Occult capitate fracture through a bone island – SPECT/CT arthrography imaging

Abstract

Background: Single photon emission tomography/computed tomography (SPECT/CT) combines the strengths of bone scintigraphy and CT and serve as an important alternative to magnetic resonance (MR) imaging in carpal trauma patients if conventional x-rays are equivocal. Case presentation: In a young patient with pain 4 days after carpal trauma conventional x-rays were negative for fracture and MR showed only bone bruise. SPECT/CT arthrography one month later revealed intensive uptake in the capitate bone corresponding to a fracture through a bone island on the CT part of the study. Conclusion: SPECT/CT combines the sensitivity of bone scintigraphy and specificity of (diagnostic) CT and might serve as an important second line imaging modality for the detection of occult carpal fracture.