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Related Experiment Videos

The sacral tubercle--a cause for hot spots on bone scan

L Blei, R A Cano, A E Jones

    Clinical Nuclear Medicine
    |September 1, 1978
    PubMed
    Summary

    The sacral tubercle can mimic sacroiliac joint disease on bone scans in males. Understanding normal sacral anatomy prevents misdiagnosis of sacroiliac joint disease.

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    Area of Science:

    • Nuclear medicine
    • Radiology
    • Anatomy

    Background:

    • The sacral tubercle (S1 posterior spinous process) can exhibit high intensity on bone scans.
    • This finding occurs in approximately 4% of normal adult males.
    • Anatomical variations, including sexual dimorphism, can affect sacrum appearance on scans.

    Purpose of the Study:

    • To describe the normal anatomy of the sacrum relevant to bone scan interpretation.
    • To elucidate potential causes of false-positive and false-negative readings in sacroiliac joint imaging.
    • To present diagnostic methods for sacral pathology.

    Main Methods:

    • Review of normal sacral anatomy on posterior bone scans.
    • Analysis of potential pitfalls in interpreting sacroiliac joint and sacral intensities.
    • Development of a diagnostic algorithm for sacral disease.

    Main Results:

    • The sacral tubercle can be mistaken for sacroiliac joint pathology.
    • Sexual differences in sacral anatomy can lead to misinterpretations.
    • Incorrectly assuming constant sacral intensity can cause false-negative results in sacroiliac disease assessment.

    Conclusions:

    • Normal sacral anatomy, particularly the sacral tubercle, is crucial for accurate bone scan interpretation.
    • Awareness of anatomical variations prevents false-positive diagnoses of sacroiliac joint disease.
    • A systematic approach is necessary to diagnose sacral conditions and avoid misinterpretation of sacroiliac joint scans.

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