ABSTRACT
Medical imaging plays an important role in the evaluation of chronic low back pain and traumatic/sports injuries. Selection of the appropriate method depends on several factors; such as the patient's condition, clinical conditions, availability and cost of the test, and the presence of contraindications. Low back pain that persists for more than 12 weeks despite conservative treatment is defined as chronic. Before planning a new treatment for low back pain that does not improve with conservative treatments, the cause of the pain should be determined. Abnormal morphology detected by computed tomography (CT) and magnetic resonance (MR) imaging in chronic low back pain may not fully reflect the underlying pathology.
Diagnosis with anatomical imaging in the early stage of traumatic/sports injuries can be difficult for clinicians. Bone tracer nuclear medicine techniques provide physiological and metabolic information in the early stages of musculoskeletal injuries, enabling early diagnosis with assessment of the activity and stage of the injury.
Bone scintigraphy is one of the basics of molecular imaging. Isotope imaging helps to detect many lesions that are metabolically active (such as cancer, active inflammation, healing fractures, after surgery) and difficult to detect with common imaging methods such as CT and MRI. In this context, hybrid functional imaging techniques such as single photon emission computed tomography/CT (SPECT/CT) imaging may be more valuable. High-resolution SPECT/CT imaging is increasingly used as a spinal imaging modality. When the results of other imaging studies are controversial, SPECT can be used to detect spinal pathology and traumatic/sports injuries. In addition, SPECT imaging can be useful in guiding treatment planning and provides significant clinical benefit in treatment follow-up. This article will describe the important contribution of hybrid imaging methods in the diagnosis of chronic low back pain and traumatic/sports injuries, as well as nuclear medicine applications with a focus on bone scintigraphy.
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