Document Detail

Bone injury associated with anterior cruciate ligament and meniscal tears: assessment with bone single photon emission computed tomography.
MedLine Citation:
PMID:  12218448     Owner:  NLM     Status:  MEDLINE    
RATIONALE AND OBJECTIVES: Acute injury of the menisci and ligaments about the knee joint is often associated with accompanying bone injury. The role of bone single photon emission computed tomography (SPECT) was assessed in this clinical setting. MATERIALS AND METHODS: Knee SPECT was performed in 94 patients with suspected ACL, meniscal tear, or both and was correlated with arthroscopy (n = 74), magnetic resonance imaging (MRI) (n = 37), or both. Scintigraphic findings were categorized based on their anatomic location and on uptake intensity (0-3 grade scale). RESULTS: Correlation with arthroscopy: Eleven patients had a normal arthroscopy of which in 10, SPECT images detected no abnormality. Sixty-three patients had abnormal arthroscopic findings, whereas all had abnormal SPECT studies. Thirty-eight patients had an anterior cruciate ligament (ACL) tear on arthroscopy. In this type of injury SPECT images detected increased uptake in the posterior aspect of the lateral tibial plateau (LTPp) with a positive predictive value (PPV) of 93% and a negative predictive value (NPV) of 97%. In 55% of the patients, increased uptake was also detected in the region of the middle sulcus of the lateral femoral condyle (LFCm): a "kissing" pattern. Tear of the medial meniscus was diagnosed by arthroscopy in 43 patients. SPECT images detected increased uptake in the medial tibial plateau (MTP) with a PPV of 78% and a NPV of 83%. Correlation with MRI: all seven cortical fractures seen on MRI were detected on SPECT. Twenty-eight patients had MRI findings suggestive of an ACL injury. Accompanying bone bruises were seen in 18 of them (64%). On SPECT images, all 28 patients with an ACL tear had increased uptake in the LTPp. Intensity of uptake in patients with associated bone bruise, however, was significantly higher; mean intensity grade 2.4 +/- 0.7 in case of accompanying bone bruise compared with 1.4 +/- 0.8 in case of an ACL tear without associated bone injury, P< 0.01. CONCLUSION: Results of the study suggest that bone SPECT is valuable in acute knee trauma for assessment of ACL, meniscal tears, or both and for detection of associated bone injury.
Einat Even-Sapir; Ron Arbel; Hedva Lerman; Gideon Flusser; Gennady Livshitz; Nachum Halperin
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Investigative radiology     Volume:  37     ISSN:  0020-9996     ISO Abbreviation:  Invest Radiol     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-09     Completed Date:  2002-10-30     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  521-7     Citation Subset:  IM    
Department of Nuclear Medicine1, Tel-Aviv Sourasky Medical Center, Israel.
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MeSH Terms
Anterior Cruciate Ligament / injuries,  radionuclide imaging*
Evaluation Studies as Topic
Knee Injuries / radionuclide imaging*
Menisci, Tibial / injuries,  radionuclide imaging*
Middle Aged
Tomography, Emission-Computed, Single-Photon*

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