1
|
Lehman VT, Tiegs-Heiden CA, Broski SM. Beyond Anatomy: Fat-Suppressed MR and Molecular Imaging of Spinal Pain Generators. Radiol Clin North Am 2024; 62:247-261. [PMID: 38272618 DOI: 10.1016/j.rcl.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Spine pain is highly prevalent and costly, but evaluation with clinical features and anatomic imaging remain limited. Fat-suppressed MR imaging and molecular imaging (MI) may help identify inflammatory, lesional, and malignant causes. Numerous MI agents are available, each with advantages and disadvantages. Herein, FDG PET, prostate-specific membrane antigen (PSMA), bone radiotracers, and others are highlighted. No specific pain MI agents have been identified, but mechanisms of key agents are shown in video format, and the mechanism of PSMA as a theranostic agent is displayed. A multidisciplinary approach is needed to master this topic.
Collapse
Affiliation(s)
- Vance T Lehman
- Department of Radiology, Mayo Clinic, 200 1st Street SouthWest, Rochester, MN 55905, USA.
| | | | - Stephen M Broski
- Department of Radiology, Mayo Clinic, 200 1st Street SouthWest, Rochester, MN 55905, USA
| |
Collapse
|
2
|
Afonso JR, Soares D, Lopes DB, Matos RM, Pinto RP. Osteoartrose costovertebral: Diagnóstico diferencial raro de dorsalgia no paciente jovem. Relato de caso. Rev Bras Ortop 2021; 57:345-347. [PMID: 35652017 PMCID: PMC9142251 DOI: 10.1055/s-0040-1722587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022] Open
Abstract
The differential diagnosis of dorsal thoracic pain can be a challange due to the proximity of the dorsal column to vital organs as well as to its unique anatomy, innervation, and rib joint. The patterns of referred visceral pain require, in most cases, extensive complementary diagnostic tests in order to exclude severe conditions. Referred pain patterns often result in numerous and expensive visceral workups in order to exclude serious conditions, and costovertebral joint osteoarthritis is usually only considered when the origin of the pain remains unexplained. The authors present the case of a 40-year-old man with disabling dorsal pain due to isolated costovertebral osteoarthrosis. The symptomatology was controlled after injection of methylprednisolone guided by computed tomography. This clinical case aims to describe the clinical presentation of a rare entity that should be considered in the differential diagnosis of back pain.
Collapse
Affiliation(s)
- João Ribeiro Afonso
- Departamento de Ortopedia e Traumatologia, Hospital Santa Maria, Porto, Portugal
| | - Diogo Soares
- Departamento de Ortopedia e Traumatologia, Hospital Santa Maria, Porto, Portugal
| | - Daniel Brás Lopes
- Departamento de Ortopedia e Traumatologia, Hospital Santa Maria, Porto, Portugal
| | - Rui Milheiro Matos
- Departamento de Ortopedia e Traumatologia, Hospital Santa Maria, Porto, Portugal
| | - Rui Peixoto Pinto
- Departamento de Ortopedia e Traumatologia, Hospital Santa Maria, Porto, Portugal
| |
Collapse
|
3
|
Nuclear Medicine in the diagnosis of pathologies of the spine: the role of hybrid imaging. Rev Esp Med Nucl Imagen Mol 2021. [DOI: 10.1016/j.remnie.2020.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
4
|
Nuclear Medicine in the diagnosis of pathologies of the spine: role of hybrid imaging. Rev Esp Med Nucl Imagen Mol 2020; 40:37-49. [PMID: 33041242 DOI: 10.1016/j.remn.2020.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 11/24/2022]
Abstract
Clinical problems in the human spine are still common in our society, often causing pain and can also limit movement. Back pain is a very common clinical entity, although difficult to diagnose due to its multifactorial nature. There are multiple processes that can alter the structure of the spine, injure vertebrae and/or the surrounding tissue. For the study of the spine, image diagnosis is essential, and within this, molecular hybrid techniques play an important role by providing us with an image of functional and morphological fusion. Among these, SPECT/CT is key in the diagnosis of traumatic and stress pathology, allowing us to locate hidden vertebral fractures, and is also very useful in degenerative and post-surgical pathology. On the other hand, PET/CT with 18F-FDG also plays an important role in the management and monitoring of infectious and oncological processes. This review describes the application of these hybrid techniques in the different pathologies of the spine and the findings of their images, being very useful for the diagnostic assessment and therapeutic management of the patient.
