Advertisement - Hide this advert





Author Topic: Bone Scan and SPECT of the knee  (Read 8044 times)

0 Members and 1 Guest are viewing this topic.

Offline Shazinoz

  • SuperKNEEgeek
  • *****
  • Posts: 1029
  • Liked: 0
  • G'Day from Australia
Bone Scan and SPECT of the knee
« on: September 23, 2002, 09:54:21 AM »
I had one of these done 14th August 02.
And the results perplex me. ::)
My GP says one thing and the Radiologist says another ?? and some of it I simpily don't understand.  :-[
Any help greatly appreciated.
Here goes....
"Flow and Blood Pool Imaging shows aome mild hyperaemia to the left knee centrally snd delayed planer imaging shows a periarticular mild increase in uptake around the left knee the features of which are probably related to her recent surgery (my last surgery was in 1998 and none of this showed up on the last bone scan 13 months before).
SPECT of the knees confirms the planar images with a mild generalised increase in uptake within the left knee itself. There is also a more focal area of increased uptake in the distribution of the Anterior Cruciate Ligament This extends form the medial aspect of the lateral condyle of the femur across to the tibial plateau. Again these features may well just represent bony reaction to her recent trauma and surgery".  :-/
Any ideas ANYONE.  ???
Basically the raidologist thinks everthing that shows up on the bone scan is related to my last surgery in 1998 (my second ACL reconstruction) even though absolutely nothing showed up on the last bone scan 13 months before. ???
And my GP says all that is showing up on this bone scan is related to THIS injury (when I bent my knee to dry my foot after a bath and it exploded (Literally). :o
Can anyone explain this difference to me and what they found actually means to me.  ???
My GP says I have fractured both ends of the ACL graft part way out of the bone and also stretched the ACL (so that it is basically twice as long and half as wide as it was) and possibly also damaged my MCL too.
I am very confused as I am getting two different answers to the one report and test.  :o
HELP PLEASE....  ;D
« Last Edit: September 30, 2002, 03:34:16 PM by admin »
2 ACL 'reco's', 3 'scopes', Pain, JRA, EDS, RSD, CMP, osetochondral defect & #, synovitis, adhesions, nerve damage, foot drop, MCL damage, tendonitis, fibrosis, ligament damage AGAIN, dislocations +++

Offline Shazinoz

  • SuperKNEEgeek
  • *****
  • Posts: 1029
  • Liked: 0
  • G'Day from Australia
Re: Bone Scan and SPECT (a bit long sorry)
« Reply #1 on: September 29, 2002, 03:17:32 PM »
1st of all PLEASE excuse my horrible typing and spelling etc. I am trying to type with a cast on my arm from fingers to elbow (I have tendonitis/tenosynovitis AGAIN in my wrist/thumb) and have a tendency to hit more than one key at once  :'( Just what I need.

Since this injury (described above) in June Nothing at all has got better, i am still in heaps of pain (taking 15mg MsContin 2x day, Neurontin 300mg 1 day, rivotril 0.5mg 1 day, Vioxx 25mg 1 day, Panadine Forte as needed) and still in pain. I still have major instability (when not in Djortho Irom telescopic enhanced) and wasting, a huge lump medially and distally on knee (have had this since the injury), Weakness (I cna hardly walk any distance at all).
My GP has decided i need to see the OS again even though when i saw him in August he said there was basically nothing wrong with my knee. My GP hopes that because it has now been more than 3 montths the OS may give it more time and consideration. My GP personally thinks that my knee will get no better with out surgery even if it is just someone looking inside to get an accurate diagnosis as the MRI was too "contaminated" by the screws and staples from my last reco. and the above bone sca is confusing..
So what do I do (i can't get into the OS until mid-end Oct & with what he said & worse what he wrote in the report to my GP i don't hold out a lot of hope (he wrote to my GP and it was so full of inaccuracies i had to check to see if it actually about me (he even got which leg it is wrong, and said i put my self into an immobiliser when my GP did).
So do i set up a 2nd opinion just incase he tres to fob me off agaon??? or do i just hope 4 the best.
2 ACL 'reco's', 3 'scopes', Pain, JRA, EDS, RSD, CMP, osetochondral defect & #, synovitis, adhesions, nerve damage, foot drop, MCL damage, tendonitis, fibrosis, ligament damage AGAIN, dislocations +++

Offline T_bone

  • MICROgeek (<20 posts)
  • *
  • Posts: 18
  • Liked: 0
  • All I want for Christmas is my kneecap back!
Re: Bone Scan and SPECT (a bit long sorry)
« Reply #2 on: September 30, 2002, 07:59:10 AM »
With regards to your bone scan -- Yes, one will get increased blood flow and bone labelling activity after many different situations (surgery, injury, arthritis, tumor, etc).  Bone scans mimic bone metabolism.  It seems a bit weird that your scan was normal after your surgery and they are now attributing the changes they're seeing to the surgery.  Also, bone scans won't show ligaments but can show what's going on in the bone where the ligaments attach.  I'm impressed they did SPECT along with planar images.  I have had several bone scans and they still show the effect of my Maquet even though it was done 15 years ago.   I think I'd push the issue as to why they're attributing these findings to your surgery even though your previous scan didn't.  Perhaps the doc who read out your original scan is the problem.

