Orthopedic Nuclear Medicine 2nd Edition by Abdelhamid Elgazzar ISBN 9783319561677 3319561677

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ISBN 10: 3319561677
ISBN 13: 9783319561677
Author: Abdelhamid Elgazzar

Orthopedic Nuclear Medicine 2nd Edition Table of contents:

1: Basic Sciences of Bone and Joint Diseases

1.1 Introduction

1.2 Anatomy and Physiology of Bone

1.2.1 Bone Development

1.2.2 Bone Anatomy

1.2.2.1 General Structural Features

1.2.2.2 Blood Supply of Bone

1.2.2.3 Features of Individual Bones

1.2.3 Bone Physiology

1.2.3.1 Bone Function

1.2.3.2 Bone Metabolism

1.3 Anatomy and Physiology of Bone Marrow

1.4 Anatomy and Physiology of Joints

1.5 Spectrum of Bone and Joint Disease

1.6 Modalities for Imaging Bone and Joint Diseases

1.7 Diagnosis of Bone and Joint Diseases by Nuclear Medicine Techniques

1.8 Technical Considerations

1.8.1 Pre-imaging Considerations

1.8.1.1 Bone Imaging Radiopharmaceuticals

1.8.1.2 Patient Preparation

1.8.1.3 Patient History and Examination

1.8.1.4 Time of Imaging After Injection

1.8.2 Imaging Considerations

1.8.2.1 Instrumentation

1.8.2.2 Positioning

1.8.2.3 Acquisition

1.8.3 Post-Imaging Considerations

1.8.4 Sources of Diagnostic Errors

References

2: Diagnosis of Inflammatory Bone Diseases

2.1 Introduction

2.2 Pathophysiology

2.2.1 Inflammation

2.2.1.1 Definition

2.2.1.2 Classification

2.2.1.3 General Pathophysiological Features

2.2.1.4 Healing

2.2.1.5 Inflammation in Cancer Patients

2.2.2 Skeletal Infections

2.2.2.1 Definitions

2.2.2.2 Classification

2.2.2.3 General Pathophysiological Features

2.2.2.4 Features of Specific Forms

2.3 Imaging Skeletal Infections

2.3.1 The Need for Diagnostic Imaging

2.3.2 Imaging Modalities for Skeletal Infections

2.4 Diagnosis of Skeletal Infection by Imaging

2.4.1 Diagnosis Using Morphologic Imaging Modalities

2.4.1.1 Standard Radiographs

2.4.1.2 Ultrasonography

2.4.1.3 Computed Tomography

2.4.1.4 Magnetic Resonance Imaging

2.4.2 Diagnosis by Scintigraphic Methods

2.4.2.1 Radiopharmaceuticals for Infection Imaging

2.4.2.2 Bone Scanning

2.4.2.3 Gallium-67 Citrate Imaging

2.4.2.4 Labeled Leukocyte Imaging

2.4.2.5 Immunoscintigraphy

2.4.2.6 Positron Emission Tomography Imaging

2.4.3 Imaging Using Combined Modalities

2.5 Diagnosis of Specific Forms of Skeletal Infections

2.5.1 Diabetic Foot Osteomyelitis

2.5.2 Vertebral Osteomyelitis (Spondylodiscitis)

2.5.3 Chronic Active Osteomyelitis

2.5.4 Periprosthetic Infection

