Nuclear Medicine Imaging of the Pediatric Musculoskeletal System

 

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ABSTRACT

Bone scintigraphy is a common pediatric nuclear medicine procedure and plays a significant role in the diagnosis of skeletal infection, trauma, and benign and malignant bone tumors. There is a complementary role for bone scintigraphy in the assessment of a child with suspected nonaccidental injury. High-quality images require careful attention to technique and positioning in children. Additional techniques such as magnification and single-photon emission computed tomography (SPECT) can be used for special indications and localization. Combined functional and anatomic imaging using SPECT/computed tomography (CT) imaging systems can improve diagnostic accuracy. Positron emission tomography (PET) using fluorine-18 fluorodeoxyglucose (FDG) is being applied with increasing frequency in the evaluation of children with malignancy. To interpret ¹⁸F-FDG PET appropriately, it is essential to know the normal physiological distribution. Using combined ¹⁸F-FDG PET/CT improves specificity and localization. This article reviews the common indications for bone scintigraphy and ¹⁸F-FDG PET/CT in benign and malignant pediatric musculoskeletal disease.

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Amer ShammasM.D. 

Department of Diagnostic Imaging, Division of Nuclear Medicine, The Hospital for Sick Children, University of Toronto

555 University Ave., Toronto, Ontario, Canada M5G 1X8

Email: amershammas@yahoo.com