title: Usefulness of 99Tcm-MDP knee SPET for pre-arthroscopic evaluation of patients with internal derangements of the knee.
abstract: The aim of this study was to ascertain whether knee SPET can localize lesion sites in patients with internal derangements of the knee. We performed knee SPET as a pre-arthroscopic examination in 63 consecutive patients. SPET imaging was performed with a triple-headed SPET camera 4 h after the injection of 99Tcm-methylene diphosphonate. Arthroscopic diagnoses were as follows: 28 medial meniscus injuries, 24 lateral meniscus injuries, 31 anterior cruciate ligament (ACL) injuries, three posterior cruciate ligament injuries and one medial collateral ligament injury. Of 30 patients with crescent-shaped increased activity at the medial tibial plateau, 22 had medial meniscus injuries (positive predictive value: PPV 73%); of 17 patients with crescent-shaped activity at the lateral tibial plateau, 13 had lateral meniscus injuries (PPV 76%). Of 18 patients with increased activity at ACL attachment sites (primary sign), 17 had ACL injuries (PPV 94%). Of 27 patients with increased activity at bone impaction sites of ACL injury (secondary sign), 22 had ACL injuries (PPV 81%). Of 32 patients who had either a primary or secondary sign, 26 had ACL injuries (PPV 81%). We conclude that knee SPET is very useful in the management of internal derangements of the knee, particularly in determining the need for arthroscopy by localizing lesion sites.
authors.affiliation: Department of Nuclear Medicine, Seoul National University College of Medicine, Korea. jkchung@plaza.snu.ac.kr
authors.forename: Y
authors.initials: Y
authors.lastname: So
authors.forename: J K
authors.initials: JK
authors.lastname: Chung
authors.forename: S C
authors.initials: SC
authors.lastname: Seong
authors.forename: Y J
authors.initials: YJ
authors.lastname: Sohn
authors.forename: H S
authors.initials: HS
authors.lastname: Kang
authors.forename: D S
authors.initials: DS
authors.lastname: Lee
authors.forename: M C
authors.initials: MC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000473:pathology; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate