Skip to main content
Log in

Combined single photon emission computerised tomography and conventional computerised tomography (SPECT/CT) in patellofemoral disorders: a clinical review

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Patellofemoral disorders are common conditions seen in a knee clinic but can present a great diagnostic challenge to the orthopaedic surgeon. Combined single photon emission computerised tomography with conventional computer tomography (SPECT/CT) provides the clinician with precise anatomical and physiological information of the patellofemoral joint. We present a clinical review that highlights the value of SPECT/CT in patients with patellofemoral disorders, where other modalities such as radiographs, MRI, and conventional CT did not provide sufficient information. SPECT/CT has proven to be helpful for establishing the diagnosis and guidance for further treatment. SPECT/CT should be recognised as a valuable diagnostic tool in orthopaedic patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Fulkerson JP (1983) The etiology of patellofemoral pain in young, active patients: a prospective study. Clin Orthop Relat Res:129–133

  2. Fulkerson JP (1994) Patellofemoral pain disorders: evaluation and management. J Am Acad Orthop Surg 2:124–132

    PubMed  Google Scholar 

  3. Fulkerson JP (2002) Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med 30:447–456

    PubMed  Google Scholar 

  4. Gerbino PG 2nd, Griffin ED, D’Hemecourt PA, Kim T, Kocher MS, Zurakowski D et al (2006) Patellofemoral pain syndrome: evaluation of location and intensity of pain. Clin J Pain 22:154–159

    Article  PubMed  Google Scholar 

  5. LaBella C (2004) Patellofemoral pain syndrome: evaluation and treatment. Prim Care 31:977–1003

    PubMed  Google Scholar 

  6. Lowry CD, Cleland JA, Dyke K (2008) Management of patients with patellofemoral pain syndrome using a multimodal approach: a case series. J Orthop Sports Phys Ther 38:691–702

    PubMed  Google Scholar 

  7. Naslund JE, Odenbring S, Naslund UB, Lundeberg T (2005) Diffusely increased bone scintigraphic uptake in patellofemoral pain syndrome. Br J Sports Med 39:162–165

    Article  PubMed  CAS  Google Scholar 

  8. Brushoj C, Holmich P, Nielsen MB, Albrecht-Beste E (2008) Acute patellofemoral pain: aggravating activities, clinical examination, MRI and ultrasound findings. Br J Sports Med 42:64–67

    Article  PubMed  CAS  Google Scholar 

  9. Pagenstert GI, Bachmann M (2008) Clinical examination for patellofemoral problems. Orthopade 37(9):890–895, 897–903

    Article  PubMed  CAS  Google Scholar 

  10. Lorberboym M, Ami DB, Zin D, Nikolov G, Adar E (2009) Incremental diagnostic value of 99mTc methylene diphosphonate bone SPECT in patients with patellofemoral pain disorders. Nucl Med Commun 24(4):403–410

    Article  Google Scholar 

  11. Kijowski R, Blankenbaker D, Stanton P, Fine J, De Smet A (2006) Correlation between radiographic findings of osteoarthritis and arthroscopic findings of articular cartilage degeneration within the patellofemoral joint. Skeletal Radiol 35(12):895–902

    Article  PubMed  Google Scholar 

  12. Elias DA, White LM (2004) Imaging of patellofemoral disorders. Clin Radiol 59(7):543–557

    Article  PubMed  CAS  Google Scholar 

  13. Carson WG Jr, James SL, Larson RL, Singer KM, Winternitz WW (1984) Patellofemoral disorders: physical and radiographic evaluation. Part II: radiographic examination. Clin Orthop Relat Res 185:178–186

    PubMed  Google Scholar 

  14. Hejgaard N, Diemer H (1987) Bone scan in the patellofemoral pain syndrome. Int Orthop 11(1):29–33

    Article  PubMed  CAS  Google Scholar 

  15. Dye S, Chew MH (1993) The use of scintigraphy to detect increased osseous metabolic activity about the knee. J Bone Joint Surg 75:1388–1406

    Google Scholar 

  16. Collier BD, Johnson RP, Carrera GF, Isitman AT, Veluvolu P, Knobel J et al (1985) Chronic knee pain assessed by SPECT: comparison with other modalities. Radiology 157(3):795–802

    PubMed  CAS  Google Scholar 

  17. Even-Sapir E, Keidar Z, Bar-Shalom R (2009) Hybrid imaging (SPECT/CT and PET/CT) improving the diagnostic accuracy of functional/metabolic and anatomic imaging. Semin Nucl Med 39(4):264–275

    Article  PubMed  Google Scholar 

  18. Breunung N, Barwick T, Fernando R, Gnanasegaran G, Vijayanathan S, Hosahalli M et al (2008) Additional benefit of SPECT-CT in investigating heel pain. Clin Nucl Med 33(10):705–706

    Article  PubMed  Google Scholar 

  19. Roarke MC, Nguyen BD, Pockaj BA (2008) Applications of SPECT/CT in nuclear radiology. AJR Am J Roentgenol 191(3):W135–W150

    Article  PubMed  Google Scholar 

  20. Hirschmann MT, Iranpour F, Davda K, Rasch H, Hugli R, Friederich NF (2010) Combined single-photon emission computerized tomography and conventional computerized tomography (SPECT/CT): clinical value for the knee surgeons? Knee Surg Sports Traumatol Arthrosc 18(3):341–345

    Google Scholar 

  21. Scharf S (2009) SPECT/CT imaging in general orthopedic practice. Semin Nucl Med 39(5):293–307

    Article  PubMed  Google Scholar 

  22. Knupp M, Pagenstert GI, Barg A, Bolliger L, Easley ME, Hintermann B (2009) SPECT-CT compared with conventional imaging modalities for the assessment of the varus and valgus malaligned hindfoot. J Orthop Res (27)11:1461–1466

    Article  Google Scholar 

  23. Hirschmann MT, Iranpour F, Konala P, Kerner A, Rasch H, Cobb JP, Friederich NF (2010) A novel standardized method for evaluating patients after total knee arthroplasty using combined single photon emission tomography and conventional computerized tomography (SPECT/CT). Knee Surg Sports Traumatol Arthrosc (accepted January 2010)

Download references

Conflict of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kinner Davda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hirschmann, M.T., Davda, K., Iranpour, F. et al. Combined single photon emission computerised tomography and conventional computerised tomography (SPECT/CT) in patellofemoral disorders: a clinical review. International Orthopaedics (SICOT) 35, 675–680 (2011). https://doi.org/10.1007/s00264-010-1049-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-010-1049-x

Keywords

Navigation