Fig. 1 - Wholebody planar 3 hours post injection
Patient History
59-year-old female with history of right reverse total shoulder arthroplasty since 13 months ago. Initially she was complaining of shoulder discomfort which later progressed into severe pain with limited abduction and external rotation for the past 3 months. Various imaging modalities did not find any abnormality or identify the site of pain. Other than mildly elevated CRP, her lab data was within normal range. She was referred to do a SPECT/CT bone scan on the 4th of October 2022.
Exam Technique
- 3-phase dynamic bone scan was performed immediately after injecting the patient.
- Dose: 800 MBq of Tc99m-MDP.
- Dynamic images of the shoulders followed by static images after 5 minutes were acquired, and delayed whole body planar images (Fig 1) followed by right shoulder SPECT/CT (Fig 2) acquisition were acquired after 3 hours. The scan was performed on the Siemens Healthineers SPECT/CT Intevo Bold 16 without iMAR.
Diagnosis
The initial dynamic scan demonstrated physiological tracer perfusion to the right shoulder joint and around the prosthesis. The immediate blood pool images that followed demonstrated normal tissue vascularity around the right shoulder joint and prosthesis.
The delayed whole body planar images (Fig. 1) demonstrate right shoulder periprosthetic focal areas of mild tracer uptake in an expected pattern of ongoing bone remodeling.
Contact
FEBNM Nuclear Medicine Unit, Amman, Jordan