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FIGURE 13. New onset of pain in left foot in patient with reflex sympathetic dystrophy. (A and D) Reformatted coronal slice through both ankles and sagittal slice of left ankle and foot showing profound demineralization of left ankle and foot. (B) Lateral MIP of 18F PET scan of left ankle with increased uptake (arrow) in subtalar joint. (C) CT and 18F fusion of normal uptake in ankle joint with minimal increase in uptake for medial malleolus. (E) Sagittal image of CT and 18F fusion showing abnormal uptake (arrow) in subtalar joint and first MTP joint. Close examination of CT images showed subtle insufficiency fractures for both areas. Fusion redirected attention to those areas where subtle insufficiency fractures were found on CT. Ankle joint is spared, as seen in rightmost fused coronal image.
