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Bone SPECT Is More Sensitive Than MRI in the Detection of Early Osteonecrosis of the Femoral Head After Renal Transplantation

¹ Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
² Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
³ Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
⁴ Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
⁵ Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

View larger version (130K): [in a new window]   FIGURE 1. A 53-y-old male renal transplant recipient complained of bilateral hip pain. Initial whole-body bone scintigraphy (A) and bone SPECT (B) show cold areas in both femoral heads, whereas MRI of both hips shows normal findings (C).

View larger version (105K): [in a new window]   FIGURE 2. Patient of Figure 1 underwent follow-up MRI, bone scintigraphy, and SPECT. T1- and T2-weighted MR images (A) show geographic areas of low signal intensity in both femoral heads, and bone scintigraphy (B) and SPECT (C) show increased uptake surrounding cold central areas in both femoral heads. Osteonecrosis of both femoral heads was pathologically confirmed after total hip replacement.

View larger version (82K): [in a new window]   FIGURE 3. A 35-y-old female renal transplant recipient complained of bilateral hip pain. Whole-body bone scintigraphy (A) and SPECT (B) show decreased uptake in both femoral heads and increased uptake in both distal femurs and left proximal tibia, but initial MRI of both hips (not shown) and several follow-up MRI examinations until 1 y later showed normal findings. Follow-up bone scintigraphy (C) and SPECT (D) 2 y later show normalized uptake in both femoral heads, distal femurs, and left proximal tibia.