SPECT/CT in Postoperative Shoulder Pain

Over the last 2 decades, the incidence of prosthetic shoulder replacements has increased considerably, leading to a rising number of complications and reoperations. In this article, we review how SPECT/CT can be of significant clinical value for shoulder surgeons. Bone SPECT/CT can provide the correct diagnosis for different types of mechanical complications: glenoiditis after hemiarthroplasty, glenoidal loosening after total shoulder arthroplasty, and scapular notching after reverse shoulder arthroplasty. Various nuclear medicine methods are available for detecting prosthesis infection. In our experience, labeled white blood cell scintigraphy combined with bone marrow scintigraphy is the reference standard. FDG-PET may be useful in case of discordance between the white blood cell scan and the clinical context and complementary test results.