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Diagnostic Utility and Clinical Significance of Three Phase Bone Scan in Symptomatic Accessory Navicular Bone
Correspondence to: Dr Pushpalatha Sudhakar Assistant Professor, Department of Nuclear Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad - 500082 Phone: +91-040-23320332 Ext 210 /310 Fax: +91-040-23310076 e-mail: pushpasudhakar@yahoo.co.in
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
Abstract
More than one center of ossification is frequently found in asymptomatic children and adolescents and is regarded as a normal variant. Accessory navicular bone is one of the supernumerary ossicles in the foot. It may present incidentally or may be present with clinical manifestations. Radiograph is non diagnostic in symptomatic cases. 99mTc MDP bone scan shows focal intense uptake. Advantage of three phase bone scan over single delayed skeletal phase in the diagnosis of symptomatic accessory naviculars and it's clinical significance in foot pain was retrospectively analyzed in ten cases of accessory naviculars (five unilateral and five bilateral) in the present study. Bone scans were correlated with radiographs. Intense hyperemia in initial phase and focal intense uptake in delayed phase was taken as characteristic feature for symptomatic accessory navicular. All the symptomatic accessory naviculars (100%) showed positive three phases. Only two out of eleven asymptomatic accessory naviculars (18%) showed positive hyperemia in the initial phase whereas rest showed absence hyperemia. Our study concluded that additional vascular & bloodpool phases improve sensitivity and specificity in diagnosing symptomatic accessory navicular as the main cause of foot pain.
