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Case Reports
. 2011 Jul;5(3):72-6.
doi: 10.4103/0973-6042.86242.

Combined single photon emission computerized tomography and conventional computerized tomography: Clinical value for the shoulder surgeons?

Michael T Hirschmann  1 , Rahel Schmid, Ranju Dhawan, Jiri Skarvan, Helmut Rasch, Niklaus F Friederich, Roger Emery
Affiliations
Case Reports

Combined single photon emission computerized tomography and conventional computerized tomography: Clinical value for the shoulder surgeons?

Michael T Hirschmann et al. Int J Shoulder Surg. 2011 Jul.

Abstract

With the cases described, we strive to introduce single photon emission computerized tomography in combination with conventional computer tomography (SPECT/CT) to shoulder surgeons, illustrate the possible clinical value it may offer as new diagnostic radiologic modality, and discuss its limitations. SPECT/CT may facilitate the establishment of diagnosis, process of decision making, and further treatment for complex shoulder pathologies. Some of these advantages were highlighted in cases that are frequently seen in most shoulder clinics.

Keywords: Hemiarthroplasty; SPECT/CT; loosening; shoulder arthroplasty.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1a
Figure 1a
Anterior-posterior and y.view radiographs of the right shoulder at initial presentation indicating a valgus-impacted humeral head fragment and doubtful partial osteonecrosis of the humeral head
Figure 1
Figure 1
(b) MRI showing extensive cystic changes within the humeral head; (c) 99mTc.HDP.SPECT/CT showing decreased uptake of the humeral head fragment indicating a humeral head necrosis
Figure 2a
Figure 2a
Anterior-posterior and y-view radiographs of the right shoulder showing wide radiolucent lines around the glenoid peg
Figure 2b
Figure 2b
99mTc-HDP-SPECT/CT showing increased tracer uptake at the glenoid component-host bone interface, which was interpreted as clear sign for mechanical loosening
Figure 2c
Figure 2c
Anterior-posterior and y-view radiographs of the right shoulder after revision to a bipolar cup prosthesis
Figure 3a
Figure 3a
Anterior-posterior and y-view radiographs of the left shoulder indicating radiolucent lines around the humeral stem
Figure 3b
Figure 3b
Planar scintigraphy and 99mTc-HDP-SPECT/CT showing increased tracer uptake around the humeral stem, which was caused by mechanical loosening
Figure 4a
Figure 4a
SPECT/CT showing erosive arthropathy with joint-based tracer uptake
Figure 4b
Figure 4b
CT showing no significant periprosthetic lucency; planar scintigraphy indicated normal blood pool activity, delayed moderate periprosthetic tracer activity;SPECT/CT clearly found increased tracer activity of the acromion and acromioclavicular joint
See this image and copyright information in PMC

References

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