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J Nucl Med. 2008; 49 (Supplement 1):270P
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General Clinical Specialties: Musculoskeletal

Musculoskeletal Posters

FDG-PET and MRI findings of neurodegenerative osteoarthropathy in the diabetic foot

Asad Nawaz1, Drew Torigian1, Hongming Zhuang1 and Abass Alavi1

1 Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

1156

Objectives: Undiagnosed neurodegenerative osteoarthropathy (Charcot joint) can result in joint destruction, foot deformity, and subsequent amputation. Our goal was to compare the diagnostic findings in FDG-PET and MRI of diabetic patients with acute charcot joint.

Methods: Subjects with diabetic foot disease enrolled in our ongoing prospective study who demonstrated a concern for acute charcot joint on FDG-PET or MRI were selected for analysis (n=43). A retrospective data review was conducted on the above patients to determine the descriptive and diagnostic patterns between the two imaging modalities.

Results: MRI made the diagnosis of acute charcot joint in 11 out of 43 patients, with 9 of these diagnoses correct based on plain film radiography (PFR) and clinical follow-up results. FDG-PET diagnosed acute charcot joint in 37 out of 43 patients, with 11 of these diagnoses correct using the same criteria as MRI. Of the total 16 true acute charcot joints, only 4 were correctly diagnosed by both imaging modalities. The distributive pattern of acute charcot joint on MRI was exclusively a diffuse midfoot distribution (9/9), while 6 out of 11 PET diagnoses demonstrated a diffuse midfoot distribution.

Conclusions: Although MRI continues to be more accurate in the diagnosis of acute charcot joint, FDG-PET may be capable of detecting inflammatory cells in the synovium prior to the development of clinical symptoms and severe bone fragmentation.

Research Support: This study was funded by an NIH grant.





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Right arrow Articles by Nawaz, A.
Right arrow Articles by Alavi, A.