Expectations from Nuclear Medicine from the Perspective of an Orthopedist; [Ortopedist Gözüyle Nükleer Tıptan Beklentiler]

The diagnosis and treatment of musculoskeletal tumors and infections are performed with a multidisciplinary approach that combines clinical findings, radiological imaging, nuclear medicine imaging methods and histopathological evaluation. Although primarily radiological imaging methods are used, nuclear medicine imaging methods are also frequently used in clinical practice in this case group. Nuclear imaging methods are used in the diagnosis of bone and soft tissue sarcomas, in the planning of the biopsy area, in the staging phase, in the evaluation of the treatment response, in the follow-up of local recurrence, and metastasis scans. In addition, nuclear imaging methods such as whole-body bone scintigraphy, single photon emission computerized tomography, positron emission tomography (PET), PET/computerized tomography are used at regular intervals for routine metastasis screening in cases already diagnosed with cancer. Another situation in which nuclear imaging methods are needed is the cases presenting with pathological fractures without known malignancy. In these cases, nuclear imaging methods are frequently used in clinical practice for primary focus investigation and detection of different metastatic foci. In patients with diabetic foot and symptomatic joint replacement prosthesis, septic aseptic separation is a difficult issue, requiring different approaches and treatment planning, and its differential diagnosis is difficult. With classical imaging methods, sufficient information can not be obtained about septic and aseptic separation. At this stage, nuclear imaging emerges as the most important method for diagnosis. In this review, the contribution and importance of nuclear medicine methods in the diagnosis and treatment follow-up of orthopedic diseases are evaluated. © Telif Hakkı 2022 Türkiye Nükleer Tıp Derneği