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Evaluation of pelvic ring injuries using SPECT/CT.
Max J Scheyerer1, Martin Hüllner, Carsten Pietsch
1Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland, maxjscheyerer@gmx.ch.
Skeletal Radiology
|August 12, 2014
Summary
SPECT/CT imaging revealed that all patients with pubic rami fractures had additional occult pelvic ring lesions. This advanced imaging technique is crucial for detecting previously undetected fractures and sacroiliac joint instability.
Area of Science:
- Orthopedic surgery
- Radiology
- Trauma care
Background:
- Pelvic fractures, though infrequent, carry high morbidity and mortality.
- Isolated pubic rami fractures in the elderly may mask occult posterior pelvic ring injuries.
- Conventional imaging often fails to detect these associated lesions.
Purpose of the Study:
- To investigate concomitant bony or soft tissue lesions in the pelvic ring.
- To evaluate the utility of SPECT/CT in diagnosing occult injuries associated with anterior pelvic fractures.
Main Methods:
- SPECT/CT was performed in patients with inconclusive or negative conventional imaging for posterior pelvic ring lesions.
- Imaging was conducted in a non-acute setting within 3 days of trauma.
Main Results:
- All patients demonstrated additional pelvic ring lesions not visible on initial X-ray or CT.
- Common findings included sacral fractures and sacroiliac joint abnormalities.
- One case showed a non-dislocated acetabular fracture.
Conclusions:
- SPECT/CT is highly effective in identifying occult fractures and instability in the pelvic ring.
- This imaging modality significantly aids clinical management of pubic rami fractures by revealing associated injuries.
