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Related Experiment Video

Updated: Apr 25, 2026

High Resolution 3D Imaging of Ex-Vivo Biological Samples by Micro CT
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Bloodpool and Late-Phase 3D-Ring CZT SPECT/CT in Freiberg Disease.

Yacine El Yaagoubi1, Caroline Prunier-Aesch1, Eric Waynberger2

  • 1Departments of Nuclear Medicine.

Clinical Nuclear Medicine
|April 24, 2026
PubMed
Summary

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Freiberg disease can mimic stress fractures in the metatarsal head, causing chronic foot pain. Advanced imaging like SPECT/CT and MRI is crucial for accurate diagnosis and appropriate treatment.

Area of Science:

  • Orthopedics
  • Radiology
  • Nuclear Medicine

Background:

  • Chronic foot pain is a common presenting complaint.
  • Metatarsal head pain can stem from various etiologies, including stress fractures and Freiberg disease.
  • Differentiating these conditions is vital for effective management.

Purpose of the Study:

  • To present a case of Freiberg disease initially suspected as a stress fracture.
  • To highlight the role of advanced imaging in diagnosing early-stage Freiberg disease.
  • To emphasize the importance of considering Freiberg disease in the differential diagnosis of metatarsal head uptake.

Main Methods:

  • A 24-year-old woman with chronic right foot pain underwent 99mTc-HDP bone scintigraphy with a 3D-ring CZT system (StarGuide).
Keywords:
3D-ring CZT SPECT/CTFreiberg diseasebloodpool SPECT/CTbone scintigraphyosteochondritisosteonecrosis

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  • Bloodpool and late-phase SPECT/CT were performed.
  • Magnetic Resonance Imaging (MRI) was utilized for confirmation.

    • Main Results:

    • Bone scintigraphy showed intense uptake in the right second metatarsal head.
    • SPECT/CT revealed subchondral sclerosis, suggestive of Freiberg disease.
    • MRI confirmed the diagnosis of Freiberg disease.

    Conclusions:

    • Freiberg disease should be included in the differential diagnosis for metatarsal head uptake, particularly in early stages.
    • CT component of SPECT/CT and/or MRI are valuable for distinguishing Freiberg disease from stress fractures.
    • Accurate diagnosis impacts therapeutic approaches for metatarsal head conditions.