The standard single-phase bone scan involves imaging 2 to 3 hours after MDP administration. The 3-phase bone scan consists of a 1-minute radionuclide angiogram followed by immediate blood pool images and 2- to 3-hour delayed views. The 3-phase scan can be helpful in the assessment of acute fracture and differentiating acute osteomyelitis from cellulitis. A positive 3-phase bone scan is often seen in neuropathic arthropathy. The use of radiolabeled white blood cells (WBC) with In-111 in conjunction with bone marrow imaging, utilizing Tc-99m sulfur colloid, can help to differentiate neuropathic reactive bone marrow from acute osteomyelitis. Serial bone scans can also assist in assessing postoperative bone remodeling and periprosthetic fracture from aseptic periprosthetic loosening. The value of WBC and marrow imaging is not only to differentiate neuropathic arthropathy from acute osteomyelitis but also to differentiate aseptic loosening from acute osteomyelitis. Like neuropathic arthropathy, aseptic loosening will demonstrate spatially congruent WBC and marrow activity, consistent with reactive or hematopoietically active marrow. Imaging After Shoulder Arthroplasty Discussion of Procedures by Variant Variant 1: Routine follow-up of the asymptomatic patient with a primary shoulder arthroplasty. 3-Phase Bone Scan with SPECT or SPECT/CT Shoulder A 3-phase bone scan is not typically ordered for evaluation of the asymptomatic patient. Although, single-photon emission computed tomography (SPECT)/CT can assess the primary osseointegration of a stemless shoulder prosthesis in the recent postoperative state [12]. Bone Scan Shoulder There is no relevant literature to support the use of a bone scan of the shoulder in the follow-up of the asymptomatic patient with a primary shoulder arthroplasty. CT Shoulder CT examinations are not typically ordered for evaluation of the asymptomatic patient.
Imaging After Shoulder Arthroplasty PCAs. The standard single-phase bone scan involves imaging 2 to 3 hours after MDP administration. The 3-phase bone scan consists of a 1-minute radionuclide angiogram followed by immediate blood pool images and 2- to 3-hour delayed views. The 3-phase scan can be helpful in the assessment of acute fracture and differentiating acute osteomyelitis from cellulitis. A positive 3-phase bone scan is often seen in neuropathic arthropathy. The use of radiolabeled white blood cells (WBC) with In-111 in conjunction with bone marrow imaging, utilizing Tc-99m sulfur colloid, can help to differentiate neuropathic reactive bone marrow from acute osteomyelitis. Serial bone scans can also assist in assessing postoperative bone remodeling and periprosthetic fracture from aseptic periprosthetic loosening. The value of WBC and marrow imaging is not only to differentiate neuropathic arthropathy from acute osteomyelitis but also to differentiate aseptic loosening from acute osteomyelitis. Like neuropathic arthropathy, aseptic loosening will demonstrate spatially congruent WBC and marrow activity, consistent with reactive or hematopoietically active marrow. Imaging After Shoulder Arthroplasty Discussion of Procedures by Variant Variant 1: Routine follow-up of the asymptomatic patient with a primary shoulder arthroplasty. 3-Phase Bone Scan with SPECT or SPECT/CT Shoulder A 3-phase bone scan is not typically ordered for evaluation of the asymptomatic patient. Although, single-photon emission computed tomography (SPECT)/CT can assess the primary osseointegration of a stemless shoulder prosthesis in the recent postoperative state [12]. Bone Scan Shoulder There is no relevant literature to support the use of a bone scan of the shoulder in the follow-up of the asymptomatic patient with a primary shoulder arthroplasty. CT Shoulder CT examinations are not typically ordered for evaluation of the asymptomatic patient.