Diagnostic Criteria to Differentiate Medial Meniscal Injury from Degenerative Changes on 99mTc-MDP Knee SPECT in Patients with Chronic Knee Pain.
- Author:
Jin Chul PAENG
1
;
June Key CHUNG
;
Hwan Jeong JEONG
;
Jae Ho YOO
;
Won Jun KANG
;
Young SO
;
Dong Soo LEE
;
Myung Chul LEE
;
Sang Cheol SEONG
;
Myung Chul LEE
Author Information
1. Department of Nuclear Medicine, Seoul national University College of Medicine, Seoul, Korea. jkchung@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
99mTc-MDP;
SPECT;
internal derangement of knee;
degenerative change
- MeSH:
Arthroscopy;
Diagnosis;
Humans;
Knee*;
Mass Screening;
Sensitivity and Specificity;
Technetium Tc 99m Medronate*;
Tomography, Emission-Computed, Single-Photon*
- From:Korean Journal of Nuclear Medicine
2003;37(2):103-109
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: In patients with chronic knee pain, the diagnostic performance of 99mTc-MDP knee SPECT for internal derangement of knee is deteriorated due to degenerative changes. In this study, we tried to establish diagnostic criteria to differentiate medial meniscal injury (MMI) from degenerative change (DC) when the uptake is increased in medial compartment. MATERIALS AND METHODS: A total of 49 knee SPECT of the patients with chronic (more than 3 months) knee pain, which showed increased 99mTc-MDP uptake in the medial compartment, were included in this study. The diagnosis was confirmed by arthroscopy. On knee SPECT, 3 diagnosic criteria for MMI were investigated. In Criterion I, MMI was diagnosed when crescentic uptake was observed in the medial tibial plateau. In Criterion II, crescentic uptake was further classified into anterior, mid, posterior, and diffuse patterns, according to the location of maximal uptake; and only crescentic mid, posterior, and diffuse patterns were diagnosed as MMI. In Criterion III, MMI was diagnosed when medial tibial plateau showed higher activity then medial femoral condyle. The diagnostic performance of the 3 criteria was compared. RESULTS: The sensitivity and specificity were 93% and 14% in Criterion I, 89% and 38% in Criterion II, and 75% and 67% in Criterion III, respectively. Criterion III had significantly improved diagnostic performance, especially, specificity. CONCLUSION: In this study, we established a practical diagnostic criterion to differentiate MMI from DC on knee SPECT. The result is helpful to improve the diagnostic value of knee SPECT as a screening test for chronic knee pain.
