[Nuclear medicine imaging for diagnosis of CRPS I]

Abstract

A three-phase bone scan, before conventional radiography shows morphological changes in CRPS 1, represents a valuable diagnostic tool thanks to the depiction of pathognomonic findings and the localisation ability in all 3 phases. It must be interpreted within the clinical context. In late or subsequent stages the lack of scintigraphic uptake seems to represent the end of the active disease process. The role of three-phase bone scintigraphy in CRPS I is to support or even confirm the diagnosis, given its various presentations. Furthermore, it enables exclusion of other diagnoses such as arthritis, benign or malignant bony lesions, or even metabolic bone diseases such as Paget's disease, particularly if an integrated SPECT/CT is added. Moreover, the earlier the diagnosis is finally established and treatment of CRPS I is initiated, the better the prognosis. Therefore, bone scintigraphy potentially has a major impact on patient management of this disorder.