A Diagnostic Algorithm for Patients with Pain after Anterior Cruciate Ligament Reconstruction: A Case Report

Faik K. Afifi, Markus P. Arnold, Niklaus F. Friederich, Michael T. Hirschmann


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.


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