Indian Journal of Nuclear Medicine
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Year : 2022  |  Volume : 37  |  Issue : 3  |  Page : 286-287

Functional characterization of posttraumatic heterotopic ossification of tibiofibular syndesmosis with dynamic bone scan and single-photon emission computed tomography/computed tomography


1 Department of Radiology, Hull University Teachings Hospitals NHS Trust, Hull, HU3 2JZ, United Kingdom
2 Department of Nuclear Medicine, Kuwait Cancer Control Center, Kuwait City, Kuwait

Correspondence Address:
Dr. Bhavana Shyamanur
Department of Radiology, Hull Royal Infirmary, Hull University Teachings Hospitals NHS Trust, Anlaby Road, Hull, HU3 2JZ
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnm.ijnm_124_21

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A 53-year-old man was investigated for ongoing right ankle pain and lateral malleolus swelling following a traumatic inversion injury 12 weeks prior. The initial ankle radiograph was normal with no evidence of fracturing. The follow-up radiograph showed bridging ossification in the distal tibiofibular syndesmosis. As the pain did not subside, posttraumatic heterotopic ossification (HO) was suspected, and triple-phase dynamic bone imaging with technetium 99m-methylene diphosphonate was performed to guide further management. The bone scan revealed intense focal tracer activity centered on the HO of the tibiofibular syndesmosis, with no evidence of occult fracturing confirming HO as a pain generator.


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