Diagnosis of an isolated occult fracture of the posterior margin of the tibia with the SPECT/CT

We report the case of a 56-year-old woman, investigated for pains of the right ankle related to a trauma of an unspecified mechanism. The radiographic assessment was negative. The 99mTc-HDP 3-phase bone scintigraphy highlighted, on the blood pool and the delayed images, a located lesion on the right ankle. The single photon emission computerized tomography guided by computerized tomography (SPECT-CT) showed a focused uptake on the posterior margin of the right tibia and a sharp lucent line within the tomo-scintigraphy spot of uptake. The diagnosis accepted was an isolated occult fracture of the posterior margin of the right tibia. The contribution of the 99mTc-HDP 3-phase bone scintigraphy combined with the SPECT-CT in the diagnosis of the occult fractures is discussed. (N.C.)