Lower back pain is an all too common clinical presentation, with chronic low back pain (of at least 3 months duration) often causing significant disability and imposing anenormous social and economic burden.
Understandably, those suffering from lower back pain require a rapid resolution to their symptoms.
Identifying the exact cause of pain would be useful only if a specific treatment option provides relief. This is the case for pain originating from the lumbar spine facet joints.
The causative relationship between facet joint arthropathy and low back pain has been questioned since a significant proportion of people with advanced facet joint degeneration, as found on structural imaging (CT, MRI) are asymptomatic.
As a result, abnormal morphology may not necessarily reflect underlying pathology. In this instance, a functional imaging techniques, such as Nuclear Medicine SPECT/CT Imaging may be of greater value.
Nuclear Medicine SPECT/CT imaging combines the functional information of SPECT and the structural information of CT imaging to accurately identify inflamed facet joint/s. These joints can then be targeted for CT guided corticosteroid injections to provide symptomatic relief.
A Nuclear Medicine Bone Scan with SPECT/CT imaging can also help in the management of patient’s with persistent bone pain after no abnormalities are detected on other imaging modalities. For example, stress fractures, fractures of complex structures and shin splints can be difficult to identify on plain X-Ray until several days or weeks post injury. A Nuclear Medicine Bone Scan can detect these types of injuries within the next 1-2 days, allowing for earlier diagnosis and management of the injury.
Nuclear Medicine Bone Scans in conjunction with SPECT/CT imaging can also be useful in the detection and follow up of some metastatic cancer (most commonly prostate and breast carcinomas), differentiation between osteomyelitis and cellulitis, evaluation of prosthetic joint for infection or loosening and for the evaluation of the significance of an incidental skeletal finding on X-Ray.