The potential of FDG PET/MRI for identification of pain generators in patients with diagnostically challenging chronic musculoskeletal pain

Motivation: Chronic low back pain (LBP) and persistent hip pain after total hip replacement (THR) are frequently under-treated, because conventional imaging methods like CT or MRI often fail to accurately locate the source of pain in these patients. Goal(s): To assess the clinical benefits of [18F]FDG PET/MRI for pinpointing pain generators in patients with diagnostically challenging LBP or post-THR hip pain. Approach: Randomized controlled trial comparing [18F]FDG PET/MRI against standard clinical care. Results: [18F]FDG PET/MRI successfully identified previously undetected pain sources in patients with chronic LBP or persistent hip pain after THR, prompting more frequent changes in clinical management than standard care. Impact: In patients with diagnostically challenging chronic low back pain or persistent pain after total hip replacement, [18F]FDG PET/MRI uncovered previously undetected pain sources. PET/MRI shows promise as a useful diagnostic tool in patients suffering from diagnostically challenging chronic pain.