Table 1.

Correlation of clinical and SPECT/CT findings with consecutive therapeutic change

Patients	Clinical symptoms	Estimated diagnosis	SPECT/CT diagnosis and therapy
1	Persistent pain after arthroplasty CMC-1 and revision with partial resection of the trapezium bone	Possible persistent osseous reaction after arthroplasty	Significant uptake in MC-1 base and the trapezium bone Therapy: additional infiltration
4	Persistent posttraumatic wrist pain 6 months after undislocated radius fracture	Posttraumatic osseous lesion	Persistent posttraumatic reactive bone remodeling at fracture site, no significant osteoarthritis Therapy: additional occupational therapy
9	Unclear pain in CMC-1 with pain, swelling, and redness	Unclear, ganglion cyst (detected in MRI) not correlating with clinical symptoms	Mild uptake in the hamate bone and distal radius, no osteoarthritic changes Therapy: immobilization and additional occupational therapy
10	Unclear persistent wrist pain and pain in both Dig-I for several years	Osteoarthritis	No significant osteoarthritis, no signs of inflammatory arthritis Therapy: rheumatologic follow-up and supportive therapy
11	Unclear right-sided wrist pain (ulnocarpal)	Unclear, possible insertion tendinosis	No pathologic osseous findings, thus exclusion of possible diagnosis (clinically possible tendinosis) Therapy: immobilization, infiltration, and occupational therapy
16	Unclear pain in right CMC-1, no trauma	Unclear	Uptake in both STT joints, beginning (activated) osteoarthritis Therapy: occupational therapy
19	Arthritic right-sided wrist pain, no trauma	Triscaphoid osteoarthritis/possible irritation of the STT joint	Moderate bone remodeling of the right RC and SL joints without significant osteoarthritis, no STT osteoarthritis Therapy: occupational therapy, change of working place environment, and NSAID
20	Persisting left-sided wrist pain during flexion, no trauma	Unclear	Persisting bone growth, no bony lesion, exclusion of other differential diagnosis
22	Unclear right-sided radiocarpal wrist pain 1 year after trauma	Posttraumatic osseous/osteoarthritic lesion	Persistent bone remodeling at fracture site Therapy: occupational therapy
24	Radiocarpal right-sided pain for more than 1 year, no trauma	Unclear, MRI findings did not explain clinical symptoms	Elevated radiocarpal bone metabolism, together with clinical findings suggestive for tendovaginitis Therapy: immobilization, infiltration, and subsequent surgery
25	Carpal pain after scaphoid pseudoarthrosis, CT shows no persisting fracture	Triscaphoid osteoarthritis	Persistent bone remodeling in former fracture zone, no ST uptake but slight stress reaction radio-scaphoidal Therapy: surgery
29	Left-sided wrist pain while grabbing and lifting	Tendinitis	Osteomalacia of the lunate bone Therapy: surgery
34	Pain in the CMC-1 and MC-1 base, wrist trauma 20 years ago	Osteoarthritis STT joint	Posttraumatic intraosseous ganglion cyst in the right scaphoid Therapy: surgery recommended, yet not operated
36	Persistent pain after posttraumatic arthrodesis IP-I	CRPS	Persistent bone remodeling in arthrodesis, osteoarthritis CMC-2 joint, no CRPS Therapy: supportive and occupational therapy
37	Persitent pain in CMC-1 joints after trapezectomy and right arthroplasty >3 years ago	CMC-1 osteoarthritis	Severely activated CMC-1 osteoarthritis Therapy: revision surgery
46	Pain after scaphoid fracture and consolidated pseudoarthrosis	RC osteoarthritis	No RC osteoarthritis, vital scaphoid fragment with bone remodeling Therapy: revision surgery
49	Persistent pain in the distal ulna after distorsion >8 months ago	Ganglion cyst (diagnosed in MRI) was suspected to cause pain	Reactive elevation of bone metabolism at ulnar styloid (insertion of TFCC), ganglion cyst as the cause of clinical symptoms was excluded Therapy: immobilization, infiltration, and shaving during later course of disease
50	Carpal pain, known radiopalmar ganglion cyst	Possible additional STT osteoarthritis	Activated osteoarthritis in multiple IP and MCP joints, exclusion of STT osteoarthritis Therapy: ganglion resection
51	Left-sided carpal pain with painful bump	Carpal boss MCP III with reactive bony lesion and possible additional degenerative joint lesions	Carpal boss MCP-III with osseous reaction
			Therapy: surgical resection without additional arthrodesis (no additional joint degenerations)

CMC, carpometacarpal joint; CRPS, complex regional pain syndrome; IP, interphalangeal joint; MC, metacarpal joint; MCP, metacarpophalangeal joint; PIP, proximal interphalangeal joint; RC, radiocarpal joint; STT, scaphoid-trapezium-trapezoideum joint.