technetium-tc-99m-medronate and Edema

The authors report atypical findings of discordant bone scans and radiography seen in a patient with transient osteoporosis of the hip (TOH). Presented in the case of a 60-year-old man who had spontaneous onset of left hip pain which worsened for 2 months with weight-bearing on the affected side. Initial and follow-up radiographs of the let hip were normal. Bone scan demonstrated intense uptake of Tc-99m MDP in the affected femoral head and neck, corresponding to characteristics of abnormal signal intensity of TOH or transient bone marrow edema syndrome on MRI. This discordant pattern of bone scan and radiographs has rarely been reported in the literature. Its possible mechanism of causation and clinical implication in TOH, together with a review of the literature, are discussed in this report.

Topics: Bone Marrow; Edema; Femur Head; Femur Neck; Hip Joint; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Osteoporosis; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Biopsy; Bone Density Conservation Agents; Bone Neoplasms; Calcinosis; Calcium; Diagnosis, Differential; Diphosphonates; Drug Therapy, Combination; Edema; Humans; Humerus; Imidazoles; Male; Middle Aged; Multimodal Imaging; Osteolysis, Essential; Positron-Emission Tomography; Radiopharmaceuticals; Sarcoma, Synovial; Scapula; Shoulder Joint; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Vitamin D; Zoledronic Acid

Topics: Acetabulum; Adult; Bone Marrow Diseases; Edema; Humans; Magnetic Resonance Imaging; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

To study the clinical hand findings in Behçet's disease (BD) and to observe scintigraphic changes of these areas.. Fifty-seven randomly selected BD patients and the patients in the control group (N=40) were evaluated by two blind rheumatologists. The hands were examined for the presence of pain, tenderness, swelling, effusion, erythema, warmth, range of motion and limitation of motion, deformities and muscle atrophy. Then scintigraphic examination of the hands was performed. Control hand scintigrams were obtained from 40 age- and sex-matched patients and were examined by the same two observers.. Thirty-two of the 57 patients (56.1%) showed Behçet's clinical hand findings. Terminal phalangeal pulp atrophy was observed in 17 (29.81%), rheumatoid-like hand findings were observed in 16 (28.1%), dorsal interosseos atrophy was observed in 12 (20.05%) and erythema over the digits was observed in 12 (20.05%). Twenty-four patients (42.1%) had scintigraphic involvement. The disease duration was observed to be an important factor for hand findings (P=0.040) and scintigraphic involvement (P=0.011).. High prevalence of hand involvement in BD and its relationship with disease duration is demonstrated. Hand involvement tends to be overlooked and careful examination is required in the evaluation of BD. The scintigraphic involvement detected in hands requires special consideration, too.

Topics: Adolescent; Adult; Arthralgia; Atrophy; Behcet Syndrome; Edema; Erythema; Female; Finger Joint; Follow-Up Studies; Hand Deformities, Acquired; Humans; Male; Middle Aged; Observer Variation; Prevalence; Radionuclide Imaging; Radiopharmaceuticals; Severity of Illness Index; Technetium Tc 99m Medronate

Topics: Diabetic Foot; Diabetic Neuropathies; Edema; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Bone and Bones; Calcinosis; Connective Tissue Diseases; Edema; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Renal Dialysis; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Remitting seronegative symmetric synovitis with pitting edema (RS3PE) was first reported by McCarty et al in 1985 and refers to a rheumatologic set of symptoms with acute onset, with no erosive bone lesions, with seronegative findings, affecting the elderly more frequently, and showing an excellent prognosis with low-dose steroid therapy. Although these characteristics make it possible to differentiate it from rheumatoid arthritis and rheumatic polymyalgia, there have been very few reports on the imaging findings. The authors present scintigraphic and magnetic resonance images in a case of RS3PE.

Topics: Bone and Bones; Edema; Female; Gallium Radioisotopes; Humans; Magnetic Resonance Imaging; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Synovitis; Technetium Tc 99m Medronate

We report a case of transient bone marrow edema syndrome migrating within two different compartments of the same knee. This unusual pattern of migration of the marrow edema, which has been previously described only in three cases of transient osteoporosis, may raise the suspicion of an aggressive disease. Radiologists should be aware of this phenomenon in order to avoid an aggressive management of this self-limiting disease.

