Blood-pool single-photon emission computed tomography (SPECT)/CT demonstrated marked focal hyperemia localized to the right medial cuneiform, with suspicion of an underlying bipartite variant, a finding not present on the left side. This blood-pool positivity is critically important: it directly demonstrates active vascular permeability and synovitis-like inflammation at the pseudoarticulation cleft, a pathophysiological layer that neither CT nor magnetic resonance imaging can provide under physiological weight-bearing conditions. Without the blood-pool phase, the inflammatory component of the synchondrosis activity would have remained entirely undetected.
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Gesquière et al. (2026) studied this question.
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