title: The value of SPECT/CT in carpal boss.
abstract: OBJECTIVE
  To assess the value of SPECT/CT in patients with carpal boss (CB).
  
  
  METHODS
  In 24 wrists with CB (18 right-sided, 6 left-sided) in 21 patients, planar images and SPECT/CT images were obtained. Three patients had bilateral CB. The grade of uptake (0 absent, 1 low, 2 moderate, 3 high) on planar imaging and SPECT/CT was assessed and compared with CT findings, clinical symptoms and follow-up findings.
  
  
  RESULTS
  CB affected carpometacarpal joint II in 4 wrists, carpometacarpal joint III in 17 wrists and both carpometacarpal joints II and III in 3 wrists. Of the 24 CB, 12 (50 %) were active (i.e. increased radionuclide uptake) on planar images and 18 (75 %) on SPECT/CT images. Of the 17 symptomatic CB, 10 (59 %) were active on planar images and 14 (82 %) were active (mean grade 1.9, range 1 - 3) on SPECT/CT images. Of the 7 asymptomatic CB, 2 were active on planar images and 4 were active (mean grade 1.25, range 1 - 2) on SPECT/CT images. CT alone showed CB in all patients and an accessory ossicle (os styloideum) in 8 wrists. MR imaging was available in 7 patients and positive for CB in 5 (sensitivity 71 %). Plain radiographs were available in 17 patients and positive in 10 (59 %). Therapeutic infiltration of the CB was performed in 9 patients, and resection of the CB in 7 patients.
  
  
  CONCLUSIONS
  SPECT/CT provides important morphological and metabolic information for the clinical assessment of CB, but because SPECT/CT tends to overestimate the clinical importance of CB, we recommend that planar images should still be obtained.
authors.affiliation: Nuclear Medicine and Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
authors.forename: Ujwal
authors.initials: U
authors.lastname: Bhure
authors.affiliation: Department of Hand and Plastic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Hug
authors.affiliation: Nuclear Medicine and Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
authors.forename: Martin W
authors.initials: MW
authors.lastname: Huellner
authors.affiliation: Nuclear Medicine and Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
authors.forename: Hannes
authors.initials: H
authors.lastname: Grünig
authors.affiliation: Nuclear Medicine and Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
authors.forename: Andrea
authors.initials: A
authors.lastname: Zander
authors.affiliation: Nuclear Medicine and Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
authors.forename: Maria
authors.initials: M
authors.lastname: Del Sol Pérez Lago
authors.affiliation: Nuclear Medicine and Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland. klaus.strobel@ksl.ch.
authors.forename: Klaus
authors.initials: K
authors.lastname: Strobel
mesh_terms: D000293:Adolescent; D000328:Adult; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Bone; Carpal boss; Joint; SPECT/CT; Wrist