technetium-tc-99m-medronate and Myositis-Ossificans

Fibrodysplasia ossificans progressiva is a rare debilitating, connective tissue disease characterized by progressive extraosseous ossification with abnormal great toes. Clinical (hallux valgus), radiological, and classical bone scan findings help to reach diagnosis and prevent patient from unnecessary surgical interventions for fibrodysplasia ossificans progressiva lesions and radiotherapy cycles. Here we present a case where a child presented with multiple swellings over the body and hallux valgus, and further bone scan findings helped to reach the diagnosis. The progressive nature of disease is difficult to halt, but early diagnosis can help in the delay of the disease process, by preventing trauma and giving disease-modifying agents.

Topics: Bone and Bones; Child; Early Diagnosis; Hallux; Humans; Male; Myositis Ossificans; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Adolescent; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Myositis Ossificans; Osteoma, Osteoid; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Child; Humans; Intellectual Disability; Male; Muscles; Myositis Ossificans; Neoplasm Metastasis; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi

Topics: Bone and Bones; Humans; Myositis Ossificans; Radionuclide Imaging; Radiopharmaceuticals; Rare Diseases; Technetium Tc 99m Medronate

Topics: Adult; Diagnosis, Differential; Fibula; Fractures, Stress; Humans; Male; Myositis Ossificans; Pain; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Ultrasonography

Topics: Adult; Bone Neoplasms; Diagnosis, Differential; Female; Humans; Ilium; Myositis Ossificans; Neurilemmoma; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Fibrodysplasia ossificans progressiva is a rare genetic disease characterized by widespread soft tissue ossification and congenital stigmata of the extremities. We report on a male child followed for ten years since the age of 3 years and 9 months, when the diagnosis was made. He was born with bilateral hypoplasic hallux valgus and ventricular septal defect, corrected by trans-sternal approach when 32 months old. Restriction of neck mobility followed and foci of ectopic ossification appeared. Four crises of disease exacerbation were treated with oral prednisone and/or other antiinflammatory drugs. Sodium etidronate 5 to 10 mg/kg/day was prescribed intermittently during about six years but was discontinued due to osteopenia. The disease course has been relentless, with severe movement restriction including the chest wall. A review showed few similar case reports in the Brazilian literature. We revisit the criteria for diagnosis and the essentials of management and treatment.

Topics: Adolescent; Child, Preschool; Etidronic Acid; Follow-Up Studies; Humans; Male; Myositis Ossificans; Radionuclide Imaging; Technetium Tc 99m Medronate

Gallium-67-citrate and 99mTc-diphosphate bone imaging agents are localized in myositis ossificans, a tumor-like benign soft-tissue mass that makes it impossible to differentiate between malignant tumor and the infection/inflammatory process. We present such a myositis ossificans patient whose bone and 67Ga-citrate imagings showed increased uptake in the left thigh and two foci of the right gluteal region leading to inconclusive results. Technetium-99m-MIBI imaging showed the absence of substantial uptake in these regions. ACT scan confirmed myositis ossificans. The lack of 99mTc-MIBI uptake in myositis ossificans means that 99mTc-MIBI imaging may be useful in the differential diagnosis.

Topics: Aged; Bone and Bones; Citrates; Gallium; Gallium Radioisotopes; Humans; Male; Myositis Ossificans; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Thigh

Fibrodysplasia ossificans progressiva is a rare hereditary variant of heterotropic bone formation that is often difficult to diagnose. A bone scan of an advanced case of this condition is presented. Nuclear medicine physicians should be familiar with various aspects of this disease.

Topics: Adult; Bone and Bones; Humans; Male; Myositis Ossificans; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Adult; Genes, Dominant; Humans; Male; Mutation; Myositis Ossificans; Radionuclide Imaging; Technetium Tc 99m Medronate

Myositis ossificans is primarily a disorder of adolescents or adults, whereby an area of muscle mass undergoes progressive ossification. Its radiographic and scintigraphic appearances have been well documented. In this paper, a case of histopathologically demonstrated myositis ossificans in the proximal thigh with unexpected TI-201 accumulation was presented.

Topics: Adult; Diagnosis, Differential; Female; Humans; Myositis Ossificans; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thallium Radioisotopes; Thigh

We present the findings on 201Tl and 99mTc-MDP scintigraphy in three patients suffering from heterotopic ossification (two patients presenting with myositis ossificans and one patient presenting with juxta-articular ossification in combination with myositis ossificans). Since resection of the lesions has to be delayed until stabilization, 99mTc-MDP is often used as a parameter of lesional activity, although it is not optimal. For this clinical problem, we evaluated 201Tl scintigraphy as a marker of metabolic activity. In addition to the well-documented uptake of 99mTc-MDP, marked accumulation of 201Tl was observed in all heterotopic ossification sites. Hence, our results support the use of 201Tl scintigraphy in the therapeutic management and monitoring of conditions associated with ectopic ossification. On the other hand, although myositis ossificans is sometimes clinically, radiographically and even histologically confused with extraosseous osteogenic sarcoma, 201Tl accumulation may not be a helpful factor in the differential diagnosis due to the presence of tracer accumulation in both disorders.