Topics: Bone Marrow Diseases; Disease Progression; Edema; Humans; Knee; Magnetic Resonance Imaging; Male; Middle Aged; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Syndrome; Technetium Tc 99m Medronate

Topics: Aged; Carcinoma; Dissection; Edema; Female; Humans; Inguinal Canal; Leg; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Radiotherapy Dosage; Technetium Tc 99m Medronate; Vulvar Neoplasms; Whole-Body Counting

A 71-year-old woman presenting with severe low back pain was found to have a large oval area of increased sacral uptake on Tc-99m MDP scan, with corresponding T1-hypointense and T2-hyperintense areas on magnetic resonance (MR) images, highly suggestive of malignancy. Open biopsies showed only callus formation. The patient responded clinically to conservative measures, with twice-repeated follow-up Tc-99m MDP and MR scans documenting resolution of transient bone marrow oedema. We suggest that this form of marrow oedema represents a variant pattern of sacral insufficiency fractures.

Topics: Aged; Bone Marrow; Edema; Female; Fractures, Spontaneous; Humans; Magnetic Resonance Imaging; Radiopharmaceuticals; Sacrum; Spinal Fractures; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Adult; Edema; Humans; Ileum; Intestinal Diseases; Male; Pancreatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate; Vipoma

The authors describe a patient with acute rheumatic fever and polyarthritis in whom scintigraphy unexpectedly identified Tc-99m MDP uptake in the diaphyses of both tibiae. A dramatic rise in antistreptolysin-O titer and rapid resolution of tibial abnormalities paralleled marked articular improvement. Magnetic resonance imaging demonstrated a pattern consistent with marrow edema in the area of abnormal Tc-99m MDP accumulation. This finding has not been previously described in acute rheumatic fever, and it was suspected that the changes in the tibiae resulted from subclinical diaphyseal hyperemia from the inflammatory process observed in the contiguous joints.

Topics: Acute Disease; Adult; Bone Marrow Diseases; Edema; Female; Humans; Magnetic Resonance Imaging; Male; Radionuclide Imaging; Rheumatic Fever; Technetium Tc 99m Medronate; Tibia; Time Factors

A quadriplegic patient with a swollen leg was suspected of having deep-venous thrombosis, and was studied with radionuclide venography (RNV) and contrast venography. Focal narrowing of the femoral vein, seen on RNV, was due to extrinsic compression. Although soft-tissue radiographs were normal, Tc-99m diphosphonate imaging established the diagnosis of early heterotopic bone formation (myositis ossificans), which was responsible for the venous compression. Clinically this inflammatory process can mimic deep-venous thrombosis, and should be considered in evaluating patients at risk for both heterotopic bone formation and deep-venous thrombosis.

Topics: Adult; Diagnosis, Differential; Diphosphonates; Edema; Femoral Vein; Humans; Male; Myositis Ossificans; Quadriplegia; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Medronate; Thrombosis

Using compartmental analysis techniques, we modeled the biodistribution of Tc-99m(Sn)methylene diphosphonate in humans on a computer, and by selectively perturbing appropriate rate constants, we simulated changes in contrast between bone and soft tissue in a number of systemic disorders. The model predicts low contrast in patients with moderate to marked edema, obesity, congestive heart failure or decreased cardiac output states and high contrast with as little as 25% increase in bone avidity for the tracer. In acute renal failure without fluid-volume imbalance, image contrast should be normal. The model predicts greater contrast shortly after injection in patients with increased cardiac output, skeletal blood flow, or bone avidity; images made at these times would be indistinguishable. These simulations are in keeping with reports in the literature of bone images and bone-to-soft tissue ratios in many of these conditions, suggesting that modeling studies could play an important role image interpretation.

Topics: Acute Kidney Injury; Aged; Blood Circulation; Bone and Bones; Bone Development; Cardiac Output; Computers; Diphosphonates; Edema; Humans; Kidney Failure, Chronic; Middle Aged; Radiographic Image Enhancement; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technology, Radiologic

Topics: Animals; Diphosphonates; Edema; Heart Failure; Humans; Lung Neoplasms; Nephrotic Syndrome; Technetium; Technetium Tc 99m Medronate