PINHOLE SCAN AND SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF BONE AND JOINT DISEASES

摘要

Since the publication of the first bone scintiscans in 1962, three decades have elapsed. The bone scan has made great strides during this period, becoming one of the most commonly used nuclear imaging tests. In spite of this progress, however, the specificity of bone scans has remained relatively low. As a result, it is a common practice to seek additional information from radiographs, computed tomography scans and magnetic resonance imaging. The basic reason is the lack of piecemeal analysis in interpreting planar and single photon emission computed tomography (SPECT) scans. Such analysis has its basis in the observation of elemental features of morphology, which include size, shape, contour, location, topography and internal architecture. Understandably, however, the miniature images of planar as well as SPECT scans do not provide these features in acceptable detail. Fortunately, pinhole scanning has the capacity to portray both the morphological and chemical profiles of bone and joint diseases in greater detail through true magnification. The magnitude of pinhole scan resolution is practically comparable to that of radiography as far as gross anatomy is concerned. Thus, it is felt strongly that pinhole scanning is a potential breakthrough in the long lamented low specificity of bone scan. The paper discusses the fundamentals, advantages and disadvantages and the most recent advances of pinhole scanning. It highlights the actual clinical applications of pinhole scanning in relation to the diagnosis of infective and inflammatory diseases of the bone and joint.