Bone Spect as a Valuable Diagnostic Tool for Evaluation of Backache

Objective: The purpose of the study is to evaluate the role of Bone SPECT in the diagnosis of backache, in cases of normal radiographic picture. Study Design: Descriptive study. Place and Duration of Study: This study was conducted with the collaboration of Neurosurgery Department Holy Family Hospital, Rawalpindi and Nuclear Medicine Department, NORI Hospital, Islamabad. The study was carried out from January 2009- October 2009. Method: The patients were selected from the Neurosurgical out patient department, Holy Family Hospital Rawalpindi, and were referred to Nuclear Medicine Department, NORI Hospital, Islamabad. A total of 36 patients with complaints of backache, and normal X-ray finding were scanned ( Whole body and SPECT of spine) with a dual head Gamma Camera after injection of the radiopharmaceutical, Tc99m MDP (Technetium labelled Methylene diphosphonate) with a minimum of 3 hours wait after the radioisotope injection. Results: Out of the 36 patients that were referred for the investigation, 10 patients had there scan results positive for any vertebral (bony/joint) pathology, the negative results (26) indicated musculoligamentous etiology for backache. In almost all positive cases the site of the disease focus was delineated. Conclusion: Bone SPECT is a very useful diagnostic modality in case of backache when radiographs are normal and pain is persistent and can be made use of, for detection and localization of disease site, before referring the patient for other expensive diagnostic tests (e.g MRI)