technetium-tc-99m-medronate and Bone-Diseases--Developmental

Os acromiale is an anatomic variant that in rare cases can cause pain. (99m)Tc-methylene diphosphonate bone scintigraphy with SPECT/CT can play an important role in diagnosing this clinical entity. We present a male football player with shoulder pain secondary to a symptomatic os acromiale, and we demonstrate the findings on bone scanning with limited SPECT/CT that diagnosed this important clinical abnormality.

Topics: Acromion; Adolescent; Bone Diseases, Developmental; Diagnosis, Differential; Humans; Male; Multimodal Imaging; Radiopharmaceuticals; Shoulder Pain; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Adult; Bone Diseases, Developmental; Camurati-Engelmann Syndrome; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Technetium Tc 99m Medronate; Tibia

This study was performed to assess the diagnostic value of bone scintigraphy to differentiate symptomatic bipartite patella from asymptomatic bipartite patella. Thirty-seven bipartite patellae (15 symptomatic and 22 asymptomatic) were evaluated by bone scintigraphy. Bone scintigraphic activity in bipartite patella was classified into the following four groups. Group A: Eleven bipartite patellae (10 symptomatic and 1 asymptomatic) demonstrated physiological and marked uptake at the epiphysio-metaphysial junction of the distal femur in bone scintiscans. Therefore, high scintigraphic uptake in the bipartite patella was difficult to distinguish from such uptake due to overlap. Group B: Five bipartite patellae (4 symptomatic and 1 asymptomatic) demonstrated both physiologically high scintigraphic uptake at the epiphysio-metaphysial junction of the distal femur and high scintigraphic uptake in the bipartite patella. Group C: Seventeen bipartite patellae (1 symptomatic and 16 asymptomatic) demonstrated abnormally high scintigraphic uptake in the bipartite patella. Group D: Four asymptomatic bipartite patellae did not demonstrate an abnormally high scintigraphic uptake. After excluding Group A, the proportion of positive bone scans in bipartite patella was 84.6% (22 of 26 patellae). Similarly, after excluding Group A, the proportion of positive bone scans in symptomatic bipartite patella was 100% (5 of 5 patellae) and in asymptomatic bipartite patella 81.0% (17 of 21 patellae). Statistical analysis using Fisher's exact test showed no significant differences in the proportion of positive bone scans between both groups (P = 0.5457). In conclusion, abnormally high scintigraphic uptake is frequent findings in both symptomatic and asymptomatic bipartite patella, and bone scintigraphy is not useful to differentiate between them. Therefore, surgical treatment should not be considered based only on scintigraphic findings.

Topics: Adolescent; Adult; Aged; Bone Diseases, Developmental; Child; Female; Humans; Male; Middle Aged; Ossification, Heterotopic; Patella; Predictive Value of Tests; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Severity of Illness Index; Technetium Tc 99m Medronate

Craniometaphyseal dysplasia is a rare genetic bone disorder characterized by undertubulation of the long bones, especially in the lower extremities, and sclerosis of the skull base. Differentiation from other sclerosing bone dysplasias, including metaphyseal dysplasia (Pyle's disease), craniodiaphyseal dysplasia, and diaphyseal dysplasia is based largely on characteristic radiographic findings. Radionuclide bone scans usually are not necessary for diagnosis, but are helpful in demonstrating the abnormal bone metabolism. The authors report the first whole-body bone images in a patient with craniometaphyseal dysplasia, demonstrating the abnormal bone activity over time.

Topics: Bone Diseases, Developmental; Child; Humans; Infant, Newborn; Male; Radionuclide Imaging; Skull; Technetium Tc 99m Medronate

Five patients with polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLO-SL) were investigated using bone scintigraphy. Abnormal findings were detected in hands, wrists, knees, ankles and feet of all five patients.

Topics: Adult; Bone and Bones; Bone Diseases, Developmental; Brain Diseases; Female; Humans; Lipodystrophy; Male; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate

Seven patients with various clinical, radiological und scintigraphic manifestations of dysplasia epiphysealis multiplex were examined by three-phase scintigraphy using 99mTc-NDP and also radiologically. A comparison of the results is shown; radiological investigation showed some abnormalities which were not demonstrated scintigraphically. No lesions were demonstrated by scintigraphy where the radiograph was normal. Increased uptake of the isotope during a three-phase scintigram is a sensitive indicator of activity of the disease. However, the extent and intensity of the uptake of the isotope did not always correlate well with joint pain and reduction in the range of joint movement.

Topics: Adolescent; Adult; Bone Diseases, Developmental; Diphosphonates; Diseases in Twins; Epiphyses; Female; Humans; Male; Middle Aged; Ossification, Heterotopic; Pedigree; Radiography; Technetium; Technetium Tc 99m Medronate

A 14-yr-old white male with a severe form of progressive diaphyseal dysplasia (Engelmann-Camurati disease) was referred to our institution for evaluation of splenomegaly, which is not usually associated with the disease. Our studies included bone-marrow, and liver-spleen scans. These scintigraphic findings, along with the probable cause for splenomegaly, are discussed.

Topics: Adolescent; Bone and Bones; Bone Diseases, Developmental; Bone Marrow; Camurati-Engelmann Syndrome; Diphosphonates; Humans; Liver; Male; Radionuclide Imaging; Spleen; Splenomegaly; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Four patients (2 males, 2 females; ages 15-47 yrs.) with variable clinical, radiographic, and scintigraphic manifestations of progressive diaphyseal dysplasia (PDD) or Engelmann disease were studied with 99mTc methylene diphosphonate bone imaging and radiographic skeletal surveys. Comparison of the results of the two imaging procedures showed that some affected bones were scintigraphically normal but radiographically abnormal and vice versa. These findings suggest that the lesions of PDD may mature, causing a significant decrease in disease activity, and that abnormally increased radiopharmaceutical accumulation during bone scintigraphy appears to be a sensitive indicator of disease activity.

Topics: Adolescent; Adult; Bone and Bones; Bone Diseases, Developmental; Camurati-Engelmann Syndrome; Diphosphonates; Female; Humans; Male; Middle Aged; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate