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The Role of Bone Scintigraphy with SPECT/CT in the Characterization and Early Diagnosis of Stage 0 Charcot Neuroarthropathy
We describe the use of Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) in the investigation and diagnosis of Charcot neuroarthropathy (CN) in patients with a hot swollen foot but normal radiographs and clinical suspicion of CN, usually termed Stage 0. This was a retrospecti...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767116/ https://www.ncbi.nlm.nih.gov/pubmed/33371286 http://dx.doi.org/10.3390/jcm9124123 |
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author | Ahluwalia, Raju Bilal, Ahmad Petrova, Nina Boddhu, Krishna Manu, Chris Vas, Prashanth Bates, Maureen Corcoran, Ben Reichert, Ines Mulholland, Nicola Kavarthapu, Venu Vivian, Gill Edmonds, Michael |
author_facet | Ahluwalia, Raju Bilal, Ahmad Petrova, Nina Boddhu, Krishna Manu, Chris Vas, Prashanth Bates, Maureen Corcoran, Ben Reichert, Ines Mulholland, Nicola Kavarthapu, Venu Vivian, Gill Edmonds, Michael |
author_sort | Ahluwalia, Raju |
collection | PubMed |
description | We describe the use of Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) in the investigation and diagnosis of Charcot neuroarthropathy (CN) in patients with a hot swollen foot but normal radiographs and clinical suspicion of CN, usually termed Stage 0. This was a retrospective cohort review of 46 diabetes patients who underwent 3 phase bone scintigraphy with “High Resolution” SPECT/CT. The imaging demonstrated that Stage 0 Charcot foot has a distinct bone pathology, which can be classified into three groups: (1) fractures on Computed Tomography (CT) with accompanying focal uptake of tracer on SPECT, (2) bony abnormalities apart from fracture on CT with focal uptake of tracer on SPECT, and (3) normal CT but focal bony uptake of tracer on SPECT. The CT component of SPECT/CT detected bony fractures in 59% of patients. Early treatment with below knee cast and follow-up for 24 months showed only 4 patients who developed Stage 1 Eichenholtz Charcot foot. Our findings support the use of 3 phase bone scintigraphy with SPECT/CT in the characterization and early diagnosis of CN. Stage 0 Charcot foot has a distinct bone pathology which requires urgent treatment to prevent progression to Stage 1 Eichenholtz Charcot foot. If SPECT/CT is unavailable, CT alone will detect bone fracture in 59% patients. |
format | Online Article Text |
id | pubmed-7767116 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-77671162020-12-28 The Role of Bone Scintigraphy with SPECT/CT in the Characterization and Early Diagnosis of Stage 0 Charcot Neuroarthropathy Ahluwalia, Raju Bilal, Ahmad Petrova, Nina Boddhu, Krishna Manu, Chris Vas, Prashanth Bates, Maureen Corcoran, Ben Reichert, Ines Mulholland, Nicola Kavarthapu, Venu Vivian, Gill Edmonds, Michael J Clin Med Article We describe the use of Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) in the investigation and diagnosis of Charcot neuroarthropathy (CN) in patients with a hot swollen foot but normal radiographs and clinical suspicion of CN, usually termed Stage 0. This was a retrospective cohort review of 46 diabetes patients who underwent 3 phase bone scintigraphy with “High Resolution” SPECT/CT. The imaging demonstrated that Stage 0 Charcot foot has a distinct bone pathology, which can be classified into three groups: (1) fractures on Computed Tomography (CT) with accompanying focal uptake of tracer on SPECT, (2) bony abnormalities apart from fracture on CT with focal uptake of tracer on SPECT, and (3) normal CT but focal bony uptake of tracer on SPECT. The CT component of SPECT/CT detected bony fractures in 59% of patients. Early treatment with below knee cast and follow-up for 24 months showed only 4 patients who developed Stage 1 Eichenholtz Charcot foot. Our findings support the use of 3 phase bone scintigraphy with SPECT/CT in the characterization and early diagnosis of CN. Stage 0 Charcot foot has a distinct bone pathology which requires urgent treatment to prevent progression to Stage 1 Eichenholtz Charcot foot. If SPECT/CT is unavailable, CT alone will detect bone fracture in 59% patients. MDPI 2020-12-21 /pmc/articles/PMC7767116/ /pubmed/33371286 http://dx.doi.org/10.3390/jcm9124123 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ahluwalia, Raju Bilal, Ahmad Petrova, Nina Boddhu, Krishna Manu, Chris Vas, Prashanth Bates, Maureen Corcoran, Ben Reichert, Ines Mulholland, Nicola Kavarthapu, Venu Vivian, Gill Edmonds, Michael The Role of Bone Scintigraphy with SPECT/CT in the Characterization and Early Diagnosis of Stage 0 Charcot Neuroarthropathy |
title | The Role of Bone Scintigraphy with SPECT/CT in the Characterization and Early Diagnosis of Stage 0 Charcot Neuroarthropathy |
title_full | The Role of Bone Scintigraphy with SPECT/CT in the Characterization and Early Diagnosis of Stage 0 Charcot Neuroarthropathy |
title_fullStr | The Role of Bone Scintigraphy with SPECT/CT in the Characterization and Early Diagnosis of Stage 0 Charcot Neuroarthropathy |
title_full_unstemmed | The Role of Bone Scintigraphy with SPECT/CT in the Characterization and Early Diagnosis of Stage 0 Charcot Neuroarthropathy |
title_short | The Role of Bone Scintigraphy with SPECT/CT in the Characterization and Early Diagnosis of Stage 0 Charcot Neuroarthropathy |
title_sort | role of bone scintigraphy with spect/ct in the characterization and early diagnosis of stage 0 charcot neuroarthropathy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767116/ https://www.ncbi.nlm.nih.gov/pubmed/33371286 http://dx.doi.org/10.3390/jcm9124123 |
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