European Radiology

, Volume 28, Issue 11, pp 4696–4704 | Cite as

Meniscal pathologies on MRI correlate with increased bone tracer uptake in SPECT/CT

  • Jan Rechsteiner
  • Michael T. Hirschmann
  • Milos Dordevic
  • Anna L. Falkowski
  • Enrique A. Testa
  • Felix Amsler
  • Anna HirschmannEmail author



To assess the relationship of subchondral bone tracer uptake (BTU) on SPECT/CT and meniscal pathologies on MRI in patients with painful knees.


Twenty-five patients who had MRI and SPECT/CT within 3 months without knee surgery or grade ≥3 cartilage lesions were prospectively included. Maximum values of each subchondral femorotibial area were quantified and a ratio was calculated in relation to a femoral shaft reference region, which represented the BTU background activity. Meniscal lesions were graded (intact/degeneration/tear) and meniscal extrusion (no/yes) was assessed using MRI by two musculoskeletal radiologists blinded to the SPECT/CT findings. One-tailed Spearman correlations served for statistics (p < 0.05).


Knees with meniscal degeneration or tear showed a significantly higher BTU in the medial femorotibial compartment (p = 0.045) when compared to intact menisci. Meniscal degeneration was associated with an increased BTU in the lateral femorotibial compartment; however, this was not statistically significant (p = 0.143). Patients with an extruded meniscus showed significantly higher BTU compared to a non-extruded meniscus (p < 0.020).


Medial femorotibial BTU in SPECT/CT was associated with meniscal pathologies. Highest BTU was found in patients with meniscal tears. SPECT/CT appears to be a useful imaging modality to identify patients with overloading or early osteoarthritis.

Key Points

Meniscal degeneration and tears correlate significantly with increased BTU using SPECT/CT.

Medial meniscus extrusion is associated with an increased BTU in SPECT/CT.

SPECT/CT allows detection of overloading and early osteoarthritis.


Single photon emission computed tomography/computed tomography Meniscus Knee injuries Osteoarthritis Magnetic resonance imaging 



Bone tracer uptake


Intraclass correlation coefficient




Single photon emission computerised tomography


Computerised tomography


Magnetic resonance imaging



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Michael Hirschmann.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Felix Amsler kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was waived by the Institutional Review Board (EK 228/13).

Ethical approval

Institutional Review Board approval was obtained (EK 228/13).

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in Dordevic et al. [9].


• prospective

• diagnostic study

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery and TraumatologyKantonsspital Baselland BruderholzBinningenSwitzerland
  2. 2.Department of RadiologyKantonsspital Baselland BruderholzBinningenSwitzerland
  3. 3.Department of Radiology and Nuclear MedicineUniversity Hospital BaselBaselSwitzerland
  4. 4.Amsler ConsultingBaselSwitzerland

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