Spectrum of Benign Articular and Periarticular Findings at FDG PET/CT

Radiographics. 2016 May-Jun;36(3):824-39. doi: 10.1148/rg.2016150100.

Abstract

Whole-body fluorine 18 fluorodeoxyglucose (FDG) positron-emission tomography (PET)/computed tomography (CT) is performed primarily for oncologic indications; however, FDG uptake is not specific for malignancy. Herein we focus on causes of increased FDG uptake in and around joints, as lesions in these locations are commonly benign. A combination of primary intra-articular processes and osseous processes that may occur near the joint space will be discussed. Causes of intra-articular and periarticular increased FDG activity can be broadly divided into infectious, inflammatory, degenerative, and benign neoplastic categories. A familiarity with the full range of these processes is important to avoid misinterpretation, in turn decreasing unnecessary follow-up studies, procedures, and treatments. Differentiation from malignancy is often possible on the basis of a different level of FDG activity, divergent response to therapy, or differing changes over time, in comparison with a patient's known primary cancer. Recognizing an intra-articular lesion location can also be critical, as intra-articular metastases are rare. In some cases, benign FDG-avid articular and periarticular entities have a specific appearance at FDG PET/CT and a correct diagnosis may be made without any additional workup. In most other cases, comparison with prior studies and/or additional imaging can afford an accurate diagnosis. This review is meant to introduce the reader to a spectrum of benign FDG-avid articular and periarticular processes that may be encountered at oncologic FDG PET/CT to increase confidence and diagnostic accuracy. (©)RSNA, 2016.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Fluorodeoxyglucose F18*
  • Humans
  • Joint Diseases / diagnostic imaging*
  • Neoplasms / diagnostic imaging
  • Positron Emission Tomography Computed Tomography*
  • Radiopharmaceuticals*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18