4 Citations (Scopus)

Abstract

Background: Single-photon emission computed tomography-computed tomography (SPECT-CT) is a highly sensitive tool for detecting bone metabolism. We determined whether subchondral bone metabolism, as indicated by SPECT-CT in the patellofemoral (PF) joint, predicts response to conservative management in middle-aged patients with chronic anterior knee pain (AKP), and whether SPECT-CT results correlate with arthroscopic assessments of chondral lesions in the PF joint. Methods: The study group comprised 74 middle-aged patients with chronic AKP. All of the patients underwent SPECT-CT, and the results were graded along a scale of 0 to 3. After 8 weeks of conservative management, they were grouped as responders (n = 40) or non-responders (n = 34) according to symptom improvement. We compared the median scintigraphic uptake of the PF joint between the two groups, and evaluated the positive predictive value (PPV) of uptake for treatment response in each patient. In non-responders, cartilage condition was assessed during arthroscopy, and the correlation of scintigraphic uptake with severity of the chondral lesion was assessed. Results: The median scintigraphic uptake in the patella was higher in non-responders than in responders (2 vs. 1). Among patients with higher patella uptake (grade 2 or 3), the PPV for non-response to conservative therapy was 62-67 %, whereas it was 24-25 % in patients with lower uptake (grade 0 or 1). Patella uptake corresponded strongly with arthroscopic assessment of patellar chondral lesions; the correlation was less strong for the femoral trochlea. Conclusions: Increased subchondral bone metabolism in the patella is associated with responsiveness to conservative therapy. SPECT-CT can benefit clinicians by predicting the treatment response from conservative management.

Original languageEnglish
Article number169
JournalBMC Musculoskeletal Disorders
Volume16
Issue number1
DOIs
StatePublished - 26 Jul 2015

Fingerprint

Knee
Patella
Patellofemoral Joint
Pain
Cartilage
Bone and Bones
Arthroscopy
Thigh
Single Photon Emission Computed Tomography Computed Tomography
Conservative Treatment
Therapeutics

Keywords

  • Anterior knee pain
  • Cartilage, bone
  • Chondral lesion
  • Patellofemoral arthritis
  • SPECT-CT

Cite this

@article{3e7d00b5f4634b1e863e1df5d13b33bf,
title = "Value of SPECT-CT Imaging for Middle-Aged Patients with Chronic Anterior Knee Pain",
abstract = "Background: Single-photon emission computed tomography-computed tomography (SPECT-CT) is a highly sensitive tool for detecting bone metabolism. We determined whether subchondral bone metabolism, as indicated by SPECT-CT in the patellofemoral (PF) joint, predicts response to conservative management in middle-aged patients with chronic anterior knee pain (AKP), and whether SPECT-CT results correlate with arthroscopic assessments of chondral lesions in the PF joint. Methods: The study group comprised 74 middle-aged patients with chronic AKP. All of the patients underwent SPECT-CT, and the results were graded along a scale of 0 to 3. After 8 weeks of conservative management, they were grouped as responders (n = 40) or non-responders (n = 34) according to symptom improvement. We compared the median scintigraphic uptake of the PF joint between the two groups, and evaluated the positive predictive value (PPV) of uptake for treatment response in each patient. In non-responders, cartilage condition was assessed during arthroscopy, and the correlation of scintigraphic uptake with severity of the chondral lesion was assessed. Results: The median scintigraphic uptake in the patella was higher in non-responders than in responders (2 vs. 1). Among patients with higher patella uptake (grade 2 or 3), the PPV for non-response to conservative therapy was 62-67 {\%}, whereas it was 24-25 {\%} in patients with lower uptake (grade 0 or 1). Patella uptake corresponded strongly with arthroscopic assessment of patellar chondral lesions; the correlation was less strong for the femoral trochlea. Conclusions: Increased subchondral bone metabolism in the patella is associated with responsiveness to conservative therapy. SPECT-CT can benefit clinicians by predicting the treatment response from conservative management.",
keywords = "Anterior knee pain, Cartilage, bone, Chondral lesion, Patellofemoral arthritis, SPECT-CT",
author = "Ro, {Du Hyun} and Lee, {Ho Young} and Chang, {Chong Bum} and Kang, {Seung Baik}",
year = "2015",
month = "7",
day = "26",
doi = "10.1186/s12891-015-0628-9",
language = "English",
volume = "16",
journal = "BMC Musculoskeletal Disorders",
issn = "1471-2474",
publisher = "BioMed Central Ltd.",
number = "1",

