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Incremental value of single photon emission tomography/computed tomography in 3-phase bone scintigraphy of an accessory navicular bone.

Jain S, Karunanithi S, Agarwal KK, Kumar G, Roy SG, Tripathi M - Indian J Nucl Med (2014)

Bottom Line: Accessory navicular bone is one of the supernumerary ossicles in the foot.Radiography is non diagnostic in symptomatic cases.Accessory navicular has been reported as a cause of foot pain and is usually associated with flat foot.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT
Accessory navicular bone is one of the supernumerary ossicles in the foot. Radiography is non diagnostic in symptomatic cases. Accessory navicular has been reported as a cause of foot pain and is usually associated with flat foot. Increased radio tracer uptake on bone scan is found to be more sensitive. We report a case highlighting the significance of single photon emission tomography/computed tomography in methylene diphosphonate bone scan in the evaluation of symptomatic accessory navicular bone where three phase bone scan is equivocal.

No MeSH data available.


Related in: MedlinePlus

Three phase 99mTc-methylene diphosphonate (MDP) bone scan images. Blood flow (a), blood pool (b) and delayed static (c) images did not reveal any definite abnormal concentration of radio tracer in right foot. Single photon emission tomography (SPECT) (d), computed tomography (CT) (e) and hybrid SPECT/CT (f) images revealing a small bony structure medial to right navicular bone with sclerosis and increased MDP uptake (arrows) which was suggestive of an accessory navicular bone
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Figure 1: Three phase 99mTc-methylene diphosphonate (MDP) bone scan images. Blood flow (a), blood pool (b) and delayed static (c) images did not reveal any definite abnormal concentration of radio tracer in right foot. Single photon emission tomography (SPECT) (d), computed tomography (CT) (e) and hybrid SPECT/CT (f) images revealing a small bony structure medial to right navicular bone with sclerosis and increased MDP uptake (arrows) which was suggestive of an accessory navicular bone

Mentions: A 10-year-old male child with bilateral club foot presented to the hospital with pain in his right foot. Plain X-ray did not reveal any abnormality. Magnetic resonance imaging (MRI) showed type II accessory navicular bone in right foot with synchondrosis and surrounding edema. Then patient was referred to our department for three phase bone scan. Blood flow, blood pool and delayed static images of 99mTc-methylene diphosphonate (MDP) bone scan did not reveal any definite abnormal concentration of radio tracer and was equivocal. However, interestingly, hybrid single photon emission tomography/computed tomography (SPECT/CT) showed a small bony structure medial to right navicular bone with sclerosis and an increased radio tracer uptake suggestive of an accessory navicular bone [Figure 1]. The CT acquisition parameters were 110/130 Kv, 100 mAs, pitch-1, 512 × 512 matrix using standard filters in a 6 slice multidetector SPECT/CT system. The CT images were reconstructed with reconstruction kernel B60s and 1 mm slice thickness in all three planes.


Incremental value of single photon emission tomography/computed tomography in 3-phase bone scintigraphy of an accessory navicular bone.

Jain S, Karunanithi S, Agarwal KK, Kumar G, Roy SG, Tripathi M - Indian J Nucl Med (2014)

Three phase 99mTc-methylene diphosphonate (MDP) bone scan images. Blood flow (a), blood pool (b) and delayed static (c) images did not reveal any definite abnormal concentration of radio tracer in right foot. Single photon emission tomography (SPECT) (d), computed tomography (CT) (e) and hybrid SPECT/CT (f) images revealing a small bony structure medial to right navicular bone with sclerosis and increased MDP uptake (arrows) which was suggestive of an accessory navicular bone
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4157201&req=5

Figure 1: Three phase 99mTc-methylene diphosphonate (MDP) bone scan images. Blood flow (a), blood pool (b) and delayed static (c) images did not reveal any definite abnormal concentration of radio tracer in right foot. Single photon emission tomography (SPECT) (d), computed tomography (CT) (e) and hybrid SPECT/CT (f) images revealing a small bony structure medial to right navicular bone with sclerosis and increased MDP uptake (arrows) which was suggestive of an accessory navicular bone
Mentions: A 10-year-old male child with bilateral club foot presented to the hospital with pain in his right foot. Plain X-ray did not reveal any abnormality. Magnetic resonance imaging (MRI) showed type II accessory navicular bone in right foot with synchondrosis and surrounding edema. Then patient was referred to our department for three phase bone scan. Blood flow, blood pool and delayed static images of 99mTc-methylene diphosphonate (MDP) bone scan did not reveal any definite abnormal concentration of radio tracer and was equivocal. However, interestingly, hybrid single photon emission tomography/computed tomography (SPECT/CT) showed a small bony structure medial to right navicular bone with sclerosis and an increased radio tracer uptake suggestive of an accessory navicular bone [Figure 1]. The CT acquisition parameters were 110/130 Kv, 100 mAs, pitch-1, 512 × 512 matrix using standard filters in a 6 slice multidetector SPECT/CT system. The CT images were reconstructed with reconstruction kernel B60s and 1 mm slice thickness in all three planes.

Bottom Line: Accessory navicular bone is one of the supernumerary ossicles in the foot.Radiography is non diagnostic in symptomatic cases.Accessory navicular has been reported as a cause of foot pain and is usually associated with flat foot.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT
Accessory navicular bone is one of the supernumerary ossicles in the foot. Radiography is non diagnostic in symptomatic cases. Accessory navicular has been reported as a cause of foot pain and is usually associated with flat foot. Increased radio tracer uptake on bone scan is found to be more sensitive. We report a case highlighting the significance of single photon emission tomography/computed tomography in methylene diphosphonate bone scan in the evaluation of symptomatic accessory navicular bone where three phase bone scan is equivocal.

No MeSH data available.


Related in: MedlinePlus