Abstract
Bone single-photon emission tomography (SPET) was performed in 40 patients within 6 months of acute knee injury where internal derangement of the knee was suspected, and the results related to the arthroscopy findings. Scan features with high sensitivity, specificity, and predictive accuracy for a meniscal tear could not be obtained on planar imaging. However, a half-crescent or more of increased tibial plateau activity on transaxial SPET gave a sensitivity of 89%, a specificity of 76%, a positive predictive accuracy of 77% and a negative predictive value of 89%. For longitudinal (bucket handle) tears alone the optimum scan pattern was a full crescent of increased tibial plateau activity with adjacent femoral activity and increased blood pool activity which gave corresponding values of 78%, 94%, 78% and 93%. It is concluded that the inclusion of tibial plateau activity of less than a full crescent and the presence of femoral condyle and blood pool activity in the diagnostic criteria improves the ability of bone SPET to detect meniscal tears. The value of bone SPET in the diagnosis of meniscal tears suggests that it could have a significant role to play in the management of knee injuries.
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Murray IPC, Dixon J, Kohan L. SPECT for acute knee pain. Clin Nucl Med 1990; 15:828–840.
Collier BD, Johnson RP, Carrera GF, Isitman AT, Veluvolu P, Knobel J, Hellman RS, Barthelemy CR. Chronic knee pain assessed by SPELT: comparison with other modalities. Radiology 1985; 157:795–802.
Fajman WA, Diehl M, Dunaway E, Stephenson R, Eisner R, Riggins RS, Berger HJ. Tomographic and planar radionuclide imaging in patients with suspected meniscal injury: arthroscopic correlation. J Nucl Med 1985; 26:P77.
Marymont JV, Lynch MA, Henning CE. Evaluation of meniscal tears of the knee by radionuclide imaging. Am J Sports Med 1983; 11:432.
Thomas RH, Resnick D, Alazraki NP, Daniel D, Greenfield R. Compartmental evaluation of osteoarthritis of the knee. Radiology 1975; 116:585–594.
Fischer SP, Fox JM, Del Pizzo W, Friedman MJ, Snyder SJ, Ferkerl RD. Accuracy of diagnoses from magnetic resonance imaging of the knee. J Bone Joint Surg [Am] 1991; 73:2–10.
Rainiest J, Oberle K, Loehnert J, Hoetzinger H. The clinical value of magnetic resonance imaging in the evaluation of meniscal disorders. J Bone Joint Surg [Am] 1991; 73:11–16.
Mink JH, Levy T, Crues JV III. Tears of the anterior cruciate ligament and menisci of the knee: MR imaging evaluation. Radiology 1988; 167:769–774.
Glashow JL, Katz R, Schneider M et al. Double blind assessment of value of magnetic resonance imaging in the diagnosis of anterior cruciate and meniscal lesions. J Bone Joint Surg [Am] 199; 71:113–119.
Polly DW, Callaghan JJ, Sikes RA et al. The accuracy of selective magnetic resonance imaging compared with the findings of arthroscopy of the knee. J Bone Joint Surg [Am] 1988; 70:192–198.
Quinn F, Brown TF. Meniscal tears diagnosed with MR imaging versus arthroscopy: how reliable a standard is arthroscopy? Radiology 1991; 181:843–847.
Tyrell RL, Gluckert K, Pathria M et al. Fast three dimensional MR imaging: comparison with arthroscopy. Radiology 1988; 166:865–872.
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Correspondence to: P.J. Ryan
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Ryan, P.J., Taylor, M., Grevitt, M. et al. Bone single-photon emission tomography in recent meniscal tears: an assessment of diagnostic criteria. Eur J Nucl Med 20, 703–707 (1993). https://doi.org/10.1007/BF00181762
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DOI: https://doi.org/10.1007/BF00181762