diagnostic algorithm for patients with pain after anterior cruciate ligament reconstruction: a case report

ABSTRACT

Reconstruction of the anterior cruciate ligament [ACL] is one of the most frequently performed procedures in orthopaedics.1 Although most of the patients show a satisfactory outcome reflecting stable and pain free knees, some complain about persistent or recurrent instability or pain after ACL reconstruction.2 The state-of-the-art diagnostic follow-up in these patients includes a thorough history and clinical examination, blood work [CRP and leucocytes], joint aspiration or biopsies from a diagnostic arthroscopy, conventional radiographs [anterior-posterior and lateral weight bearing, tunnel view and skyline view of the patella], computerized tomography [CT], and magnetic resonance imaging [MRI]. To date, single photon emission tomography and combined conventional CT [SPECT/CT] was used only in a few cases.3,4 With this case, we strive to present the diagnostic work-up in a patient with pain after ACL reconstruction and introduce SPECT/CT as a new diagnostic imaging modality. Furthermore, the possible clinical value of SPECT/CT as new diagnostic imaging modality is highlighted