Topics: Adult; Diagnosis, Differential; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Muscle, Skeletal; Myositis Ossificans; Ossification, Heterotopic; Osteosarcoma; Radionuclide Imaging; Technetium Tc 99m Medronate; Thallium Radioisotopes

To characterize the radiographic and scintigraphic features of modeling and remodeling in the heterotopic skeleton of patients who have fibrodysplasia ossificans progressiva, radiographs from 47 patients and radionuclide bone scans from 12 of those patients, all of whom had a confirmed diagnosis of the disease, were reviewed. A wide range of normal bone modeling and remodeling features was seen in the heterotopic skeleton of all but the youngest two (age, 1 year) of the 47 patients. Characteristic features of normal bone modeling identified on radiographs of the heterotopic skeleton included: (a) the development of tubular and flat bones with mature cortical and trabecular organization; (b) the presence of well defined cortical-endosteal borders enclosing medullary canals; and (c) the presence of metaphyseal funnelization in isolated ossicles or at sites of synostoses. Characteristic features of normal bone remodeling identified on radiographs of the heterotopic skeleton included: (a) the response of heterotopic bone to weight bearing stress with osteosclerosis of use and osteopenia of disuse, and (b) the resistance of heterotopic bone to fatigue failure with the absence of pathologic fractures and stress fractures. Radionuclide bone scans in 12 patients showed that remodeling of mature heterotopic bone occurred at a rate consistent with that of mature normotopic bone. This study documents the radiographic and scintigraphic features of a heterotopic skeletal system in 47 patients who have fibrodysplasia ossificans progressiva. These data provide additional support for the hypothesis that the genetic defect leading to the formation of a heterotopic skeleton involves normal skeletal morphogenesis at heterotopic sites.

Topics: Adolescent; Adult; Bone Remodeling; Child; Child, Preschool; Female; Humans; Infant; Male; Middle Aged; Myositis Ossificans; Ossification, Heterotopic; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

Myositis ossificans, or heterotopic bone formation, is a possible sequela of musculoskeletal trauma. Its radiographic and scintigraphic appearances have been well documented. Specifically, plain film radiographs usually show soft tissue calcification in the muscle groups adjacent to the trauma. The three-phase bone scan may demonstrate an area of nonspecific increased tracer uptake in all three phases. The authors present a case of radiographically demonstrated heterotopic bone formation in the leg of a retired football player.

Topics: Adult; Humans; Male; Myositis Ossificans; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

An atypical heterotopic bone formation that was difficult to diagnose presented in a young paraplegic patient as an acute deep vein thrombosis. A number of imaging methods, including contrast venography, ultrasonography, conventional radiography, bone scanning, leukocyte scanning, computed tomography, and magnetic resonance imaging, were used to arrive eventually at the final diagnosis. Early bone scanning remains a sensitive and effective method of diagnosis. Computed tomography can be useful in difficult cases, but the role of other imaging studies appears limited.

Topics: Adult; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Myositis Ossificans; Paraplegia; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Myositis ossificans progressiva most commonly effects adolescents and young adults. It is characterized by progressive calcification of muscle and frequently follows trauma. Bone imaging may be helpful in determining the full extent of the disease process and may be more accurate than conventional radiographs. Bone imaging is able to detect lesions before they can be observed with radiographs. In addition, radiographs may tend to underestimate the severity of the disease.

Topics: Adult; Humans; Male; Myositis Ossificans; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Adult; Biopsy; Diagnosis, Differential; Humans; Male; Myositis Ossificans; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Wounds and Injuries

Topics: Adult; Bone and Bones; Female; Humans; Myositis Ossificans; Radionuclide Imaging; Technetium Tc 99m Medronate

In a patient with Pellegrini-Stieda disease, radiographs of the knees were unremarkable at the time the three-phase bone scintigraphy was abnormal. The results of follow-up radiographs three months later remained normal in the left knee, where local steroid injection was given, but revealed typical positive results in the right knee with no treatment. The three-phase bone scintigraphic pattern is rather typical and antedates the radiographic changes. Thus, the radionuclide technique would provide a useful procedure for the early diagnosis and treatment of Pellegrini-Stieda disease.

Topics: Adolescent; Calcinosis; Humans; Knee Joint; Ligaments, Articular; Male; Methods; Myositis Ossificans; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate; Tibia

The extensive heterotopic bone formation in patients with fibrodysplasia ossificans progressiva (FOP) has been documented previously with radiographs. A case in which a Tc-99m MDP bone scan showed increased uptake at sites well before ossification could be documented radiographically is described. This finding suggests that bone scans would likely be useful to monitor the extent of involvement with FOP and to detect areas of new activity.

Topics: Child; Female; Humans; Myositis Ossificans; Ossification, Heterotopic; Radiography; Radionuclide Imaging; Shoulder; Technetium Tc 99m Medronate

A histologically proven case of myositis ossificans is presented. Both 99mTc-MDP and 67Ga imaging demonstrated extensive uptake of radiotracers in the lesion.

Topics: Adult; Diagnosis, Differential; Female; Gallium Radioisotopes; Humans; Myositis Ossificans; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Adolescent; Diphosphonates; Gallium Radioisotopes; Humans; Male; Myositis Ossificans; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

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

Topics: Adult; Diphosphonates; Female; Hemiplegia; Hip Joint; Humans; Myositis Ossificans; Pelvic Bones; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Thigh; Time Factors

Topics: Adolescent; Bone and Bones; Diphosphonates; Female; Humans; Male; Myositis Ossificans; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Adult; Brain Injuries; Coma; Diphosphonates; Humans; Male; Myositis Ossificans; Radionuclide Imaging; Syndrome; Technetium; Technetium Tc 99m Medronate