2.5.5 Posttraumatic Osteomyelitis

2.5.6 Osteomyelitis in Patients with Sickle Cell Disease

2.5.7 Neonatal Osteomyelitis

2.5.8 Epiphyseal Osteomyelitis

2.6 Follow-Up of Response to Therapy

2.7 Differentiating Osteomyelitis from Infectious Arthritis

2.8 Differentiating Infection from Tumors

2.9 Noninfectious Inflammatory Conditions

2.9.1 Chronic Nonbacterial Osteomyelitis

2.9.1.1 Chronic Recurrent Multifocal Osteomyelitis

2.9.1.2 Chronic Sclerosing Osteomyelitis

2.9.2 Osteitis Condensans Ilii

2.9.3 Osteitis Pubis

2.9.4 Infantile Cortical Hyperostosis (Caffey-Sillverman Disease) See also Chapter 3

2.9.5 Sternoclavicular Hyperostosis

2.9.6 Osteitis Condensans of the Clavicle

2.10 Scintigraphic Patterns of Skeletal Manifestations of Poliomyelitis

References

3: Diagnosis of Metabolic, Endocrine, and Congenital Bone Disease

3.1 Introduction

3.2 Paget’s Disease (Osteitis Deformans)

3.3 Osteoporosis

3.4 Osteomalacia and Rickets

3.5 Hyperparathyroidism

3.6 Renal Osteodystrophy

3.7 Complex Regional Pain Syndrome I (Reflex Sympathetic Dystrophy)

3.8 Hypertrophic Osteoarthropathy

3.9 Fibrous Dysplasia

3.10 Other Metabolic and Endocrine Conditions

3.10.1 Hypothyroidism

3.10.2 Hyperthyroidism

3.10.3 Fluoride Toxicity

3.10.4 Aluminum Toxicity

3.10.5 Hypervitaminosis A

3.11 Osteopetrosis

3.12 Medullary Diaphyseal Sclerosis (Medullary Diaphyseal Stenosis or Hardcastle Syndrome)

3.13 Gorlin’s Syndrome

3.14 Progressive Diaphyseal Dysplasia (Camurati-�Engelmann Disease)

3.15 Infantile Cortical Hyperostosis (Caffey-�Silverman Syndrome)

3.16 Madibular Condylar Hyperplasia

References

4: Diagnosis of Traumatic Disorders

4.1 Introduction

4.2 Pathophysiology

4.2.1 Acute Fractures

4.2.2 Stress Fractures

4.2.3 Spondylolysis

4.2.4 Spondylolisthesis

4.2.5 Fracture Healing

4.2.6 Trauma to Bone-Adjacent Structures

4.3 Scintigraphic Diagnosis of Acute Fractures

4.3.1 Role of Scintigraphy in Acute Fracture

4.3.2 Scintigraphic Appearance of Acute Fractures

4.3.3 Scintigraphic Imaging of Specific Fractures

4.3.3.1 Rib and Sternal Fractures

4.3.3.2 Scaphoid Bone Fractures

4.3.3.3 Lisfranc Fracture and Other Feet Fractures

4.3.3.4 Pediatric Fractures and Traumatic Injuries

Growth Plate Injuries

Toddler’s Fracture

Tarsal Coalition

Battered Child Syndrome

Scheuermann’s Disease

Osteochondritis Dissecans (Transchondral Fractures)

Slipped Capital Femoral Epiphysis

Osgood-Schlatter Disease (Tibial Tuberosity Avulsion Injury) (See also Chap. 5)

