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KMID : 1130920110150040212
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Journal of Korean Foot and Ankle Society
2011 Volume.15 No. 4 p.212 ~ p.216
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Diagnosing Symptomatic Accessory Tarsal Bones Using SPECT/CT
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Kim Ryuh-Sup
Kang Joon-Soon
Kim Young-Tae
Kim Bom-Soo
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Abstract
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Purpose: This study was designed to analyze the usefulness of Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) in diagnosing symptomatic accessory tarsal bones.
Materials and Methods: Twenty four feet (16 patients) with symptomatic accessory navicular and/or os trigonum, who agreed to take SPECT/CT, were included in this study. Fifteen feet had accessory navicular, five had os trigonum, and four had both. According to the uptake in the SPECT/CT, 11 feet were classified into high and 13 into low uptake groups. The low uptake group was treated non-operatively, while the high uptake group received operations when initial conservative management failed. A modified Kidner procedure was performed for accessory navicular and arthroscopic excision was done for os trigonum. After a mean follow-up of 6.8 (range, 3~13) months, the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Visual Analogue Scale (VAS) for pain were compared.
Results: Patients in the high uptake group had a higher initial mean VAS score (7.0±0.8 vs 2.2±0.9 , p<0.05) and a lower initial mean AOFAS score (45.9±9.2 vs 83.9±4.2, p<0.05) compared to the low uptake group. All patients in the low uptake group improved after non-operative treatment. Seven patients underwent operations and had a decreased VAS (1.6±0.5) and an increased AOFAS score (88.3±1.8) at the last follow-up. Four patients in the high uptake group demonstrated erratic symptoms.
Conclusion: SPECT/CT can be a useful diagnostic tool and helpful in designing treatment plans for symptomatic accessory navicular and os trigonum.
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KEYWORD
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Accessory navicular, Tarsal, Os trigonum, SPECT/CT
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