclear imaging.
Main Methods:
- Prospective study of 25 patients with chronic hip pain and a positive impingement sign.
- All patients underwent plain radiographs and a three-phase bone scan with SPECT imaging of both hips.
- FAI diagnosis was based on hip pain, positive impingement sign, and diagnostic radiographs.
Main Results:
- Of 50 hips evaluated, 46 showed bony abnormalities on radiographs, and 26 were diagnosed with FAI.
- Bone SPECT demonstrated increased uptake in 22 of the 26 FAI hips (true-positives).
- Sensitivity was 84.7%, specificity 62.5%, positive predictive value 71%, and negative predictive value 78.9% for bone SPECT in diagnosing FAI. Focal uptake correlated with known FAI pathology.
Conclusions:
- Bone SPECT imaging is a sensitive tool for diagnosing femoroacetabular impingement.
- SPECT findings, including focal uptake in specific hip regions, are consistent with FAI and associated intra-articular damage.
