Abstract
Aim
Single-photon emission computed tomography is a new imaging modality combining high detail CT with highly sensitive triple phase nuclear bone scanning to help clinicians in diagnosis and management of various conditions. Little has been published about its particular usefulness in foot and ankle pathology. We conducted a prospective study to evaluate the role of SPECT for the same.
Material and Methods
Fifty patients were seen in a tertiary referral foot and ankle clinic presenting with a variety of foot and ankle conditions. SPECT-CT was requested when a definitive clinical diagnosis could not be reached after thorough clinical examination and plain radiography. Pathology shown by SPECT-CT was taken as the final diagnosis and interventional surgical management carried out accordingly. Patients were subsequently seen in the follow up clinic to evaluate the outcome of their treatment.
Results
In eleven (22%) cases, clinical correlation matched with the findings of the SPECT-CT and no change in treatment was necessary.
However, in 39 patients (78%) findings of SPECT-CT did not correlate exactly with clinical findings and led to a modified treatment plan. Of these 39 patients, 35 (88%) improved after the intervention based on SPECT-CT findings.
Conclusions
We found SPECT-CT to be a very useful investigation in complex foot and ankle cases where definite diagnosis after clinical and simple radiographic examination was still somewhat unclear. Our study suggests that SPECT-CT helps clinical decision making and improves outcome.
