Scoliosis other imaging findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

Technetium 99m bone scan and 18F-fluoride positron emission tomography (PET) scan may be helpful in the diagnosis of the cases of persistent back pain with scoliosis, with negative findings on plain radiographs, CT, and/or MRI. 68Ga-citrate an emerging, generator-based tracer has shown promising results in pilot studies.

Other Imaging Findings

PET/PET CT

Thoracic Endplate Osteomyeltis with discitis. Source: Case courtesy of Dr Chris O’Donnell, Radiopaedia.org, rID: 18272

18F-fluoride positron emission tomography (PET) imaging may help in cases of persistent back pain with scoliosis, with negative findings on plain radiographs, CT, and/or MRI.^[1]^[2]
Post-operatively, patients can experience post-operative pain related to incomplete bone healing or osseous nonunion, hardware loosening, or infection.
PET scan can help localize the site of abnormal bone turnover and particularly be useful when implanted orthopedic hardware limits or prevents the use of CT or magnetic resonance imaging

(MRI) to image the spine.

However, the presence of orthopedic hardware raises concerns about attenuation artifacts, and sites of increased 18F-fluoride uptake should be confirmed on PET images reconstructed without attenuation correction.

Bone Scan

A Tc-99 m whole-body bone scan has a high sensitivity in detecting stress fractures and most bone lesions with osteoclastic activity.^[3]

68Ga-Citrate

68Ga-citrate an emerging, generator-based tracer has shown promising results in pilot studies, where infection has been implicated as a cause for scoliosis.^[4]^[5]

^[6]

References

↑ Grant FD (2014). “¹⁸F-fluoride PET and PET/CT in children and young adults”. PET Clin. 9 (3): 287–97. doi:10.1016/j.cpet.2014.03.004. PMID 25030392.
↑ Taniguchi Y, Takahashi M, Matsudaira K, Oka H, Momose T (2016). “Potential use of (18)F-FDG-PET/CT to visualize hypermetabolism associated with muscle pain in patients with adult spinal deformity: a case report”. Skeletal Radiol. 45 (11): 1577–81. doi:10.1007/s00256-016-2464-x. PMID 27562570.
↑ Hospach T, Langendoerfer M, von Kalle T, Maier J, Dannecker GE (2010). “Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate”. Eur J Pediatr. 169 (9): 1105–11. doi:10.1007/s00431-010-1188-5. PMID 20339868.
↑ Nanni C, Errani C, Boriani L, Fantini L, Ambrosini V, Boschi S; et al. (2010). “68Ga-citrate PET/CT for evaluating patients with infections of the bone: preliminary results”. J Nucl Med. 51 (12): 1932–6. doi:10.2967/jnumed.110.080184. PMID 21078801.
↑ Hadjipavlou AG, Cesani-Vazquez F, Villaneuva-Meyer J, Mader JT, Necessary JT, Crow W; et al. (1998). “The effectiveness of gallium citrate Ga 67 radionuclide imaging in vertebral osteomyelitis revisited”. Am J Orthop (Belle Mead NJ). 27 (3): 179–83. PMID 9544359.
↑ Gratz S, Dörner J, Oestmann JW, Opitz M, Behr T, Meller J; et al. (2000). “67Ga-citrate and 99Tcm-MDP for estimating the severity of vertebral osteomyelitis”. Nucl Med Commun. 21 (1): 111–20. PMID 10717911.

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[pmid25030392-1] Grant FD (2014). “¹⁸F-fluoride PET and PET/CT in children and young adults”. PET Clin. 9 (3): 287–97. doi:10.1016/j.cpet.2014.03.004. PMID 25030392.

[pmid27562570-2] Taniguchi Y, Takahashi M, Matsudaira K, Oka H, Momose T (2016). “Potential use of (18)F-FDG-PET/CT to visualize hypermetabolism associated with muscle pain in patients with adult spinal deformity: a case report”. Skeletal Radiol. 45 (11): 1577–81. doi:10.1007/s00256-016-2464-x. PMID 27562570.

[pmid20339868-3] Hospach T, Langendoerfer M, von Kalle T, Maier J, Dannecker GE (2010). “Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate”. Eur J Pediatr. 169 (9): 1105–11. doi:10.1007/s00431-010-1188-5. PMID 20339868.

[pmid21078801-4] Nanni C, Errani C, Boriani L, Fantini L, Ambrosini V, Boschi S; et al. (2010). “68Ga-citrate PET/CT for evaluating patients with infections of the bone: preliminary results”. J Nucl Med. 51 (12): 1932–6. doi:10.2967/jnumed.110.080184. PMID 21078801.

[pmid9544359-5] Hadjipavlou AG, Cesani-Vazquez F, Villaneuva-Meyer J, Mader JT, Necessary JT, Crow W; et al. (1998). “The effectiveness of gallium citrate Ga 67 radionuclide imaging in vertebral osteomyelitis revisited”. Am J Orthop (Belle Mead NJ). 27 (3): 179–83. PMID 9544359.

[pmid10717911-6] Gratz S, Dörner J, Oestmann JW, Opitz M, Behr T, Meller J; et al. (2000). “67Ga-citrate and 99Tcm-MDP for estimating the severity of vertebral osteomyelitis”. Nucl Med Commun. 21 (1): 111–20. PMID 10717911.

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