technetium-tc-99m-medronate and Myositis

We studied the effectiveness of 99mTc-MDP (methylendiphosphate) scintigraphy in imaging inflammatory myopathy. The three subjects including 1 male and 2 female patients had high creatine kinase (CK) levels and proximal dominant muscle weakness. In whole body muscle surveillance by 99mTc-MDP scintigraphy, abnormal 99mTc-MDP accumulation was found in the extremities of all patients. The sites with high 99mTc-MDP accumulation showed high intensity on T2 weighted MR imaging, suggesting an inflammatory process. Muscle biopsy was performed on two patients from the muscles with the abnormal MRI findings, which showed the diagnostic finding of inflammatory changes. Because muscle involvement in inflammatory myopathy differs from muscle to muscle, it is sometimes difficult to choose appropriate muscle biopsy sites for diagnostic purposes. Affected muscles are more easily identified by using 99mTc-MDP muscle scintigraphy and muscle MRI, therefore, a correct diagnosis and choice of biopsy site can be made. 99mTc-PYP scintigraphy is permitted for use in myocardial infarction alone and 111In-antimyosin scintigraphy is not available in Japan. Therefore, we recommend 99mTc-MDP scintigraphy for diagnosis of inflammatory myopathy and for determination of muscle biopsy sites.

Topics: Adolescent; Adult; Female; Humans; Magnetic Resonance Imaging; Male; Muscle, Skeletal; Myositis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

A 27-year-old man developed polymyositis as a manifestation of chronic graft-versus-host disease (GVHD) after non-myeloablative peripheral blood stem cell transplantation (PBSCT). Bone scintigraphy showed intense, striped, and heterogeneous accumulation of Tc-99m methylene diphosphonate (MDP) in the soft-tissue of his lower limbs, while faint activities were seen in the right upper limb. Tc-99m MDP scintigraphy was very useful for accurate and objective evaluation of the severity of the muscle injury and the extent of polymyositis caused by chronic GVHD.

Topics: Adult; Bone and Bones; Extremities; Graft vs Host Disease; Humans; Male; Myositis; Peripheral Blood Stem Cell Transplantation; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Adult; Bone and Bones; Humans; Magnetic Resonance Imaging; Male; Muscle, Skeletal; Myositis; Periostitis; Polyarteritis Nodosa; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Pyomyositis, although uncommon, is being reported with greater frequency in temperate climates. The presentation is similar to a number of infectious processes, and when associated with a traumatic event, the clinical picture may be confused with that of a musculoskeletal injury. This, coupled with an unfamiliarity of the disease, may result in a delay in diagnosis. Early antibiotic therapy may obviate surgery. Progression to the suppurative stage requires surgical drainage along with antibiotics. CT guided drainage may be accomplished in certain cases. In immunocompromised patients, progression to the septicemic stage is associated with high morbidity and mortality.

Topics: Ankle Injuries; Biopsy; Child; Combined Modality Therapy; Compartment Syndromes; Debridement; Decompression, Surgical; Diagnostic Errors; Disease Progression; Emergency Treatment; Female; Humans; Myositis; Nafcillin; Necrosis; Osteomyelitis; Penicillins; Staphylococcal Infections; Suppuration; Technetium Tc 99m Medronate

Bone scintigraphy was performed on a 6-year-old boy with possible sacroiliitis.. Extraosseous uptake in the region of the paraspinal, psoas and calf muscles was noted and suggested myositis. Subsequently, his creatine kinase level was found to be elevated. Results of a neuromuscular examination, muscle biopsy with dystrophin immunostaining, and a multiplex polymerase chain reaction led to the diagnosis of Becker muscular dystrophy.. A patient with Becker muscular dystrophy had several distinct areas of myositis localized by bone scintigraphy. Pathologic features including focal myonecrosis and regeneration may contribute to this scintigraphic picture.

Topics: Bone and Bones; Child; Humans; Male; Muscular Dystrophy, Duchenne; Myositis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

A case of proliferative myositis, an unusual inflammatory pseudotumor of a skeletal muscle, is presented. Often it is erroneously misdiagnosed as a malignant neoplasm.

Topics: Adolescent; Diagnosis, Differential; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Humans; Male; Muscle Neoplasms; Myositis; Psoas Muscles; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed

A case of traumatic myositis of the intrinsic muscles of the hand is presented. This is believed to be the first report in which the diagnosis of this type of soft tissue injury was made based upon phases I and II of a three-phase bone scan. An incorrect diagnosis of primary skeletal injury could have been made if delayed, 3-4 hour (phase III) imaging alone had been performed because there was augmented uptake of tracer in the normal bone adjacent to the area of soft tissue hyperemia. This report emphasizes the need to perform three-phase scintigraphy to diagnose nonskeletal injury in patients with suspected bone trauma or pain of unknown etiology.

Topics: Hand Injuries; Humans; Male; Middle Aged; Myositis; Radionuclide Angiography; Technetium Tc 99m Medronate

We report a case of myositis associated with human immunodeficiency virus (HIV) reactivity which was demonstrated on bone scan in the presence of normal muscle enzymes, contrast computed tomography, and electromyography. The diagnosis was confirmed by muscle biopsy. Radionuclide bone scanning may be a valuable diagnostic tool in HIV positive patients who present with muscle pain and an otherwise normal diagnostic evaluation.

Topics: Adult; Bone and Bones; HIV Seropositivity; Humans; Male; Myositis; Radionuclide Imaging; Technetium Tc 99m Medronate; Thigh; Tomography, X-Ray Computed

Two patients with polymyositis showed abnormal muscular uptake of Tc-99m-methylene diphosphonate (MDP) during routine bone imaging. Imaging with Tc-99m MDP is a useful tool in monitoring the activity of the diseased muscle.

Topics: Adult; Aged; Female; Humans; Male; Muscles; Myositis; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Acute Disease; Bone and Bones; Female; Humans; Middle Aged; Myositis; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

Pyomyositis is a bacterial infection of skeletal muscle occurring in the absence of trauma or a primary site of infection. The condition is rare in temperate climates. The diagnosis is often difficult to make and frequently delayed since the suppurative process is confined by the tense overlying muscle and fascia. The bone scan is very useful in differentiating underlying osteomyelitis and septic arthritis. An 11-year-old boy is described who presented with multifocal pyomyositis in the elbow region and thigh. Lateral blood pool images suggested infection with liquefaction within the muscles without evidence of osteomyelitis.

Topics: Bone and Bones; Child; Diphosphonates; Humans; Male; Myositis; Radionuclide Imaging; Staphylococcal Infections; Technetium; Technetium Tc 99m Medronate

Topics: Abscess; Bone and Bones; Child, Preschool; Diagnosis, Differential; Diphosphonates; Female; Gallium Radioisotopes; Humans; Leg; Muscles; Myositis; Neoplasms; Radionuclide Imaging; Staphylococcal Infections; Technetium; Technetium Tc 99m Medronate