Lon S. Weiner, M.D.,
Section Chief, Orthopedic Trauma

 

Stephen C. Scharf, M.D.,
Chief of Nuclear Medicine

 

Excellence in SPECT/CT imaging

 

Lenox Hill Hospital

Manhattan, NY, USA

 

When renowned Orthopedic Surgeon Lon S.Weiner, M.D., Section Chief, Orthopedic Trauma, Lenox Hill Hospital (Manhattan, New York, USA), agreed to see Madlyn Sitton’s son, he had no idea just how grave the situation was. Until he saw the leg.

 

A rush to diagnose

Hit by a car in the summer of 2004, teenager Ronnie Sitton was lucky to be alive.

 

Rushed to a nearby hospital, surgical fixation to repair shattered femurs in both legs left him immobile for three months and on crutches for six. While his right leg healed, his left leg started to swell.

 

“By the time I saw him, nearly a year and a half post surgery, I knew we had just a matter of time to reverse a potentially tragic outcome,” says Dr. Weiner. “Ronnie had no knee mobility. His left leg was twice as big as the other; it was so swollen and angry that we thought he might have a vascular situation.”

 

Dr. Weiner suspected Ronnie had an infection deep in his leg.  He immediately sent him to see Dr. Scharf.

 

Using the power of the scan

Stephen C. Scharf, M.D., Chief of Nuclear Medicine, Lenox Hill Hospital performed a gallium study using the new Philips Precedence SPECT/CT system.  With this special ‘hybrid’ imaging system doctors can ‘fuse’ two different types of images together to see more than either image alone.

 

Dr. Scharf immediately discovered an abnormality in the leg. “With SPECT alone, we would have been able to confirm a soft tissue infection. However, by fusing SPECT images with CT images we were able to pinpoint the exact location of the infection. In this case, the SPECT/CT scan showed infection in the screws with soft tissue infection in the lateral part of the thigh,” recalls Dr. Scharf.

 

“We used the power of the scan to help us save this boy’s leg. Not only did the scan confirm one of our suspicions, but it also guided us and allowed us to intervene with tremendous accuracy. We removed the plates and screws, cleaned out the infection, and most importantly, stayed away from the knee,” says Dr. Weiner.

 

The ability to properly plan

“Ronnie could have had a vascular occlusion, a boney infection or an unhealed fracture which could have been disguised by the immense swelling in the leg and knee,” explains Dr. Weiner. “A number of things could have been going on that we couldn’t see without taking a look inside.” 

 

“Fortunately, the SPECT/CT scan Dr. Scharf performed allowed us an initial, non-surgical look at what was going on inside the leg. The scan helped us prove Ronnie had an infection. It helped us understand that the bone was healed and it helped us know exactly where the infection was,” says Dr. Weiner.

 

Saving time, improving confidence

“The key is that we were able to give Dr. Weiner more information than ever before by simply fusing the CT and SPECT images,” says Dr. Scharf.  “Without the scan, his patient would have required exploratory surgery and Dr. Weiner may have been forced to poke around in an area where there was no infection. With the scan, he knew where he was going before he made the first incision.”

 

Dr. Weiner agrees, “Rather than moving blindly about, I referred to the scan and was able to remove the infected plates and screws in his leg and clean out the abscess within the pins — without disturbing the knee.”  Today Ronnie, is not only walking, but is also back on his skateboard. 

 

 

- December 2007

+ More 'Profiles'

 

 

 

This content on this site is intended to be used for educational purposes only ...