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SPECT/CT in Persistent Ankle Pain: Detecting ATFL Injury and Enthesitis

  • 5:03
  • EN

About this Video Lesson

This lecture presents a case of a 14-year-old football player with persistent left ankle pain following a sports injury. Despite initial treatment for an ankle sprain and a recent MRI reporting only nonspecific soft tissue edema, pain continued for nearly a year. SPECT/CT was performed to further investigate the cause.

Through stepwise review of perfusion, blood pool, and delayed phases, and careful correlation with CT anatomy, this lecture highlights the added diagnostic value of hybrid imaging in identifying ligamentous injury, enthesitis, and associated impingement.

Learning Objectives

By the end of this lecture, participants will be able to:

  • Describe the role of SPECT/CT in evaluating persistent ankle pain when MRI findings are inconclusive.
  • Recognize the imaging features of anterior talofibular ligament (ATFL) injury across perfusion, blood pool, and delayed phases.
  • Identify CT correlates of ligament pathology, including soft tissue fullness and hypertrophy.
  • Interpret focal uptake at the enthesis as a sign of enthesitis and differentiate it from osseous pathology.
  • Appreciate the diagnostic value of comparing symptomatic and contralateral sides in hybrid imaging.

Authors

Risheq, Ziad

Ziad Risheq

Dr. Ziad Risheq is a highly respected nuclear medicine physician in Amman, Jordan, and a Fellow of the European Board of Nuclear Medicine (FEBNM), a recognition of his advanced expertise and dedication to the field. With a deep commitment to advancing nuclear medicine, he has contributed to clinical practice, research, and education, establishing himself as a trusted professional in the discipline.

In addition to his professional achievements, Dr. Risheq actively engages with the broader medical community through social media. He shares insights, educational content, and updates about nuclear medicine on Instagram, where he has cultivated a following under his handle @nuclide.notes. His approachable style and dedication to sharing knowledge have made him a valuable presence in the online medical community.

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SPECT/CT in Persistent Ankle Pain: Detecting ATFL Injury and Enthesitis
SPECT/CT in Persistent Ankle Pain: Detecting ATFL Injury and Enthesitis

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