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· DOS Abstracts
Early experience with bone scan SPECT CT in
assessing adolescents with complex problems
in the foot and ankle region
Ole Rahbek, Deborah M Eastwood, Marina Easty, Lorenzo Biassoni
Department of Orthopaedics, Great Ormond Street Hospital for Children NHS
Foundation Trust, London (UK); Department of Radiology, Great Ormond
Street Hospital for Children NHS Foundation Trust, London (UK)
Background:
Adolescents, particularly those with proven foot pathology, may
develop unexpected foot pain during periods of changing growth rates. It can be
difficult to differentiate between functional and organic foot pain.
Purpose / Aim of Study:
The aim of this retrospective study was to review
our preliminary experience on bone scan with SPECT CT in the assessment and
management of the child with complex foot/ankle pain.
Materials and Methods:
We reviewed the notes and imaging of 11 patients
with complex foot and ankle pain, referred for bone scanning (12 scans per-
formed). All patients had plain films, 7/11 patients had MRI (1 patient had CT).
Bone scanning was performed with a dual head Siemens Symbia T2 SPECT/CT
gamma camera. Planar blood pool and delayed static images of the feet, with
SPECT/CT images of both feet and ankles, were acquired
Findings / Results:
Mean age was 13yr (range 9-17), 9/11 patients were
female. The underlying diagnoses were: tarsal coalition [n=3], non-specific in-
flammation [n=2], spastic diplegia [n=2], clubfeet [n=2], chronic regional pain
syndrome, dystonic foot posturing [n=1]. Four feet had undergone previous
surgical treatment. Bone scan SPECT/CT added decisive clinical value versus
x-rays and MRI/CT in 9/12 cases. In four cases it prompted surgical manage-
ment (fusion, screw removal, coalition excision, arthrodesis). In two patients it
showed other focal areas of mechanical stress, thus excluding surgery. In 3/12
patients the bone scan confirmed the diagnosis without adding significant clini-
cal information.
Conclusions:
These preliminary results are encouraging and suggest that a
prospective evaluation of bone scan with SPECT/CT in adolescents with foot
pain and complex problems of the foot and ankle is justified.
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