4.4 Scintigraphic Diagnosis of Stress Fractures

4.4.1 Role of Scintigraphy in Stress Fractures

4.4.2 Scintigraphic Appearance of Stress Fractures

4.4.3 Scintigraphic Diagnosis of Specific Stress Fractures

4.4.3.1 Stress Fractures of the Feet

4.4.3.2 Stress Fractures of the Ribs

4.4.3.3 Stress Fractures of the Tibia

4.4.3.4 Stress Fractures of the Femur

4.4.3.5 Pelvic Fractures

4.4.3.6 Vertebral Fractures

4.4.3.7 Schmorl’s Node

4.4.3.8 Patellofemoral stress syndrome

4.5 Scintigraphic Evaluation of Fracture and Bone Graft Healing

4.5.1 Evaluation of Fracture Healing

4.5.2 Evaluation of Bone Graft Viability

4.5.3 Evaluation of Metallic Implants for Removal

4.6 Scintigraphic Diagnosis of Injuries to Bone-Adjacent Structures

4.6.1 Avulsion Injury

4.6.2 Skeletal Muscle Injury

4.6.3 Post-Traumatic Soft Tissue Calcification

4.6.4 Meniscal and Ligament Tears

4.6.5 Enthesopathies (See also Chap. 7)

4.6.6 Impingement Syndromes

References

5: Diagnosis of Circulatory Disorders

5.1 Introduction

5.2 Pathophysiology

5.3 General Scintigraphic Features and Staging

5.4 Distinctive Forms of Osteonecrosis

5.4.1 Post-traumatic Osteonecrosis

5.4.2 Osteonecrosis of the Femoral Head in Children (Legg-Calvé-­Perthes Disease)

5.4.3 Osteonecrosis of the Femoral Head in Adults

5.4.3.1 Spontaneous Osteonecrosis of the Femoral Head in Adults

5.4.4 Spontaneous Osteonecrosis of the Knee

5.4.4.1 Stage I

5.4.4.2 Stage II

5.4.4.3 Stage III

5.4.4.4 Stage IV

5.4.5 Multifocal Osteonecrosis

5.4.6 Sickle Cell Disease Osteonecrosis

5.4.7 Dysbaric Osteonecrosis

5.4.8 Osteochondroses Featuring Osteonecrosis

5.4.8.1 Freiberg’s Disease

5.4.8.2 Kohler’s Disease

5.4.8.3 Osgood-Schlatter Disease (See also Chap. 4)

References

6: Neoplastic Bone Diseases

6.1 Introduction

6.2 Pathophysiology

6.2.1 Primary Bone Tumors

6.2.1.1 Osteogenic Tumors

6.2.1.2 Chondrogenic Tumors

6.2.1.3 Collagenic Tumors

6.2.1.4 Myelogenic Tumors

6.2.1.5 Other Tumors and Tumorlike Lesions

6.2.2 Metastatic Bone Disease

6.2.2.1 Definition

6.2.2.2 Methods of Tumor Cell Transport

Lymphatic Spread

Hematogenous Spread

Intraspinal Spread

6.2.2.3 Bone Response to Metastases

6.2.2.4 Distribution of Bone Metastasis

6.2.2.5 Classification of Bone Metastases

6.2.2.6 Sources of Bone Metastases

6.2.2.7 Sequelae of Skeletal Metastases

Local Consequences

Bone Destruction

Pathological Fractures

Periosteal New Bone Formation

Soft Tissue Extension

Bone Expansion

Generalized or Metabolic Consequences

Malignant Hypercalcemia

Hypocalcemia

Oncogenic Osteomalacia

6.3 Imaging of Primary Bone Tumors

6.3.1 Overall Role of imaging

6.3.2 Imaging of Major Specific Primary Tumors

6.3.2.1 Osteoid Osteoma

6.3.2.2 Osteoblastoma

6.3.2.3 Osteochondroma

6.3.2.4 Osteogenic Sarcoma

6.3.2.5 Myeloma

6.3.2.6 Ewing’s Sarcoma

6.3.2.7 Bone Hemangiomas

6.4 Scintigraphy and Correlative Imaging of Metastatic Bone Disease

6.4.1 Scintigraphic Patterns of Bone Metastases on Bone Scans

