LOWER-EXTREMITY SCINTIGRAPHY - THE FOOT AND ANKLE

Disorders of the ankle and foot are common and may pose a significant clinical problem. Acute injuries of the ankle and foot are routinely e valuated by radiographs and, if inconclusive, by magnetic resonance im aging (MRI) or computed tomagraphy (CT). In subacute or chronic injuri es, where prolonged pain is unexplained, bone scintigraphy may play a significant role. The bone scan may differentiate soft tissue from bon e pathology, and, being a sensitive test, it may indicate the region t hat needs further specific radiologic examination. It may also indicat e the clinical significance of a radiologic finding. Moreover, in some clinical settings bone scintigraphy can be specific in the diagnosis. Careful attention to the technique enhances the efficiency of bone sc intigraphy and SPECT allows better investigation of the hindfoot. The importance of ankle and foot injuries in the orthopedic practice and t he better understanding of subacute and chronic injuries in athletes a nd in the general population has led to an increased use of specific t ests such as MRI, CT, and bone scintigraphy. With improved technique a nd instrumentation it is no longer sufficient to indicate a focal abno rmality in the ankle or foot on bone scintigraphy. More precise inform ation about perfusion, blood pool, and specific location of a lesion c an be obtained by high resolution and tomographic images. The role of bone scintigraphy in the diagnosis of such disorders will be presented with a focus on subacute traumatic injuries and related disorders, as well as its role in systemic inflammatory disorders that often involv e the ankle and foot. Copyright (C) 1998 by W.B. Saunders Company.