[SPECT/CT in diagnostics of the hand joint].
OBJECTIVE
Hand and wrist pain remains a diagnostic challenge, both for hand surgeons and for radiologists. Especially chronic wrist pain is often hard to localize clinically and further cross-sectional imaging is often indispensable.


METHODS
The well-established standard for non-invasive diagnostic imaging in chronic wrist pain is magnetic resonance imaging (MRI).


METHODS
Recently, state-of-the-art single photon emission computed tomography/computed tomography (SPECT/CT) systems have been introduced into the diagnostic array for musculoskeletal conditions. Besides morphological data SPECT/CT also provides metabolic information.


METHODS
SPECT/CT allows an exact detection and precise anatomical mapping of different pathologies of the wrist, which is often crucial for therapy.


RESULTS
In patients with chronic wrist pain, SPECT/CT is more specific than MRI. It is also beneficial in patients with posttraumatic conditions and metal implants and may serve as a problem-solving tool in difficult cases.


CONCLUSIONS
It is considered that SPECT/CT imaging is useful if MRI results are equivocal or present no clearly leading pathology. A primary examination with SPECT/CT seems to be a reasonable option for patients with certain bone pathologies, metal implants and non-specific wrist pain.
Institut für Radiologie und Nuklearmedizin, Luzerner Kantonsspital, CH-6004, Luzern, Schweiz. martin.huellner@usz.ch
M W
MW
Huellner
K
K
Strobel
U
U
Hug
U
U
von Wartburg
P
P
Veit-Haibach
D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007592:Joint Diseases / Q000000981:diagnostic imaging*; D011859:Radiography; D011877:Radionuclide Imaging