An exploratory multimodal imaging and clinicopathological strategy for suspected Kümmell’s disease in the absence of MRI

To propose and preliminarily evaluate a multimodal diagnostic strategy for diagnosing Kümmell’s disease (KD) in patients who cannot undergo MRI.

Initial Screening: Patients underwent clinical symptom screening followed by plain radiography and high-resolution CT to detect morphological signs.
Imaging Techniques: CT scans provided anatomical evidence of vertebral injury, while 99ᵐTc-MDP bone scintigraphy assessed metabolic status through emission computed tomography (ECT).

CT scans provided conclusive anatomical evidence of vertebral injury and instability, including intervertebral vacuum clefts and fracture-end sclerosis.
ECT scans revealed metabolic activity, identifying lesions with high metabolic activity (hot areas) or decreased radiotracer uptake intensity (cold areas), corresponding to repair processes and avascular necrosis.
The combination of CT and ECT provided convergent imaging evidence supportive of the diagnosis of KD.

The multimodal approach may enhance diagnostic accuracy for KD in patients with MRI contraindications by integrating anatomical and metabolic data.

The study was a single-center, retrospective exploratory study with a limited sample size.
The method's efficacy has not been validated against a standardized diagnostic pathway.

Combining CT and ECT bone imaging may serve as a feasible exploratory diagnostic approach for KD in patients unsuitable for MRI.