technetium-tc-99m-medronate and Acquired-Hyperostosis-Syndrome

Topics: Acquired Hyperostosis Syndrome; Bone Neoplasms; Face; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Hyperplasia; Infections; Mandibular Condyle; Maxilla; Osteitis Deformans; Periodontitis; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals; Sjogren's Syndrome; Technetium Tc 99m Medronate; Technology, Dental; Temporomandibular Joint Disorders; Tomography, X-Ray Computed

A young woman presented with deteriorated visual acuity due to acute retinal vasculitis. The diagnosis of Behçet's disease was made on the basis of the ophthalmologic findings and recurrent oral and genital aphthous ulcerations. In the past, this young woman had been operated on several times because of progressive aseptic osteitis of the right clavicle. The actual examination revealed chronic osteitis, osteosclerosis and hyperostosis of the anterior chest wall, as well as severe acne papulopustulosa et conglobata. These findings resulted in an additional diagnosis of SAPHO syndrome. This report is the first description of Behçet's disease occurring in association with SAPHO syndrome, both fulfilling the diagnostic criteria.

Topics: Acquired Hyperostosis Syndrome; Administration, Oral; Adolescent; Behcet Syndrome; Clavicle; Cyclophosphamide; Cyclosporine; Drug Therapy, Combination; Female; Humans; Immunosuppressive Agents; Prednisone; Radiography, Thoracic; Radionuclide Imaging; Technetium Tc 99m Medronate; Treatment Outcome

We report about an 18-year-old man, suffering from acne on his face and trunk and complaining about indefinite bone pains--without any trauma. SAPHO-syndrome was diagnosed which consists of synovitis, acne, pustulosis, hyperostosis and osteitis. Five types of this syndrome can be differentiated: spondarthritis hyperostotica pustulo-psoriatica, chronic recurrent multifocal osteomyelitis, inflammatory chest wall syndrome, isolated sternocostoclavicular hyperostosis, and the combined form of acne-associated spondarthritis and chronic recurrent osteomyelitis. Although the sapho-syndrome is very rare, it should be considered a possible diagnosis in the case of indefinite bone pains in combination with acne, pustulosis and hyperostosis.

Topics: Acne Vulgaris; Acquired Hyperostosis Syndrome; Adolescent; Arthralgia; Clavicle; Diagnosis, Differential; Humans; Male; Radionuclide Imaging; Sternum; Technetium Tc 99m Medronate

The authors describe the clinical and bone scintigraphic findings of the SAPHO syndrome, which is characterized by synovitis, acne, palmoplantar pustulosis, hyperostosis, and osteitis. The case report illustrates the significance of bone scintigraphy in the diagnosis. It shows that Tc-99m MDP scanning can detect signs of arthritis not seen with other imaging methods, because the arthritis is inflammatory in nature and does not always cause bone erosion. Thus it is not visualized on plain radiographs. Knowledge of this disorder may help in the differential diagnosis of arthritis.. Tc-99m MDP bone scintigraphy was used to diagnose arthritic changes. Whole-body and multiple delayed spot images were obtained in a 39-year-old diabetic, hypertensive woman who had tenderness in the plantar aspect of her heels. Swelling of the small and large joints of the feet, ankles, knees, hips, right sacroiliac joints, and shoulders was noted. She also had hydradenitis suppurativa and a history of a previous episode in which the arthritis improved after surgical treatment for the hydradenitis.. All active joint lesions were visualized on the bone scan, including the arthritis, which was not detected with other imaging methods. They were all well demonstrated in the bone scintiscan. The scan findings, along with the presence of hydradenitis, led to the correct diagnosis of SAPHO syndrome.. Tc-99m MDP bone scanning may be helpful in diagnosing arthritis as associated with the SAPHO syndrome.

Topics: Acquired Hyperostosis Syndrome; Adult; Arthritis; Bone and Bones; Diagnosis, Differential; Female; Humans; Joints; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

A patient with SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis) was evaluated by combined scintigraphy. (99m)Tc HMDP scintigraphy showed accumulation in the sternum and lumbar vertebrae as well as the right mandible, whereas (67)Ga citrate showed an accumulation in the right mandible, but not in the sternum or lumbar vertebrae. These results are consistent with chronic osteomyelitis in the mandible.

Topics: Acquired Hyperostosis Syndrome; Aged; Chronic Disease; Citrates; Gallium; Gallium Radioisotopes; Humans; Lumbar Vertebrae; Male; Mandibular Diseases; Osteomyelitis; Radionuclide Imaging; Radiopharmaceuticals; Sternum; Technetium Tc 99m Medronate