In late-stage osteonecrosis, radiography will also show findings of secondary osteoarthritis. Bone Scan Area of Interest In recent years, bone scintigraphy has been replaced by MRI for detection of osteonecrosis because of poor spatial resolution, low specificity, and the inability to quantify size of the necrotic lesion [29]. Single-photon emission CT (SPECT) was shown to improve accuracy of bone scintigraphy in a small group of posttransplant patients [30], but radionucleotide scintigraphy is not commonly performed for detection of osteonecrosis. Early limited data for PET/CT have not been shown to useful in diagnosis of early osteonecrosis [31]. More studies are needed to see if PET/CT may be useful in the detection of multifocal osteonecrosis. CT Area of Interest With IV Contrast There is limited evidence to support the use of CT with IV contrast as the initial imaging study for clinically suspected osteonecrosis. Osteonecrosis CT Area of Interest Without and With IV Contrast There is limited evidence to support the use of CT without and with IV contrast as the initial imaging study for clinically suspected osteonecrosis. CT Area of Interest Without IV Contrast There is limited evidence to support the use of CT without IV contrast as the initial imaging study for clinically suspected osteonecrosis. MRI Area of Interest Without and With IV Contrast There is limited evidence to support the use of MRI without and with IV contrast as the initial imaging study for clinically suspected osteonecrosis. MRI Area of Interest Without IV Contrast There is limited evidence to support the use of MRI without IV contrast as the initial imaging study for clinically suspected osteonecrosis. Variant 2: Clinically suspected osteonecrosis. Normal radiographs or radiographs that show findings suspicious for osteonecrosis. Next imaging study. The body regions covered in this clinical scenario are chest, pelvis, hip, femur, knee, tibia/fibula, ankle, foot, shoulder, humerus, elbow, forearm, wrist, and hand.
Osteonecrosis PCAs. In late-stage osteonecrosis, radiography will also show findings of secondary osteoarthritis. Bone Scan Area of Interest In recent years, bone scintigraphy has been replaced by MRI for detection of osteonecrosis because of poor spatial resolution, low specificity, and the inability to quantify size of the necrotic lesion [29]. Single-photon emission CT (SPECT) was shown to improve accuracy of bone scintigraphy in a small group of posttransplant patients [30], but radionucleotide scintigraphy is not commonly performed for detection of osteonecrosis. Early limited data for PET/CT have not been shown to useful in diagnosis of early osteonecrosis [31]. More studies are needed to see if PET/CT may be useful in the detection of multifocal osteonecrosis. CT Area of Interest With IV Contrast There is limited evidence to support the use of CT with IV contrast as the initial imaging study for clinically suspected osteonecrosis. Osteonecrosis CT Area of Interest Without and With IV Contrast There is limited evidence to support the use of CT without and with IV contrast as the initial imaging study for clinically suspected osteonecrosis. CT Area of Interest Without IV Contrast There is limited evidence to support the use of CT without IV contrast as the initial imaging study for clinically suspected osteonecrosis. MRI Area of Interest Without and With IV Contrast There is limited evidence to support the use of MRI without and with IV contrast as the initial imaging study for clinically suspected osteonecrosis. MRI Area of Interest Without IV Contrast There is limited evidence to support the use of MRI without IV contrast as the initial imaging study for clinically suspected osteonecrosis. Variant 2: Clinically suspected osteonecrosis. Normal radiographs or radiographs that show findings suspicious for osteonecrosis. Next imaging study. The body regions covered in this clinical scenario are chest, pelvis, hip, femur, knee, tibia/fibula, ankle, foot, shoulder, humerus, elbow, forearm, wrist, and hand.