Presentation
Ankle pain post fusion
Patient Data
Apparently successful metallic fusion of ankle joint with obliteration of joint space
Planar bone scan shows increased blood flow and 2 sites of abnormal iostope accumulation around the ankle but difficult to localize. SPECT - CT shows that these 2 sites correspond to the anterior talus and posterior subtalar region (not to the ankle joint)
Review of the CT data indicates that the anterior talar hot spot is a well-defined degenerative cyst in the head and the posterior subtalar hot spot represents osteoarthritic change.
Case Discussion
An injection of local anesthetic into the posterior subtalar joint will confirm it as the pain source.