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European Spine Journal

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01-04-2015 | Original Article

The diagnostic value of single-photon emission computed tomography/computed tomography for severe sacroiliac joint dysfunction

Authors: Katsuhiro Tofuku, Hiroaki Koga, Setsuro Komiya

Published in: European Spine Journal | Issue 4/2015

Abstract

Purpose

We aimed to evaluate the value of single-photon emission computed tomography (SPECT)/computed tomography (CT) for the diagnosis of sacroiliac joint (SIJ) dysfunction.

Methods

SPECT/CT was performed in 32 patients with severe SIJ dysfunction, who did not respond to 1-year conservative treatment and had a score of >4 points on a 10-cm visual analog scale. We investigated the relationship between the presence of severe SIJ dysfunction and tracer accumulation, as confirmed by SPECT/CT. In cases of bilateral SIJ dysfunction, we also compared the intensity of tracer accumulation on each side. Moreover, we examined the relationship between the intensity of tracer accumulation and the different treatments the patients subsequently received.

Results

All 32 patients with severe SIJ dysfunction had tracer accumulation with a standardized uptake value (SUV) of >2.2 (mean SUV 4.7). In the 19 patients with lateralized symptom intensity, mean SUVs of the dominant side were significantly higher than those of the nondominant side. In 10 patients with no lateralization, the difference in the SUVs between sides was <0.6. Patients exhibiting higher levels of tracer accumulation required more advanced treatment.

Conclusion

Patients with higher levels of tracer accumulation had greater symptom severity and also required more advanced treatment. Thus, we believe that SPECT/CT may be a suitable supplementary diagnostic modality for SIJ dysfunction as well as a useful technique for predicting the prognosis of this condition.

Hansen HC, McKenzie-Brown AM, Cohen SP, Swicegood JR, Colson JD, Manchikanti L (2007) Sacroiliac joint interventions: a systematic review. Pain Physician 10:165–184PubMed

Albert HB, Godskesen M, Westergaard JG (2002) Incidence of four syndromes of pregnancy-related pelvic joint pain. Spine 27:2831–2834CrossRefPubMed

Galm R, Fröhling M, Rittmeister M, Schmitt E (1998) Sacroiliac joint dysfunction in patients with imaging-proven lumbar disc herniation. Eur Spine J 7:450–453CrossRefPubMedCentralPubMed

Cusi M, Saunders J, Van der Wall H, Fogelman I (2013) Metabolic disturbances identified by SPECT-CT in patients with a clinical diagnosis of sacroiliac joint incompetence. Eur Spine J 22:1674–1682CrossRefPubMedCentralPubMed

Beauregard JM, Hofman MS, Pereira JM, Eu P, Hicks RJ (2011) Quantitative (177)Lu SPECT (QSPECT) imaging using a commercially available SPECT/CT system. Cancer Imaging 11:56–66CrossRefPubMedCentralPubMed

Cachovan M, Vija AH, Hornegger J, Kuwert T (2013) Quantification of 99mTc-DPD concentration in the lumbar spine with SPECT/CT. EJNMMI Res 3:45CrossRefPubMedCentralPubMed

Atlihan D, Tekdemir I, Ateŝ Y, Elhan A (2000) Anatomy of the anterior sacroiliac joint with reference to lumbosacral nerves. Clin Orthop Relat Res 376:236–241CrossRefPubMed

Katz V, Schofferman J, Reynolds J (2003) The sacroiliac joint: a potential cause of pain after lumbar fusion to the sacrum. J Spinal Disord Tech 16:96–99CrossRefPubMed

Albert H, Godskesen M, Westergaard J (2001) Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand 80:505–510CrossRefPubMed

10.

Bastian L, Lange U, Knop C, Tusch G, Blauth M (2001) Evaluation of the mobility of adjacent segments after posterior thoracolumbar fixation: a biomechanical study. Eur Spine J 10:295–300CrossRefPubMedCentralPubMed

11.

Chen CS, Cheng CK, Liu CL (2002) A biomechanical comparison of posterolateral fusion and posterior fusion in the lumbar spine. J Spinal Disord Tech 15:53–63CrossRefPubMed

12.

Laslett M, Aprill CN, McDonald B, Young SB (2005) Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther 10:207–218CrossRefPubMed

13.

van der Wurff P, Buijs EJ, Groen GJ (2006) A multitest regimen of pain provocation tests as an aid to reduce unnecessary minimally invasive sacroiliac joint procedures. Arch Phys Med Rehabil 87:10–14CrossRefPubMed

14.

Szadek KM, van der Wurff P, van Tulder MW, Zuurmond WW, Perez RS (2009) Diagnostic validity of criteria for sacroiliac joint pain: a systematic review. J Pain 10:354–368CrossRefPubMed

15.

Hansen HC, McKenzie-Brown AM, Cohen SP, Swicegood JR, Colson JD, Manchikanti L (2007) Sacroiliac joint interventions: a systematic review. Pain Physician 10:165–184PubMed

16.

Dieppe PA, Cushnaghan J, Shepstone L (1997) The Bristol ‘OA500′ study: progression of osteoarthritis (OA) over 3 years and the relationship between clinical and radiographic changes at the knee joint. Osteoarthr Cartil 5:87–97CrossRefPubMed

17.

Kim HR, So Y, Moon SG, Lee IS, Lee SH (2008) Clinical value of (99 m)Tc-methylene diphosphonate (MDP) bone single photon emission computed tomography (SPECT) in patients with knee osteoarthritis. Osteoarthr Cartil 16:212–218CrossRefPubMed

18.

Slipman CW, Sterenfeld EB, Chou LH, Herzog R, Vresilovic E (1996) The value of radionuclide imaging in the diagnosis of sacroiliac joint syndrome. Spine 21:2251–2254CrossRefPubMed

19.

Maigne JY, Boulahdour H, Chatellier G (1998) Value of quantitative radionuclide bone scanning in the diagnosis of sacroiliac joint syndrome in 32 patients with low back pain. Eur Spine J 7:328–331CrossRefPubMedCentralPubMed

20.

Gates GF (1998) SPECT bone scanning of the spine. Semin Nucl Med 28:78–94CrossRefPubMed

21.

Reinartz P, Schaffeldt J, Sabri O, Zimny M, Nowak B, Ostwald E, Cremerius U, Buell U (2000) Benign versus malignant osseous lesions in the lumbar vertebrae: differentiation by means of bone SPET. Eur J Nucl Med 27:721–726CrossRefPubMed

22.

Dolan AL, Ryan PJ, Arden NK, Stratton R, Wedley JR, Hamann W, Fogelman I, Gibson T (1996) The value of SPECT scans in identifying back pain likely to benefit from facet joint injection. Br J Rheumatol 35:1269–1273CrossRefPubMed

23.

Pneumaticos SG, Chatziioannou SN, Hipp JA, Moore WH, Esses SI (2006) Low back pain: prediction of short-term outcome of facet joint injection with bone scintigraphy. Radiology 238:693–698CrossRefPubMed

24.

Horger M, Eschmann SM, Pfannenberg C, Vonthein R, Besenfelder H, Claussen CD, Bares R (2004) Evaluation of combined transmission and emission tomography for classification of skeletal lesions. AJR Am J Roentgenol 183:655–661CrossRefPubMed

Title: The diagnostic value of single-photon emission computed tomography/computed tomography for severe sacroiliac joint dysfunction
Authors: Katsuhiro Tofuku
Hiroaki Koga
Setsuro Komiya
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 4/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-014-3375-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The diagnostic value of single-photon emission computed tomography/computed tomography for severe sacroiliac joint dysfunction

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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