Therapeutic impact of [(18)F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain.

Objective: To evaluate the therapeutic impact of [(18)F]fluoride positron-emission tomography/computed tomography ([(18)F]fluoride PET/CT) imaging on patients with unclear foot pain.

Methods: Twenty-eight patients were prospectively included in this study. Therapeutic management was defined by two experienced dedicated foot surgeons before and after [(18)F]fluoride PET/CT imaging. Twenty-six patients underwent cross-sectional imaging [CT, magnetic resonance (MR)] prior to PET/CT. A retrospective analysis of the magnetic resonance imaging (MRI) diagnoses was performed when a therapy change occurred after PET/CT imaging.

Results: In 13/28 (46%) patients therapeutic management was changed due to PET/CT results. Management changes occurred in patients with the following diagnoses: os trigonum syndrome; sinus tarsi syndrome; os tibiale externum syndrome; osteoarthritis of several joints; non-consolidated fragments; calcaneo-navicular coalition; plantar fasciitis; insertional tendinopathy; suggestion of periostitis; neoarticulations between metatarsal bones. Os trigonum, os tibiale externum, subtalar osteoarthritis and plantar fasciitis were only seen to be active on PET/CT images but not on MR images.

Conclusions: [(18)F]fluoride PET/CT has a substantial therapeutic impact on management in patients with unclear foot pain.