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Single-photon emission computed tomography/computed tomography arthrography of wrist, ankle, and knee joints
Ujwal Bhure1, Justus E Roos, Maria Del Sol Perez-Lago
1Department of Radiology and Nuclear Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Objective:
To evaluate the additional value of single-photon emission computed tomography/computed tomography arthrography compared with single-photon emission computed tomography/computed tomography alone in wrist, ankle, and knee joints.
Materials And Methods:
Retrospective evaluation of 68 patients including 74 joints (48 wrists, 13 upper ankle (talocrural joint), and 13 knee joints) was performed. Activity in single-photon emission computed tomography/computed tomography images was graded using a four-point scale: 0 no uptake, one low uptake, two moderate uptake, and three high uptake. Arthrography images were evaluated for the presence of cartilage/ligament/meniscal lesions, and loose bodies.
Results:
Fifty-six joints (76%) showed increased activity in late planar and 58 (78%) in single-photon emission computed tomography/computed tomography images, the latter graded as follows: grade 1 in 20 (34%), grade 2 in 29 (50%), grade 3 in nine (16%) joints. 16 joints were inactive (grade 0) in single-photon emission computed tomography/computed tomography. In 57 joints (77%), intraarticular contrast unmasked additional pathologies (37 cartilage lesions, 25 ligaments tears, 25 triangular fibrocartilage complex tears, six meniscal lesions, and four loose bodies). There was matching findings between single-photon emission computed tomography and computed tomography arthrography in 57 joints (77%) and mismatching findings in 17 joints (23%). Out of these 17 mismatched joints, eight were metabolically inactive but showed some lesion in computed tomography arthrography, whereas nine metabolically active joints did not show any abnormality in computed tomography arthrography.
Conclusion:
The addition of arthrography to single-photon emission computed tomography/computed tomography of wrist, ankle, and knee joints leads to supplementary visibility of lesions of cartilage, ligaments, triangular fibrocartilage complex, meniscus, or loose bodies in 77% of joints. Single-photon emission computed tomography/computed tomography arthrography can serve as promising alternative especially in patients with magnetic resonance imaging contraindications or metallic hardware.
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