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BENEFITS OF NUCLEAR IMAGING FOR FOOT & ANKLE PAIN

Your feet act as shock absorbers that protect the body with every step, accumulating over one million pounds of force, on average, every day. Along with your ankles, they are also incredibly complex mechanisms – that’s why it’s so important to keep them healthy.

Each foot contains 26 bones, 33 joints, and more than a hundred muscles, ligaments, and tendons. The ankle is often referred to as one joint, but it actually accounts for three of those 33 joints. That is a lot of moving parts, some of which are very small.

While the complexity of your feet helps make them strong and agile, it can make treating injuries a challenge. With the amount of stress your feet experience on a daily basis, an accurate diagnosis and appropriate treatment for any concern is paramount. Your health care practitioner will examine the outside of your foot to look for external signs of injury, such as swelling or deformities, but for a specific diagnosis it is usually necessary to take a look inside. A standard X-ray can confirm a bone fracture or arthritis damage, but a more detailed look might require a bone scan.

HOW DOES A BONE SCAN HELP WITH TREATMENT OPTIONS?

For complex cases, a type of nuclear medicine imaging called a bone scan with SPECT/CT (single photon emission computed tomography/computed tomography) is often recommended. This type of exam can provide detailed pictures of the area of concern and localized information about each specific bone or even specific regions of particular bones. This makes it particularly useful in examining areas with many small bones and joints like the foot and ankle.

A bone scan with SPECT/CT can look at both the structure and function of the area of concern, offering high diagnostic accuracy. For example, when foot and ankle surgery is indicated exact localization of arthritis, stress fractures, and other bone conditions is necessary for optimal results.

HOW DOES SPECT/CT WORK?

A bone scan with SPECT/CT involves two separate appointments booked on the same day. The first appointment will take approximately 15 minutes. During this time, a small amount of radioactive material is injected; usually into an arm vein, and through blood flow is delivered to the bones in the area of concern. A gamma camera detects the location of the material, taking pictures in a “planar” format.

During the second appointment, imaging will be performed without any additional injections. It will take approximately 30 minutes. A SPECT/CT exam combines a “SPECT” scan with a “CT” scan to help localize the area of abnormal activity that may be present on the planar bone scan image. For the “SPECT” part, the nuclear medicine gamma camera rotates 360 degrees around the body and forms pictures, which the system reconstructs into an image. For the “CT” portion, a low-dose CT image is taken, similar to those from a classic diagnostic CT scan. In this case, they are fused electronically with the SPECT images to get the SPECT/CT image.

HOW DO I GET A BONE SCAN WITH SPECT/CT?

This exam is covered under your Alberta Health Care Insurance Plan and must be requested by a health care practitioner. To determine whether it’s appropriate for you, your doctor will often review your medical and family history, risk factors, how long symptoms have been present, and how they affect daily activities. If this exam is indicated as a best next course of action, your doctor will provide you with a requisition and the appointment can be booked.

These exams are performed at our Castleridge, Mahogany Village, Market Mall, Mayfair Place, and Sunpark locations.

It’s important to note that this exam involves a small dose of ionizing radiation from the radiopharmaceutical injected into your vein, and also from the CT scan. CT imaging is a form of X-ray and the exposure to radiation from this scan is slightly higher than that of standard X-rays, but the associated risk is still small. Overall, the radiation exposure from a bone scan with SPECT/CT is about the equivalent of exposure to the earth’s natural background radiation over two years. In most cases, the benefits of a CT, such as the early detection of a serious illness, outweigh the small increased risk from radiation exposure.

 

REFERENCES

Canadian Podiatric Medical Association (2022) “Foot Health.” www.podiatrycanada.org. Accessed October 19, 2022.

Eelsing, R. et al. (2020) “The added value of SPECT/CT in the painful foot and ankle: A review of the literature.” Foot and Ankle Surgery, Vol. 27 (7): 715-722. Accessed October 19, 2022.

Horisberger, M. et al. (2015) “Nuclear Medicine Imaging of Ankle Injuries.” Nuclear Medicine and Radiologic Imaging in Sports Injuries. January 2015: p. 803-816. Accessed October 19, 2022.

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abdomen CT

If you are interested or have any questions, send us a message.

Computed tomography (CT) is an advanced imaging system that uses a combination of X-rays and computer technology to produce comprehensive images of your abdomen. CT scans give a much more detailed picture than regular X-rays and can identify many conditions that may escape detection on other imaging tests.

Your health care practitioners may order an abdomen CT scan to examine one of the following (or, for a more comprehensive exam, a combined abdomen/pelvis CT):

  • A cause of pain or swelling.

  • Lymph nodes or blood vessels.

  • The kidney or bladder.

  • The liver, pancreas, or spleen.

  • The small or large bowel.

HOW DO I PREPARE FOR MY EXAM?

WITHOUT CONTRAST: If contrast is not used, you will need to fast for two hours prior to your appointment.
ORAL CONTRAST: If oral contrast is prescribed, you will need to fast for four hours prior to your appointment and arrive two hours prior to your exam, unless otherwise specified at the time of booking.
IV CONTRAST: If oral contrast and/or IV contrast is prescribed, please arrive 15 minutes before your appointment to allow enough time to check-in with reception.
Bring photo identification and your provincial health card.
Please do not drink coffee, tea, or juice six hours prior to your exam.