technetium-tc-99m-exametazime and Sarcoma--Ewing

An 11-year-old girl presented with the clinical picture of osteomyelitis of the distal tibia. A bone scintigram, although abnormal, did not confirm the diagnosis, but a 99mTc leucocyte scan showed focal white cell uptake in the distal tibia. This was felt to confirm infection and subsequent aspiration revealed what was thought to be pus. However, histology of the aspirated material demonstrated Ewing's Sarcoma. The differential diagnosis and the place of scintigraphy in this clinical situation are discussed.

Topics: Bone Neoplasms; Child; Diagnosis, Differential; Diagnostic Errors; Female; Humans; Organotechnetium Compounds; Osteomyelitis; Oximes; Radiography; Radionuclide Imaging; Sarcoma, Ewing; Technetium Tc 99m Exametazime; Tibia