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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
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.
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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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