One our our surgeons is encouraging us to use spect/ct as a diagnostic tool for patients with axial pain to identify specific facet joints as the pain generator as well as to help identify patients with vertebrogenic vs facet mediated pain. Anyone incorporate this in their practice and find it of value?
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SPECT/CT
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It's not wrong but MRI is more SOC in the states. I think someone was saying in Canada they use NM Bone Scans as a poor man's MRI to rule in arthritis. I use it rarely in patients that can't get an MRI or where I can't reasonably order that many regions of the body to be scanned. The CT SPECT findings should correlate with MRI findings but may be easier to interpret for bone pathology if you aren't using to looking at your own films or the radiologists ignore things.
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We used to have a surgeon that would order them. They type that would dictate a 3 page note talking himself into and out of surgery, plans to order all imaging, and consult all other services (psych, pcp, cardiology, endo, pulmonary). And he wouldn’t ever do any surgeries.
