Value of [18F]FDG PET/CT in Diagnosis and Management of Spondylodiscitis

Constantin Lapa; Christoph Rischpler; Ralph Alexander Bundschuh; Alexander Dierks; Sigmund Lang; Georgi Wassilew; Volker Alt

doi:10.1055/a-2075-8873

Zeitschrift für Orthopädie und Unfallchirurgie, Table of Contents

Z Orthop Unfall 2023; 161(05): 544-551
DOI: 10.1055/a-2075-8873

Original Article

Value of [¹⁸F]FDG PET/CT in Diagnosis and Management of Spondylodiscitis

Stellenwert der [¹⁸F]FDG-PET/CT bei der Diagnose und dem Management der Spondylodiszitis

Constantin Lapa

¹Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany

²Deutsche Gesellschaft für Nuklearmedizin (DGN), Berlin, Germany

,

Christoph Rischpler

³Department of Nuclear Medicine, University Hospital Essen, Essen, Germany (Ringgold ID: RIN39081)

⁴Department of Nuclear Medicine, Klinikum Stuttgart, Stuttgart, Germany

,

Ralph Alexander Bundschuh

⁵Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany

,

Alexander Dierks

⁶Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany

,

Sigmund Lang

⁷Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany

,

Georgi Wassilew

⁸Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany (Ringgold ID: RIN60634)

,

Volker Alt

⁹Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany

¹⁰Sektion Muskuloskelettale Infektionen der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Berlin, Germany

› Author Affiliations

Abstract

Vertebral osteomyelitis is the third most common form of osteomyelitis in patients over 50 years of age.

Whereas prompt (pathogen-directed) therapy is crucially associated with better outcomes, the heterogeneous clinical presentation of disease with unspecific symptoms often delays adequate treatment initiation. Diagnosis requires a careful investigation of medical history, clinical findings and diagnostic imaging, including magnetic resonance imaging and nuclear medicine techniques.

Due to its high sensitivity, [¹⁸F]FDG PET/CT is becoming increasingly important in diagnosis and management of spondylodiscitis, especially in the postoperative setting with presence of spinal hardware or other implantable devices in which MRI is limited.

Zusammenfassung

Die vertebrale Osteomyelitis ist die dritthäufigste Form der Osteomyelitis bei Patienten über 50 Jahren. Obwohl eine rasche (auf den Erreger ausgerichtete) Therapie mit besseren Ergebnissen verbunden ist, verzögert das heterogene klinische Erscheinungsbild der Erkrankung mit unspezifischen Symptomen oft die Einleitung der Behandlung. Die Diagnose erfordert eine sorgfältige Untersuchung der Krankengeschichte, der klinischen Befunde und Bildgebung einschließlich Magnetresonanztomografie und nuklearmedizinischer Verfahren.

Aufgrund der hohen Empfindlichkeit gewinnt das [18F]FDG PET/CT zunehmend an Bedeutung für die Diagnose und Behandlung der Spondylodiszitis, insbesondere im postoperativen Setting, wenn spinales Fremdmaterial oder andere Implantate vorhanden sind und folglich die Aussagekraft der MRT begrenzt ist.

Schlüsselwörter

Spondylodiszitis - FDG-PET/CT - molekulare Bildgebung - Osteomyelitis - Wirbelsäule

Keywords

spondylodiscitis - FDG-PET/CT - molecular imaging - osteomyelitis - spine

Full Text

References

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