}

TY - JOUR

T1 - Value of SPECT-CT Imaging for Middle-Aged Patients with Chronic Anterior Knee Pain

AU - Ro, Du Hyun

AU - Lee, Ho Young

AU - Chang, Chong Bum

AU - Kang, Seung Baik

PY - 2015/7/26

Y1 - 2015/7/26

N2 - Background: Single-photon emission computed tomography-computed tomography (SPECT-CT) is a highly sensitive tool for detecting bone metabolism. We determined whether subchondral bone metabolism, as indicated by SPECT-CT in the patellofemoral (PF) joint, predicts response to conservative management in middle-aged patients with chronic anterior knee pain (AKP), and whether SPECT-CT results correlate with arthroscopic assessments of chondral lesions in the PF joint. Methods: The study group comprised 74 middle-aged patients with chronic AKP. All of the patients underwent SPECT-CT, and the results were graded along a scale of 0 to 3. After 8 weeks of conservative management, they were grouped as responders (n = 40) or non-responders (n = 34) according to symptom improvement. We compared the median scintigraphic uptake of the PF joint between the two groups, and evaluated the positive predictive value (PPV) of uptake for treatment response in each patient. In non-responders, cartilage condition was assessed during arthroscopy, and the correlation of scintigraphic uptake with severity of the chondral lesion was assessed. Results: The median scintigraphic uptake in the patella was higher in non-responders than in responders (2 vs. 1). Among patients with higher patella uptake (grade 2 or 3), the PPV for non-response to conservative therapy was 62-67 %, whereas it was 24-25 % in patients with lower uptake (grade 0 or 1). Patella uptake corresponded strongly with arthroscopic assessment of patellar chondral lesions; the correlation was less strong for the femoral trochlea. Conclusions: Increased subchondral bone metabolism in the patella is associated with responsiveness to conservative therapy. SPECT-CT can benefit clinicians by predicting the treatment response from conservative management.

AB - Background: Single-photon emission computed tomography-computed tomography (SPECT-CT) is a highly sensitive tool for detecting bone metabolism. We determined whether subchondral bone metabolism, as indicated by SPECT-CT in the patellofemoral (PF) joint, predicts response to conservative management in middle-aged patients with chronic anterior knee pain (AKP), and whether SPECT-CT results correlate with arthroscopic assessments of chondral lesions in the PF joint. Methods: The study group comprised 74 middle-aged patients with chronic AKP. All of the patients underwent SPECT-CT, and the results were graded along a scale of 0 to 3. After 8 weeks of conservative management, they were grouped as responders (n = 40) or non-responders (n = 34) according to symptom improvement. We compared the median scintigraphic uptake of the PF joint between the two groups, and evaluated the positive predictive value (PPV) of uptake for treatment response in each patient. In non-responders, cartilage condition was assessed during arthroscopy, and the correlation of scintigraphic uptake with severity of the chondral lesion was assessed. Results: The median scintigraphic uptake in the patella was higher in non-responders than in responders (2 vs. 1). Among patients with higher patella uptake (grade 2 or 3), the PPV for non-response to conservative therapy was 62-67 %, whereas it was 24-25 % in patients with lower uptake (grade 0 or 1). Patella uptake corresponded strongly with arthroscopic assessment of patellar chondral lesions; the correlation was less strong for the femoral trochlea. Conclusions: Increased subchondral bone metabolism in the patella is associated with responsiveness to conservative therapy. SPECT-CT can benefit clinicians by predicting the treatment response from conservative management.

KW - Anterior knee pain

KW - Cartilage, bone

KW - Chondral lesion

KW - Patellofemoral arthritis

KW - SPECT-CT

UR - http://www.scopus.com/inward/record.url?scp=84937930673&partnerID=8YFLogxK

U2 - 10.1186/s12891-015-0628-9

DO - 10.1186/s12891-015-0628-9

M3 - Article

C2 - 26210673

AN - SCOPUS:84937930673

VL - 16

JO - BMC Musculoskeletal Disorders

JF - BMC Musculoskeletal Disorders

SN - 1471-2474

IS - 1

M1 - 169

ER -