6.4.1.1 Typical Pattern

6.4.1.2 Atypical Patterns

Solitary Lesion

Cold Lesions

Flare Pattern

Diffuse Pattern

Symmetrical Pattern

6.4.2 Scintigraphic Evaluation of Metastases of Certain Tumors

6.4.2.1 Metastases of Breast Cancer

6.4.2.2 Metastases of Prostate Cancer

6.4.2.3 Metastases of Lung Cancer

6.4.2.4 Metastases of Renal Cell Carcinoma

6.4.2.5 Metastases of Thyroid Cancer

6.4.2.6 Metastases of Other Tumors

Gynecological Tumors

Lymphomas

Gastrointestinal Tumors

Nasopharyngeal Carcinoma

Neuroblastoma

Kaposi’s Sarcoma

Carcinoid Tumor

6.5 Follow-Up of Malignant Bone Disease

References

7: Diagnosis of Joint Disorders

7.1 Introduction

7.2 Classification

7.3 Rheumatoid Arthritis

7.4 Crystal Deposition Arthropathies

7.4.1 Gouty Arthritis

7.4.2 Calcium Pyrophosphate Dihydrate Deposition Disease

7.5 Infectious Arthritis (See also Chap. 2)

7.6 Osteoarthritis

7.7 Sacroiliitis

7.8 Neuroarthropathy (See also Chap. 2)

7.9 Spondyloarthropathies

7.9.1 Ankylosing Spondylitis

7.9.2 Psoriatic Arthritis

7.9.3 Reactive Arthritis (Reiter’s Disease)

7.9.4 Enteropathic Spondylitis

7.10 Other Arthropathies and Related Conditions

7.10.1 Behçet’s Syndrome

7.10.2 Costochondritis (Tietze’s Syndrome)

7.10.3 SAPHO Syndrome

7.10.4 Synovitis

7.10.4.1 Transient Synovitis (See also Chap. 4)

7.10.4.2 Synovitis in Renal Transplantation

7.10.4.3 Pigmented Villonodular Synovitis

7.11 Periarticular Soft Tissue Syndromes

7.11.1 Diffuse Idiopathic Skeletal Hyperostosis (DISH)

7.11.2 Septic Bursitis

7.11.3 Septic Tenosynovitis

7.11.4 Plantar Fasciitis

References

8: Bone Marrow Imaging

8.1 Introduction

8.2 Development and Structure of Bone Marrow

8.3 Conversion and Reconversion

8.4 Alterations to Bone Marrow

8.5 Imaging of Bone Marrow

8.6 Bone Marrow Scintigraphy

8.7 Clinical Uses of Bone Marrow Scintigraphy

8.7.1 Diagnosis of Skeletal Infections

8.7.1.1 Diagnosis of Diabetic Foot Osteomyelitis

8.7.1.2 Diagnosis of Prosthetic Joint Infection

8.7.1.3 Differentiation Between Bone Infarction and Acute Osteomyelitis in Children with Sickle

8.7.2 Assessment and Follow-Up of Gaucher’s Disease

8.7.3 Treatment Planning in Cancer Patients

8.7.4 Paget’s Disease

8.7.5 Bone Marrow Tumors and Bone Marrow Extension

8.7.6 Other Uses

References

9: Diagnosis of Soft Tissue Calcification

9.1 Introduction

9.2 Dystrophic Calcification

9.3 Metastatic Calcification

9.4 Heterotopic Bone Formation

9.4.1 Pathophysiology

9.4.2 Scintigraphic Evaluation

9.4.3 Correlative Imaging

9.4.4 Special Forms of Heterotopic Bone Formation

9.4.4.1 Myositis Ossificans Progressiva

9.4.4.2 Tumoral Calcinosis

9.4.4.3 Progressive Osseous Heteroplasia

9.4.4.4 Tumoral Calcium Pyrophosphate Dihydrate Crystal Deposition Disease

9.5 Calcinosis Cutis

9.5.1 Calcinosis Cutis Universalis

9.5.2 Calcinosis Cutis Circumscripta

9.6 Rhabdomyolysis

References

10: Hybrid Imaging in the Diagnosis of Bone Diseases

10.1 Introduction

