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==Overview==
Technetium 99m bone scan and 18F-fluoride [[positron emission tomography]] (PET) scan may be helpful in the diagnosis of the cases of persistent [[back pain]] with [[scoliosis]], with negative findings on plain [[radiographs]], [[Computed tomography|CT]], and/or [[Magnetic resonance imaging|MRI]]. 68Ga-citrate an emerging, generator-based tracer has shown promising results in pilot studies.
 
==Other Imaging Findings==
 
===PET/PET CT===
{| align="right"
|
[[File:PET scan -Thoracic endplate osteomyeltisdiscitis.jpg|thumb|rightt|500px|Thoracic Endplate Osteomyeltis with discitis. [https://radiopaedia.org/articles/spondylodiscitis Source: Case courtesy of Dr Chris O'Donnell, Radiopaedia.org, rID: 18272]]]
|}
*18F-fluoride [[positron emission tomography]] (PET) imaging may help in cases of persistent [[back pain]] with [[scoliosis]], with negative findings on plain [[Radiography|radiographs]], [[Computed tomography|CT]], and/or [[Magnetic resonance imaging|MRI]].<ref name="pmid25030392">{{cite journal| author=Grant FD| title=¹⁸F-fluoride PET and PET/CT in children and young adults. | journal=PET Clin | year= 2014 | volume= 9 | issue= 3 | pages= 287-97 | pmid=25030392 | doi=10.1016/j.cpet.2014.03.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25030392 }} </ref><ref name="pmid27562570">{{cite journal| author=Taniguchi Y, Takahashi M, Matsudaira K, Oka H, Momose T| title=Potential use of (18)F-FDG-PET/CT to visualize hypermetabolism associated with muscle pain in patients with adult spinal deformity: a case report. | journal=Skeletal Radiol | year= 2016 | volume= 45 | issue= 11 | pages= 1577-81 | pmid=27562570 | doi=10.1007/s00256-016-2464-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27562570 }} </ref>
*Post-operatively, patients can experience post-operative [[pain]] related to incomplete bone healing or osseous [[nonunion]], hardware loosening, or [[infection]].
*[[Positron emission tomography|PET scan]] can help localize the site of abnormal bone turnover and particularly be useful when implanted orthopedic hardware limits or prevents the use of [[Computed tomography|CT]] or [[magnetic resonance imaging]]
(MRI) to image the [[spine]].
*However, the presence of orthopedic hardware raises concerns about attenuation artifacts, and sites of increased 18F-fluoride uptake should be confirmed on [[Positron emission tomography|PET]] images reconstructed without attenuation correction.
<br><br><br><br><br>
 
===Bone Scan===
*A Tc-99 m whole-body [[bone scan]] has a high sensitivity in detecting [[Fractures|stress fractures]] and most bone lesions with osteoclastic activity.<ref name="pmid20339868">{{cite journal| author=Hospach T, Langendoerfer M, von Kalle T, Maier J, Dannecker GE| title=Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate. | journal=Eur J Pediatr | year= 2010 | volume= 169 | issue= 9 | pages= 1105-11 | pmid=20339868 | doi=10.1007/s00431-010-1188-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20339868  }} </ref>
 
===68Ga-Citrate===
*68Ga-citrate an emerging, generator-based tracer has shown promising results in pilot studies, where [[infection]] has been implicated as a cause for [[scoliosis]].<ref name="pmid21078801">{{cite journal| author=Nanni C, Errani C, Boriani L, Fantini L, Ambrosini V, Boschi S et al.| title=68Ga-citrate PET/CT for evaluating patients with infections of the bone: preliminary results. | journal=J Nucl Med | year= 2010 | volume= 51 | issue= 12 | pages= 1932-6 | pmid=21078801 | doi=10.2967/jnumed.110.080184 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21078801  }} </ref><ref name="pmid9544359">{{cite journal| author=Hadjipavlou AG, Cesani-Vazquez F, Villaneuva-Meyer J, Mader JT, Necessary JT, Crow W et al.| title=The effectiveness of gallium citrate Ga 67 radionuclide imaging in vertebral osteomyelitis revisited. | journal=Am J Orthop (Belle Mead NJ) | year= 1998 | volume= 27 | issue= 3 | pages= 179-83 | pmid=9544359 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9544359  }} </ref>
<ref name="pmid10717911">{{cite journal| author=Gratz S, Dörner J, Oestmann JW, Opitz M, Behr T, Meller J et al.| title=67Ga-citrate and 99Tcm-MDP for estimating the severity of vertebral osteomyelitis. | journal=Nucl Med Commun | year= 2000 | volume= 21 | issue= 1 | pages= 111-20 | pmid=10717911 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10717911  }} </ref>


==References==
==References==

Latest revision as of 16:18, 10 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

Technetium 99m bone scan and 18F-fluoride positron emission tomography (PET) scan may be helpful in the diagnosis of the cases of persistent back pain with scoliosis, with negative findings on plain radiographs, CT, and/or MRI. 68Ga-citrate an emerging, generator-based tracer has shown promising results in pilot studies.

Other Imaging Findings

PET/PET CT

Thoracic Endplate Osteomyeltis with discitis. Source: Case courtesy of Dr Chris O'Donnell, Radiopaedia.org, rID: 18272

(MRI) to image the spine.

  • However, the presence of orthopedic hardware raises concerns about attenuation artifacts, and sites of increased 18F-fluoride uptake should be confirmed on PET images reconstructed without attenuation correction.






Bone Scan

68Ga-Citrate

  • 68Ga-citrate an emerging, generator-based tracer has shown promising results in pilot studies, where infection has been implicated as a cause for scoliosis.[4][5]

[6]

References

  1. Grant FD (2014). "¹⁸F-fluoride PET and PET/CT in children and young adults". PET Clin. 9 (3): 287–97. doi:10.1016/j.cpet.2014.03.004. PMID 25030392.
  2. Taniguchi Y, Takahashi M, Matsudaira K, Oka H, Momose T (2016). "Potential use of (18)F-FDG-PET/CT to visualize hypermetabolism associated with muscle pain in patients with adult spinal deformity: a case report". Skeletal Radiol. 45 (11): 1577–81. doi:10.1007/s00256-016-2464-x. PMID 27562570.
  3. Hospach T, Langendoerfer M, von Kalle T, Maier J, Dannecker GE (2010). "Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate". Eur J Pediatr. 169 (9): 1105–11. doi:10.1007/s00431-010-1188-5. PMID 20339868.
  4. Nanni C, Errani C, Boriani L, Fantini L, Ambrosini V, Boschi S; et al. (2010). "68Ga-citrate PET/CT for evaluating patients with infections of the bone: preliminary results". J Nucl Med. 51 (12): 1932–6. doi:10.2967/jnumed.110.080184. PMID 21078801.
  5. Hadjipavlou AG, Cesani-Vazquez F, Villaneuva-Meyer J, Mader JT, Necessary JT, Crow W; et al. (1998). "The effectiveness of gallium citrate Ga 67 radionuclide imaging in vertebral osteomyelitis revisited". Am J Orthop (Belle Mead NJ). 27 (3): 179–83. PMID 9544359.
  6. Gratz S, Dörner J, Oestmann JW, Opitz M, Behr T, Meller J; et al. (2000). "67Ga-citrate and 99Tcm-MDP for estimating the severity of vertebral osteomyelitis". Nucl Med Commun. 21 (1): 111–20. PMID 10717911.

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