Maud Mostafa Morshedi MD, PhD, Presenter: Nothing to Disclose

Suzanne Marie Shepherd MD, Abstract Co-Author: Nothing to Disclose

Poorvi Patel, Abstract Co-Author: Nothing to Disclose

Sebastian Obrzut MD, Abstract Co-Author: Nothing to Disclose

Osteoarthrosis (OA) affects millions of Americans often involving the shoulders, hips, and knees. OA is seen in patients with other morbid conditions including malignant processes. 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) is widely accepted for evaluating several malignancies. Incidental FDG uptake is frequently seen in joints of patients undergoing PET and has been attributed to OA; however, few studies correlate symptomatic or radiologic findings of OA with FDG uptake. OA is traditionally diagnosed by self-reported symptoms and physical and radiologic evaluation. Various self-reporting questionnaires exist with the Western Ontario and McMaster University Osteoarthritis (WOMAC) Index most widely used. The Kellgren-Lawrence (K/L) grading system is a widely accepted radiographic measurement of OA. The purpose of this study is to evaluate the added benefit of PET for identification and classification of OA of the shoulders, hips, and knees compared to these grading schemes.

Consented patients undergoing FDG PET with CT imaging for other primary disease were evaluated and a WOMAC questionnaire completed. PET images were reviewed and evaluated for increased FDG uptake in the acromioclavicular (AC), glenohumeral, hip, and knee joints and the joints were scored with a modified K/L grading system using the concurrent CT images with scout films. Visual and semiquantitative PET were compared to the self-assessment questionnaire and radiographic grading system.

Preliminary results based on 102 joints suggest that visual and semiquantitative FDG uptake significantly correlate (p <0.01) with both self-reported symptoms and radiographic findings of OA. In addition, evaluation of individual joints suggests that increased FDG uptake significantly correlates with hip self reported symptoms (p < 0.05) and hip and knee radiographic findings (p <0.05). The data also suggests that FDG PET, not radiographic analysis, may better correlate with self reported symptoms.

In our study, increased FDG uptake in the large joints correlates with radiographic OA and self reported symptoms, which implies PET may be useful in the diagnosis and staging of OA.

Whole body FDG PET may provide a new approach for the diagnosis and evaluation of OA and semiquantitative PET may be helpful in staging OA if a standardized and validated approach is followed.

Morshedi, M, Shepherd, S, Patel, P, Obrzut, S, Utility of FDG-PET in the Evaluation of Osteoarthrosis of the Shoulders, Hips, and Knees: Comparison to Self-reporting Questionnaire and Radiographic Staging.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11002207.html