Bone SPECT/CT of the Foot and Ankle: Potential Clinical Application for Chronic Foot Pain

Diseases of the foot and ankle are common but relatively difficult to diagnose because of the complexity of the anatomy and the frequent occurrence of multiple diseases at the same time. For these reasons, management of chronic foot pain is often clinically challenging. MRI is the imaging modality of choice in many types of diseases causing chronic foot pain, due to high resolution and excellent soft tissue contrast. However, in the postoperative state, the use of MRI can be limited by artifact from metallic devices, and it may be difficult to confirm whether the pathology detected on the MRI is the actual cause of the pain. As bone scintigraphy provides metabolic information, it can help to find the origin of pain, and SPECT/CT can further improve the specificity by adding anatomical information. In daily clinical practice for management of foot and ankle pathologies, the use of bone SPECT/CT is gradually increasing. However, there has been limited evidence of usefulness of SPECT/CT in evaluating chronic foot pain. In this review article, the potential application of bone SPECT/CT for chronic foot pain is illustrated, and the role of SPECT/CT in the management of the foot and ankle diseases in clinical practice is described.