Value of SPECT/CT in the evaluation of knee pain

Bone scintigraphy (BS) has a good sensitivity but limited specificity. Moreover, planar imaging limits localization of lesion especially of overlapping structures in close proximity. SPECT allows tomographic imaging, resulting in better localization and characterization of the lesion. Addition of CT to SPECT in hybrid SPECT/CT further improves the precision of localization and accuracy of characterization of the lesion. Combining functional and anatomical imaging is complementary with improved sensitivity, specificity, and diagnostic confidence. These advantages of SPECT/CT are illustrated by 3 cases where diagnostic confidence was higher with SPECT/CT compared to BS or CT alone, highlighting the incremental value of SPECT/CT in assessing knee pain.