Utility of Radionuclide Bone Scintigraphy in Complex Regional Pain Syndrome.

Journal Article (Journal Article;Review)

PURPOSE OF REVIEW: To describe the current understanding of the role of three-phase bone scintigraphy (TPBS) in the diagnosis and management of complex regional pain syndrome (CRPS), discuss its advantages and limitations, and present three examples of TPBS patterns typically seen in CRPS patients. RECENT FINDINGS: CRPS is a debilitating disorder frequently presenting with pain to ordinarily non-painful stimuli, redness, swelling, following fractures, stroke, myocardial infarction, surgery, or even minor trauma, and its diagnosis, based on clinical criteria and supportive imaging findings, is difficult. Of the available adjunctive diagnostic imaging modalities, radionuclide bone scintigraphy using a TPBS protocol is the most sensitive and specific for detecting abnormalities commonly seen with this condition-classically, increased periarticular uptake on delayed phase of TPBS, with variable increased uptake on perfusion phases, depending on chronicity. Recent studies have (1) demonstrated a more heterogeneous correlation of TPBS findings with CRPS diagnosis using the current Budapest criteria than in studies using older criteria, (2) pointed to the utility of novel quantitative scintigraphic techniques, and (3) highlighted the value of the early perfusion phases of TPBS in predicting treatment response. TPBS remains a valuable imaging adjunct to clinical diagnosis of CRPS. In combination with a multi-modal analgesic approach, TPBS can be used to follow disease course and potentially treatment response, although prospective trials are needed to further delineate its role.

Full Text

Duke Authors

Cited Authors

  • Howard, BA; Roy, L; Kaye, AD; Pyati, S

Published Date

  • February 1, 2018

Published In

Volume / Issue

  • 22 / 1

Start / End Page

  • 7 -

PubMed ID

  • 29388057

Electronic International Standard Serial Number (EISSN)

  • 1534-3081

Digital Object Identifier (DOI)

  • 10.1007/s11916-018-0659-7


  • eng

Conference Location

  • United States