• Matthew S Manganaro, John D Millet, Richard Kj Brown, Benjamin L Viglianti, Daniel J Wale, and Ka Kit Wong.
• 1 Departments of Radiology/Nuclear Medicine, University of Michigan Hospital , Ann Arbor, MI , USA.
• Br J Radiol. 2019 Feb 1; 92 (1094): 20180545.

Objective:Frostbite is a localized cold-thermal injury resulting from prolonged exposure of flesh to freezing and near freezing temperatures. The depth and extent of frostbite injuries are not easily assessed, from a clinical standpoint, at the time of injury making it challenging to plan appropriate management and treatment.Methods:A review of the literature of management of cold-related injuries and retrospective case review of the imaging and clinical course of frostbite injury.Results:Bone scintigraphy with single photon emission computed tomography (SPECT)/CT was performed in the acute and subacute course of frostbite injuries, subsequently leading to earlier definitive management and shorter hospital stay.Conclusion:Multiphase technetium-99m-methylenediphosphonate (99mTc-MDP) bone scintigraphy with SPECT/CT can expedite clinical management of frostbite injuries by determining the extent of injury and can accurately predict the level of amputation if needed.Advances In Knowledge: SPECT/CT is underutilized at many facilities but can have a profound and immediate impact on clinical management of patients with frostbite when used in combination with physiological bone scan imaging.

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