Stress fractures of bones can be difficult to detect using traditional X-rays, but that doesn’t prevent them from cracking further and causing great displeasure to the patients. Early detection can lead to preventative rehab, so radiologists at the General Leonard Wood Army Community Hospital in Missouri have developed a better, though more expensive, way of finding small fractures.
They combined SPECT (Single Photon Emission Computed Tomography), typically used for imaging soft tissue, with low dose CT to create fusion images that reveal fractures otherwise unseen. Now U.S. Army soldiers visiting the hospital after an injury have a much higher chance of going to therapy rather than back to work with an active fracture.
Traditionally, injured Soldiers in training are given an X-ray and sent back to continue training if an injury is not visible. Undiscovered stress injuries then progress and are discovered at a later date as a more serious insufficiency fracture, or stress fracture.
“We have seen a dramatic increase in identification of early stress injuries here at GLWACH, which has led to better outcomes for our Soldier population and less patients who have progressed to more advanced stress injuries and [Medical Evaluation Board] cases,” [Maj. Mustafa Ali-Khan, GLWACH Radiology chief] said. “Fewer patients end up with serious stress fractures due to the early intervention.”
“SPECT-CT fusion imaging has worked well in the training environment to mitigate the overall number of bad outcomes with respect to evolving stress injuries,” said Ali-Khan, “We have every reason to believe that other installations with SPECT equipment, as well as other branches of the military with high training populations subject to bone stress injuries, could use our SPECT-CT fusion imaging protocol with a high success rate as well.”