Authors: Hongming Zhuang Joseph W Sam Thomas K Chacko Paulo S Duarte Marc Hickeson Qi Feng Kozaim Z Nakhoda Liang Guan Phillip Reich Shirley M Altimari Abass Alavi
Publish Date: 2003/05/22
Volume: 30, Issue: 8, Pages: 1096-1103
Abstract
It is known that following a traumatic fracture or surgical intervention bone scintigraphy reveals positive results for an extended period of time posing a challenge when evaluating patients for possible malignancy or superimposed osteomyelitis Previous reports indicate that acute fractures can also result in increased fluorine18 fluorodeoxyglucose FDG accumulation and therefore cause difficulties when patients are evaluated for other indications by FDGPET The purpose of this study was to assess the pattern and time course of abnormal FDG uptake following traumatic or surgical fracture A total of 1517 consecutive patients who underwent wholebody FDGPET imaging were retrospectively studied A history of fractures or orthopedic intervention was obtained from an interview prior to scanning The FDGPET results were compared with the results of other imaging studies including bone scans radiographs CT and MRI as well as surgical pathology reports Thirtyseven patients with a known date of traumatic or surgical fracture were identified Among these 14 had fractures or surgery within 3 months prior to FDGPET while 23 had fractures or surgical intervention greater than 3 months prior to FDGPET FDGPET showed no abnormally increased uptake at the known fracture or surgical sites in 30 of these patients Notably in the 23 patients with fractures more than 3 months old all but one showed no abnormally increased uptake Furthermore the positive FDG uptake in this exception was a result of complicating osteomyelitis In the 14 patients with a history of fracture less than 3 months old only six had abnormally increased FDG uptake Following traumatic or surgical fractures FDG uptake is expected to be normal within 3 months unless the process is complicated by infection or malignancy
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