Diffuse FDG Shoulder Uptake on PET Is Associated with Clinical Findings of Osteoarthritis

HOME

HELP

FEEDBACK

SUBSCRIPTIONS

Diffuse FDG Shoulder Uptake on PET Is Associated with Clinical Findings of Osteoarthritis

Eric Wandler¹, Elissa L. Kramer², Orrin Sherman³, James Babb², Jean Scarola² and Mahvash Rafii²

¹ Department of Nuclear Medicine, New York University School of Medicine, New York, NY 10016.
² Department of Radiology, New York University School of Medicine, 550 First Ave., New York, NY 10016.
³ Department of Orthopedic Surgery, New York University School of Medicine, New York, NY 10016.

View larger version (57K):

[in a new window]

Fig. 1A —74-year-old woman referred for ¹⁸F-FDG PET evaluation of solitary pulmonary nodule. Although she had no specific complaints referable to shoulder, DASH score was 12.9. She also had history of knee and hip arthritis and had undergone hip replacement. Physical examination of shoulders revealed difficulty in extension of right arm with internal rotation, slightly weakened lift-off test, and positive Hawkins test. This constellation of findings was clinically consistent with osteoarthritis. ¹⁸F-FDG PET images (A, transaxial; B, coronal; and C, sagittal) showed diffuse uptake in right shoulder in distribution of joint capsule.

View larger version (106K):

[in a new window]

Fig. 1B —74-year-old woman referred for ¹⁸F-FDG PET evaluation of solitary pulmonary nodule. Although she had no specific complaints referable to shoulder, DASH score was 12.9. She also had history of knee and hip arthritis and had undergone hip replacement. Physical examination of shoulders revealed difficulty in extension of right arm with internal rotation, slightly weakened lift-off test, and positive Hawkins test. This constellation of findings was clinically consistent with osteoarthritis. ¹⁸F-FDG PET images (A, transaxial; B, coronal; and C, sagittal) showed diffuse uptake in right shoulder in distribution of joint capsule.

View larger version (95K):

[in a new window]

Fig. 1C —74-year-old woman referred for ¹⁸F-FDG PET evaluation of solitary pulmonary nodule. Although she had no specific complaints referable to shoulder, DASH score was 12.9. She also had history of knee and hip arthritis and had undergone hip replacement. Physical examination of shoulders revealed difficulty in extension of right arm with internal rotation, slightly weakened lift-off test, and positive Hawkins test. This constellation of findings was clinically consistent with osteoarthritis. ¹⁸F-FDG PET images (A, transaxial; B, coronal; and C, sagittal) showed diffuse uptake in right shoulder in distribution of joint capsule.

View larger version (65K):

[in a new window]

Fig. 2A —76-year-old man referred for staging of non-small cell lung cancer. He gave history of pain and disability associated with left-sided rotator cuff tear. His DASH score was 24.1. On physical examination, there was positive lift-off sign and difficulty with active extension and internal rotation on left side. These findings were consistent with his history of rotator cuff tear. ¹⁸F-FDG PET images (A, transaxial; and B, coronal) show some diffuse uptake about shoulder joint but more intense uptake at left greater tuberosity.

View larger version (94K):

[in a new window]

Fig. 2B —76-year-old man referred for staging of non-small cell lung cancer. He gave history of pain and disability associated with left-sided rotator cuff tear. His DASH score was 24.1. On physical examination, there was positive lift-off sign and difficulty with active extension and internal rotation on left side. These findings were consistent with his history of rotator cuff tear. ¹⁸F-FDG PET images (A, transaxial; and B, coronal) show some diffuse uptake about shoulder joint but more intense uptake at left greater tuberosity.

View larger version (53K):

[in a new window]

Fig. 3A —62-year-old man who underwent ¹⁸F-FDG PET examination for possible recurrent thyroid carcinoma. He had 10-year history of painful frozen shoulder and complained of limited flexibility. He took acetaminophen several times per week and had undergone physical therapy for treatment of shoulder problem. His DASH score was 0. On physical examination, there was difficulty flexing left shoulder on scratch test and mild decrease in active range of motion of shoulder in flexion and abduction consistent with residual frozen shoulder. ¹⁸F-FDG PET images (A, transaxial; and B, coronal) showed increased uptake at medial aspect of humeral head in left glenohumeral joint.

View larger version (70K):

[in a new window]

Fig. 3B —62-year-old man who underwent ¹⁸F-FDG PET examination for possible recurrent thyroid carcinoma. He had 10-year history of painful frozen shoulder and complained of limited flexibility. He took acetaminophen several times per week and had undergone physical therapy for treatment of shoulder problem. His DASH score was 0. On physical examination, there was difficulty flexing left shoulder on scratch test and mild decrease in active range of motion of shoulder in flexion and abduction consistent with residual frozen shoulder. ¹⁸F-FDG PET images (A, transaxial; and B, coronal) showed increased uptake at medial aspect of humeral head in left glenohumeral joint.

View larger version (7K):

[in a new window]

Fig. 4 —Scatterplot illustrating significant positive association of maximum standardized uptake value (max SUV) with age. Line and prediction equation it represents were generated using least squares regression to model max SUV as linear function of patient age. Prediction equation: max SUV + 1.16006 + 0.0230381 x age. R² = 31.3%.

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

Technorati What's this?