BONE SINGLE-PHOTON EMISSION TOMOGRAPHY IN RECENT MENISCAL TEARS - AN ASSESSMENT OF DIAGNOSTIC-CRITERIA

Bone single-photon emission tomography (SPET) was performed in 40 pati ents within 6 months of acute knee injury where internal derangement o f the knee was suspected, and the results related to the arthroscopy f indings. Scan features with high sensitivity, specificity, and predict ive accuracy for a meniscal tear could not be obtained on planar imagi ng. However, a half-crescent or more of increased tibial plateau activ ity on transaxial SPET gave a sensitivity of 89%, a specificity of 76% , a positive predictive accuracy of 77% and a negative predictive valu e of 89%. For longitudinal (bucket handle) tears alone the optimum sca n pattern was a full crescent of increased tibial plateau activity wit h adjacent femoral activity and increased blood pool activity which ga ve 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 di agnostic criteria improves the ability of bone SPET to detect meniscal tears. The value of bone SPET in the diagnosis of meniscal tears sugg ests that it could have a significant role to play in the management o f knee injuries.