SPECT/CT in Postoperative Shoulder Pain.

Area of Science:

• Orthopedic Surgery
• Nuclear Medicine
• Radiology

Background:

• Prosthetic shoulder replacements have seen a significant increase in incidence over the past 20 years.
• This rise in procedures has led to a corresponding increase in complications and reoperations.
• Accurate diagnosis of these complications is crucial for effective patient management.

Purpose of the Study:

• To review the clinical value of SPECT/CT in diagnosing complications of prosthetic shoulder replacements.
• To outline the utility of SPECT/CT in identifying mechanical issues and infections.
• To discuss various nuclear medicine techniques for prosthesis infection detection.

Main Methods:

• Review of clinical applications of SPECT/CT for shoulder arthroplasty complications.
• Discussion of bone SPECT/CT for mechanical complications (glenoiditis, loosening, scapular notching).
• Evaluation of nuclear medicine methods for prosthesis infection, including labeled white blood cell scintigraphy, bone marrow scintigraphy, and FDG-PET.

Main Results:

• Bone SPECT/CT effectively diagnoses mechanical complications such as glenoiditis, glenoidal loosening, and scapular notching.
• Labeled white blood cell scintigraphy combined with bone marrow scintigraphy is presented as the reference standard for detecting prosthesis infection.
• FDG-PET can serve as a complementary test in specific clinical scenarios.

Conclusions:

• SPECT/CT is a valuable tool for shoulder surgeons in diagnosing mechanical complications after shoulder replacement.
• Nuclear medicine, particularly labeled white blood cell scintigraphy, is essential for identifying prosthetic joint infections.
• SPECT/CT and other nuclear imaging modalities enhance diagnostic accuracy and guide treatment decisions for shoulder arthroplasty complications.