I know this will probably only muddle things for you even more.  Sorry and good luck.  Keep them honest ;)

Offline Shazinoz

  • SuperKNEEgeek
  • *****
  • Posts: 1029
  • Liked: 0
  • G'Day from Australia
Re: Bone Scan and SPECT (a bit long sorry)
« Reply #3 on: September 30, 2002, 02:33:52 PM »
tbone,
even I can see that 13 months previous the bone scan was clear this bone scan has a pretty dark spot where the injury is. I wish I could somehow scan and post them. I rang the radiologists (it was the smae company both this time and last) and they are still sticking to there guns about it beinmg old damage, even though it can't be seen on the other bone scan. I did have a MRI but it was comprimised severely by the screws and basically according to my GP was that poor you could even see near the ACL let alone if the ACL was intact or stretched. I guess I wait again until I see the OS again in end Oct.
2 ACL 'reco's', 3 'scopes', Pain, JRA, EDS, RSD, CMP, osetochondral defect & #, synovitis, adhesions, nerve damage, foot drop, MCL damage, tendonitis, fibrosis, ligament damage AGAIN, dislocations +++

Offline The KNEEguru

  • Administrator
  • SuperKNEEgeek
  • *****
  • Posts: 2555
  • Liked: 96
  • The KNEEguru
    • The KNEEguru
Re: Bone Scan and SPECT of the knee
« Reply #4 on: September 30, 2002, 03:41:22 PM »
Hi T_bone
For the sake of the group, please tell us what SPECT is and how and why a bone scan is done. Don't worry about talking down to us - at least then we will all understand and can progress to geek-speak later!
Many thanks
KNEEguru
--
KNEEguru

Offline T_bone

  • MICROgeek (<20 posts)
  • *
  • Posts: 18
  • Liked: 0
  • All I want for Christmas is my kneecap back!
Re: Bone Scan and SPECT of the knee
« Reply #5 on: October 28, 2002, 08:42:04 PM »
Bone scans are useful for showing changes in bone activity (metabolism).  Your bones are (so to speak) constantly in a building phase.  Whenever there is an abnormal event in a specific bony area this activity picks up.  This could come from a variety of things - arthritis, injury, tumor, stress fracture, etc.  When you undergo a bone scan you are injected with a radiotracer that is tagged to a material that mimics bony metabolism.  Any area that has increased activity will show a greater concentration of this radiotracer (hot spot).  You will most likely have images taken as you receive the injection.  This allows the physician to look at blood flow to the area being scanned.  Oftentimes increased blood flow accompanies abnormal bone scan findings.  Most bone scans are done with planar views - say one from the front, one from the back and one from the side.  SPECT imaging is 360 degrees of imaging rather than just the planar views.  

It is important to realize that many NORMAL  healing phases of surgery and injury can show increased bony activity (hot spots) and blood flow activity.  This is where the physician uses his knowledge to come up with an appropriate diagnosis.

Hope this helps and doesn't confuse anybody.

Offline wofford99

  • Forum Faithful
  • ****
  • Posts: 152
  • Liked: 0
  • User's Text
Bone Scan and Indium-111 scan
« Reply #6 on: August 06, 2003, 03:48:53 AM »
Hi everyone-
       I enjoyed reading all the posts about bone scans. I have had several done, the most recent in April. I also had an Indium-111 scan which traces white blood cells-these appear where infections are including osteomyelitis (bone infection).
       My radiologist explained bone scans to me and basically increased uptake can mean increased activity and inflammation.  I had increased uptake in my knee on the top of my tibia and bottom of my femur.  Now this could be a stress fracture, arthritis, or post-op changes from 2 years ago.  The key is to have a good radiologist who looks at your x-rays, history, and MRI scans to determinewhat the problem is.  However, as my orthopedic surgeon said, if you've had many surgeries bone scans will most always be positive.
    The docs think I have severe arthritic degeneration going on but it also could be a stress fracture. Margaret
-37y/o; multiple patella dislocations
-34 knee surgeries- bilaterally- fulkerson osteotomies/
right knee patellofemoral arthrosurface 2013

Offline Leentje

  • SuperKNEEgeek
  • *****
  • Posts: 2114
  • Liked: 2
  • ER nursing rules !!!
Re: Bone Scan and SPECT of the knee
« Reply #7 on: August 09, 2003, 09:57:34 PM »
SPECT = Single Proton Emmision Computerized Tomography

Helena
Bilat patellar malalignment/PFdysplasia
00/06/83 L wrist #
11/12/00 L knee LR + chondroplasty
21/08/02 L knee TTT
02/03/04 L knee stretched PCL
11/09/07 L ankle dislocation/medial avulsion #
25/05/09 L ankle medial avulsion # AGAIN!
05/06/13 R ankle dislocation















support