A 48-year-old female with symptomatic bilateral CMC-1 osteoarthritis. The patient had a history of trapezectomy on the left hand 3 years ago. (A) Plain radiographs showed moderate CMC-1 osteoarthritis on the left side. (B) Intense uptake in the right CMC-1 joint and moderate uptake in the left CMC-1 joint on early-phase imaging (left), intense radioisotope uptake in both CMC-1 joints on late-phase imaging (right). (C) SPECT/CT confirmed activated bilateral rhizarthritis/osteoarthritis with neoarticulation of the MC-1 and trapezoid bone on the right side. Patient received re-arthroplasty (top row: 3D-SPECT and fusion SPECT/CT, bottom row: planar SPECT and CT-alone).