Collapse
|
5
|
Yolcu YU, Lehman VT, Bhatti AUR, Goyal A, Alvi MA, Bydon M. Use of Hybrid Imaging Techniques in Diagnosis of Facet Joint Arthropathy: A Narrative Review of Three Modalities. World Neurosurg 2019; 134:201-210. [PMID: 31655232 DOI: 10.1016/j.wneu.2019.10.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 11/18/2022]
Abstract
Facet joint osteoarthritis/arthropathy of the spine is a common cause of back and neck pain that frequently overlaps clinically with other diseases of the spine. Because of the possible overlap, it is crucial to have an accurate diagnostic strategy, especially when determining the management approach. Various strategies have been suggested and adopted, with several these still being used in clinics. Over the years, because of the disadvantages of single-modality imaging methods (computed tomography, magnetic resonance imaging, single-photon emission computed tomography), the interest in radiologic examination started to move toward hybrid imaging techniques. Although the data are mixed, many initial studies have shown promise. However, there are relatively few data with comparative medial branch blocks, and further investigation is needed. Given the advantages and disadvantages of these new techniques, the imaging results have to be interpreted within clinical context and with consideration of the current state of knowledge in the decision-making process.
Collapse
Affiliation(s)
- Yagiz Ugur Yolcu
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Vance T Lehman
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Atiq Ur Rehman Bhatti
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Anshit Goyal
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mohammed Ali Alvi
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mohamad Bydon
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
| |
Collapse
|
6
|
Xi LC, Li HY, Zhang M, Huang SC. Effects of bone cement filling in rabbit proximal femoral medullary cavity on distal femoral blood flow and metabolism. J Int Med Res 2018; 46:5237-5244. [PMID: 30319010 PMCID: PMC6300938 DOI: 10.1177/0300060518802717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective A rabbit model was used to evaluate the effects of bone-cemented hip arthroplasty on distal femoral blood flow and metabolism relative to that of the non-cemented contralateral leg. Methods The marrow cavity of the right hind femur was filled with bone cement. At each of the following time points, rabbits were randomly selected to receive an injection of one dose of 99mTc-methylene diphosphonate and then immediately scanned using a gamma camera: immediately postoperatively and at 4 and 8 weeks postoperatively. A BL-410 model biofunction experimental system was used to analyze the acquired images and determine the radioactive counts of each hind leg. Results The X-ray and photographic images of the right femoral bones confirmed successful filling of the marrow cavity with bone cement. The radioactive counts were significantly lower in the experimental than control legs at each time point. The ratio of the radioactive count of the experimental to control leg increased considerably at each time point, but each ratio was <1. Conclusion Blocking the proximal femoral medullary cavity with bone cement was associated with significant lowering of the blood circulation of the femur and marrow, decreasing the distal femoral blood flow and bone metabolic rate.
Collapse
Affiliation(s)
- Li-Cheng Xi
- 1 Department of Orthopedics, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6 Taoyuan Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Hong-Yu Li
- 1 Department of Orthopedics, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6 Taoyuan Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Ming Zhang
- 2 Department of Orthopedics, The Liuzhou Workers' Hospital of Guangxi Zhuang Autonomous Region, No. 47 Hongyan Road, Liu Nan District, Liuzhou 545007, Guangxi Zhuang Autonomous Region, China
| | - Si-Cheng Huang
- 1 Department of Orthopedics, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6 Taoyuan Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| |
Collapse
|
7
|
Rivers WE, Rimmalapudi V, Heit JJ. Progress in Advanced Imaging Techniques for the Lumbar Spine. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2016. [DOI: 10.1007/s40141-016-0114-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|