10.2 SPECT/CT

10.2.1 Uses of SPECT/CT in Neoplastic Diseases

10.2.1.1 Skeletal Metastases

10.2.1.2 Benign bone Tumors

10.2.2 Uses of SPECT/CT in Nonneoplastic Diseases

10.2.2.1 Trauma

Fractures

Spine Conditions

Compression Fractures

Spondylolysis

Spinal Fusion

Ankle and Foot Trauma

Osteochondritis Dissecans

Tarsal Coalition

Wrist and Hand Trauma

10.2.2.2 Infections

10.2.2.3 Other Nonneoplastic Diseases

Osteoarthritis

Sacroiliitis

Heterotopic Bone Formation

Osteonecrosis

10.3 PET/CT

10.3.1 F-18 FDG PET/CT

10.3.1.1 Detection of Metastatic Bone Disease (See also Chap. 6)

10.3.1.2 Follow-Up of Primary and Metastatic Tumors

10.3.1.3 Skeletal Infections (See also Chap. 2)

Chronic Active Osteomyelitis

Spondylodiscitis (Vertebral Osteomyelitis)

Diabetic Foot Osteomyelitis

Post-arthroplastic Infections

10.3.2 F-18 Sodium Fluoride PET/CT

10.3.3 Combined F-18 NaF and F-18 FDG PET/CT

10.3.4 Ga-68-Citrate PET/CT

10.3.5 Ga-68 PSMA PET/CT

10.4 PET/MR

References

11: Therapeutic Use of Radionuclides in Bone and Joint Disease

11.1 Introduction

11.2 Treatment of Cancer-Related Bone Pain

11.2.1 Rationale

11.2.2 Radiopharmaceuticals

11.2.2.1 Strontium-89 Chloride

11.2.2.2 Phosphorus-32 Orthophosphate

11.2.2.3 Samarium-153 Ethylenediaminetetramethylene Phosphonate

11.2.2.4 Rhenium-186 Ethylene Hydroxy Diphosphonate

11.2.2.5 Tin-117m Diethylenetriamine�pentaacetic Acid

11.2.2.6 Rhenium-188-Labeled Dimercaptosuccinic Acid Complex (DMSA) and Hydroxyethylidine Diphospho

11.2.2.7 Lutetium-177 Ethyle�nediaminetetramethylene Phosphonic Acid (EDTMP)

11.2.2.8 Radium-223 Dichloride

11.2.3 Mechanism of Action

11.2.4 Choice of Radiopharmaceutical

11.2.5 Clinical Use

11.2.5.1 Current Indications

11.2.5.2 Contraindications

11.2.5.3 Clinical Response

11.2.5.4 Precautions and Radiation Safety

11.3 Radionuclide Synovectomy

11.3.1 Rationale

11.3.2 Radiopharmaceuticals

11.3.2.1 Yttrium-90 Colloid

11.3.2.2 Rhenium-186 Sulfide (Re-186 Colloid)

11.3.2.3 Erbium-169 Citrate (Er-169 Colloid)

11.3.2.4 Phosphorus-32 Chromic Sulfate

11.3.2.5 Radioactive Gold

11.3.2.6 Rhenium-188 Colloid

11.3.2.7 Dysprosium-165

11.3.2.8 Holmium-166 Ferric Hydroxide

11.3.2.9 Samarium-153 Hydroxyapatite

11.3.2.10 Mechanism of Action

11.3.3 Choice of Radiopharmaceutical

11.3.4 Clinical Uses

11.3.4.1 Indications

11.3.4.2 Contraindications

11.3.4.3 Patient Preparation

11.3.4.4 Treatment Protocol and Clinical Outcome

Hemophilia

Arthritis

Rheumatoid Arthritis

Other Arthropathies

11.3.4.5 Side Effects of Radiosynovectomy

Radiopharmaceutical Leakage

Post-therapeutic Regional Inflammatory Reaction

Somatic and Genetic Effects

Radiation Sickness

11.4 Other Radionuclide Therapies

11.4.1 Treatment of Primary Osteogenic Sarcoma

11.4.2 Metastatic Prostate Carcinoma

11.4.3 Multiple Myeloma

11.4.4 Treatment of Neuroblastoma

11.4.5 Bone Marrow Ablation

References

Glossary

Index

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