The utility of bone scintigraphy with SPECT/CT in the evaluation and management of frostbite injuries

Br J Radiol. 2019 Feb;92(1094):20180545. doi: 10.1259/bjr.20180545. Epub 2018 Nov 1.

Abstract

Objective:: Frostbite is a localized cold-thermal injury resulting from prolonged exposure of flesh to freezing and near freezing temperatures. The depth and extent of frostbite injuries are not easily assessed, from a clinical standpoint, at the time of injury making it challenging to plan appropriate management and treatment.

Methods:: A review of the literature of management of cold-related injuries and retrospective case review of the imaging and clinical course of frostbite injury.

Results:: Bone scintigraphy with single photon emission computed tomography (SPECT)/CT was performed in the acute and subacute course of frostbite injuries, subsequently leading to earlier definitive management and shorter hospital stay.

Conclusion:: Multiphase technetium-99m-methylenediphosphonate (99mTc-MDP) bone scintigraphy with SPECT/CT can expedite clinical management of frostbite injuries by determining the extent of injury and can accurately predict the level of amputation if needed.

Advances in knowledge:: SPECT/CT is underutilized at many facilities but can have a profound and immediate impact on clinical management of patients with frostbite when used in combination with physiological bone scan imaging.

Publication types

  • Review

MeSH terms

  • Frostbite / diagnostic imaging*
  • Frostbite / physiopathology
  • Humans
  • Radionuclide Imaging*
  • Radiopharmaceuticals
  • Single Photon Emission Computed Tomography Computed Tomography*
  • Technetium Tc 99m Medronate

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Medronate