technetium-tc-99m-medronate and Orbital-Diseases

Orbital wall infarctions resulting in orbital and epidural hematomas are rare manifestations of sickle cell disease (SCD). We report orbital compression syndrome associated with an epidural hematoma and wide cephalohematoma in a 15-year-old boy with SCD. An infarcted orbital bone was observed on magnetic resonance imaging and three-phase bone scintigraphy with Technetium-99m methylene diphosphonate. The patient recovered completely without surgical intervention at the end of the fourth week. Prompt diagnosis and proper management are critical for complete recovery.

Topics: Adolescent; Anemia, Sickle Cell; Bone Marrow; Hematoma; Hematoma, Epidural, Cranial; Humans; Infarction; Magnetic Resonance Imaging; Male; Orbital Diseases; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Erdheim-Chester's disease is a form of histiocytic granulomatosis afflicting the skeletal system and various inner organs. Apart from incidental findings of involvement of various structures and tissues, a complete diagnostic workup to evaluate afflicted bodily parts is not known. The authors we present several specific isotope-diagnostic techniques of a case to support the identification of this rare multisystem infiltrative disease.

Topics: Bone and Bones; Coronary Disease; Erdheim-Chester Disease; Heart; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Orbital Diseases; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Whole Body Imaging

Functional imaging identifies areas of abnormal bone turnover, providing a useful adjunct in the treatment of osteomyelitis and bone tumors. The low resolution and lack of anatomical detail limit the application of bone scans in craniofacial surgery, however. Multimodality image registration addresses this problem by fusing functional images (single photon emission computed tomography [SPECT]) to high-resolution structural images (computed tomography [CT]) for precise anatomical delineation of bone activity. This article describes a technique for spatial registration of CT and SPECT images to provide precise anatomical delineation of abnormal bone turnover, thereby guiding the extent of resection in the management of craniofacial osteomyelitis. Standard CT and SPECT imaging protocols were used in imaging the skull from the vertex to the mentum. Image data were imported into Analyze (Biomedical Imaging Resource; Mayo Foundation, Rochester, MN) on a dedicated Windows NT (Microsoft Corporation, Redmond, WA) workstation. Using the CT data, the craniofacial skeleton, osteotomy segments, and bone grafts were interactively mapped out. Consecutive axial slices were then reconstructed to form a three-dimensional volume of interest. The CT-derived volume of interest was registered to the technetium Tc 99m-methylene diphosphonate SPECT scan using the Analyze program to provide a fused multimodality image. The imaging technique was used to localize osteomyelitis in a complex craniofacial reconstruction. The fused images guided the extent of resection during surgery, and postoperative microbiological and histological testing confirmed the diagnosis. Multimodality image registration provides a readily available method to relate facial skeletal anatomy and physiology. This technique is valuable in planning and monitoring therapeutic interventions in clinical conditions in which bone turnover is abnormal.

Topics: Adult; Bone Transplantation; Facial Bones; Frontal Bone; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Male; Orbital Diseases; Osteomyelitis; Osteotomy; Patient Care Planning; Radiopharmaceuticals; Surgery, Computer-Assisted; Surgical Wound Infection; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

To describe a 55-year-old male with Erdheim-Chester disease with bilateral orbital infiltration and visual loss who was successfully treated with interferon-alpha.. Interventional case report.. The patient was treated with interferon-alpha and had an improvement in his clinical signs, including his visual acuity, after 4 weeks of interferon therapy.. Interferon-alpha can be effective in the treatment of orbital infiltration secondary to Erdheim-Chester disease.

Topics: Exophthalmos; Granuloma; Histiocytosis, Non-Langerhans-Cell; Humans; Interferon-alpha; Magnetic Resonance Imaging; Male; Middle Aged; Orbital Diseases; Osteosclerosis; Radionuclide Imaging; Technetium Tc 99m Medronate; Visual Acuity; Xanthomatosis

Erdheim-Chester disease usually involves the diaphyseal and metaphyseal regions of tubular bones and various visceral organs. A 56-year-old woman presented with the histologically confirmed diagnosis of Erdheim-Chester disease. A Tc-99m MDP bone scan revealed the entire extent of the skeletal disease and showed unusual involvement of the epiphyses and axial skeleton. In addition to MRI, a Ga-67 citrate scan including SPECT showed extensive soft-tissue infiltration of different organs. Both Tc-99m MDP and Ga-67 scintigraphy are useful tools in determining the distribution of this rare disease.

Topics: Biopsy; Bone Diseases; Brain Diseases; Diaphyses; Epiphyses; Female; Foam Cells; Gallium Radioisotopes; Humans; Joint Diseases; Middle Aged; Orbital Diseases; Parotid Diseases; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Xanthomatosis

There have been few reports in the literature concerning the long-term prognosis of fibrous dysplasia. We reported here a boy with craniofacial fibrous dysplasia, which showed marked involution at the end of his puberty.

Topics: Child; Fibrous Dysplasia, Polyostotic; Humans; Male; Maxillary Diseases; Orbital Diseases; Postoperative Period; Puberty; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Bone infarction is common in sickle cell disease; however, involvement of the orbit is not. Only four cases have been reported in the English literature. We describe a patient who presented with headache, proptosis and lid edema due to infarction of the sphenoid bone. The combination of radionuclide bone imaging and computed tomography (CT) of the orbit were useful in differentiating bone infarction from other etiologies of proptosis.

Topics: Adult; Anemia, Sickle Cell; Diphosphonates; Humans; Infarction; Male; Orbital Diseases; Sphenoid Bone; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Two cases of unilateral and bilateral periorbital hematomas occurred in patients with sickle cell anemia. The cause of periorbital swelling in these cases was found to be orbital and frontal bone infarctions, respectively, diagnosed by technetium Tc 99m medronate bone scintigraphy. To our knowledge, periorbital bone infarction, as a part of the differential diagnosis of periorbital hematoma and as part of the possible ocular manifestations in patients with sickle cell anemia, has not previously been described.

Topics: Anemia, Sickle Cell; Child; Diphosphonates; Female; Frontal Bone; Hematoma; Humans; Infarction; Male; Orbit; Orbital Diseases; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate