Details

Autor(en) / Beteiligte

• Duchstein, Linus Daniel Leonhard
• Jakobsen, Jens Rithamer
• Marker, Line
• Okholm, Mads
• Friberg, Lars
• Simonsen, Lene
• Krogsgaard, Michael Rindom

Titel

The role of 18F-FDG PET/CT in the diagnosis of frozen shoulder

Ist Teil von

• Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021, Vol.29 (1), p.210-215

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Wiley Online Library Journals Frontfile Complete

Beschreibungen/Notizen

• Purpose Frozen shoulder is characterized by pain and reduced passive movement capability, and the diagnose is made clinically. However, pain is the major symptom in the first stage before stiffness occurs, and the condition can be mistaken for subacromial impingement. This study explored the possibility to use positron emission tomography/computed tomography (PET/CT) with a 18 F Flour-Deoxy-Glucose (FDG) tracer in the diagnostic process. Methods Eleven patients with frozen shoulder and 9 patients with subacromial impingement received a 18 F-FDG PET/CT scan before being treated surgically. During arthroscopy, the diagnoses were confirmed. Images were blindly analyzed visually by two nuclear medicine physicians. Also, semi-quantified analysis applying a set of standard regions was performed, and standard uptake value in both shoulder regions was recorded. Results Both the visual description of the pictures and the semi-quantified analysis generally showed increased FDG uptake in the affected shoulder regions of patients that had frozen shoulder and no uptake in patients with subacromial impingement. Kappa for interobserver agreement in the visual assessments was 0.74. Sensitivity was 92% and specificity 93% of the visual assessment, 77% and 93%, respectively, of the semi-quantified analyses, and by combining the two types of analyses sensitivity was 100% and specificity was 93% for the distinction between frozen shoulders and subacromial impingement/unaffected shoulders. Conclusion 18 F-FDG PET/CT seems to be a valid method to diagnose frozen shoulder. This is clinically relevant in diagnostically challenging cases, for instance in the first phase of frozen shoulder, which can be difficult to distinguish from subacromial impingement. Level of evidence II.