SPECT-CT vs MRI for the Diagnosis of Osteoarthritis in the Foot and Ankle

Summary

The diagnose of symptomatic osteoarthritis in the ankle, mid- and hind foot remains challenging. There is no gold standard for the work-up and various hospitals use different protocols. Current literature shows a promising role for SPECT-CT imaging in ankle, hind- and midfoot OA. In a previous study investigating the role of SPECT-CT in a reproducible group we have observed a change in diagnosis in 53% when SPECT-CT data was added to the data of conventional workup alone. In 26% of patients addition of SPECT-CT data resulted in change of the original treatment plan. To our knowledge no prospective studies are available on this subject for both SPECT-CT and MRI. In our clinic both SPECT-CT and MRI are used in the work-up for patients with ankle, hind- and midfoot pain. Although we experience good result with SPECT-CT, MRI might be able to detect symptomatic OA as well. Moreover MRI provide more information about soft tissue and is less harmful for the patient in comparison to SPECT-CT. The aim of this study is to determine the diagnostic performance of SPECT-CT and MRI when used routinely in patients with symptomatic OA of the ankle, hind- and midfoot.

Eligibility

Inclusion Criteria:

* Suspected symptomatic ankle, hind- or midfoot OA
* Informed consent
* Age ≥ 18 years
* Average NRS ≥4 over the past week.

Exclusion Criteria:

* Contraindication for surgery
* Contraindication for SPECT-CT or MRI
* Contraindication for intra-articular injections
* Isolated forefoot pathology
* Fracture, ligamentous or tendon injury of the ankle, hind- and/or midfoot trauma within one year before presentation
* History of neurological disease
* History of foot and/or ankle surgery (affected side)
* Inability to read and understand the written information

Conditions3

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