Therapeutic impact of [(18)F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain

Skeletal Radiol. 2010 Oct;39(10):987-97. doi: 10.1007/s00256-010-0875-7. Epub 2010 Feb 23.

Abstract

Purpose: To evaluate the therapeutic impact of [(18)F]fluoride positron-emission tomography/computed tomography ([(18)F]fluoride PET/CT) imaging on patients with unclear foot pain.

Methods: Twenty-eight patients were prospectively included in this study. Therapeutic management was defined by two experienced dedicated foot surgeons before and after [(18)F]fluoride PET/CT imaging. Twenty-six patients underwent cross-sectional imaging [CT, magnetic resonance (MR)] prior to PET/CT. A retrospective analysis of the magnetic resonance imaging (MRI) diagnoses was performed when a therapy change occurred after PET/CT imaging.

Results: In 13/28 (46%) patients therapeutic management was changed due to PET/CT results. Management changes occurred in patients with the following diagnoses: os trigonum syndrome; sinus tarsi syndrome; os tibiale externum syndrome; osteoarthritis of several joints; non-consolidated fragments; calcaneo-navicular coalition; plantar fasciitis; insertional tendinopathy; suggestion of periostitis; neoarticulations between metatarsal bones. Os trigonum, os tibiale externum, subtalar osteoarthritis and plantar fasciitis were only seen to be active on PET/CT images but not on MR images.

Conclusion: [(18)F]fluoride PET/CT has a substantial therapeutic impact on management in patients with unclear foot pain.

MeSH terms

  • Adult
  • Aged
  • Female
  • Fluorodeoxyglucose F18*
  • Foot / diagnostic imaging
  • Foot Diseases / complications
  • Foot Diseases / diagnosis*
  • Foot Diseases / therapy*
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Observer Variation
  • Pain / etiology
  • Pain Management*
  • Positron-Emission Tomography / methods
  • Prospective Studies
  • Radiopharmaceuticals*
  • Tomography, X-Ray Computed / methods*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18