technetium-tc-99m-medronate and Pneumonia

We describe a patient with bilobar pneumonia and acute renal failure, whose unusual skeletal muscle uptake on technetium methylenediphosphonate bone scan led to the diagnosis of rhabdomyolysis. The clinical and serologic findings were most consistent with Legionnaires' disease. Radioisotope scanning may occasionally be useful in the diagnosis and management of muscle disease, particularly myositis and rhabdomyolysis.

Topics: Acute Kidney Injury; Adult; Bone and Bones; Female; Humans; Legionnaires' Disease; Pneumonia; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

99mTc-methylene diphosphonate (MDP) bone scan was performed in a 49-year-old female patient who had non-Hodgkin lymphoma. 99mTc-MDP uptake was significant in both lungs. Bilateral bacterial pneumonia associated with secondary hemophagocytic lymphohistiocytosis was diagnosed after extensive examination.

Topics: Female; Humans; Lymphohistiocytosis, Hemophagocytic; Lymphoma, Non-Hodgkin; Middle Aged; Pneumonia; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

The authors present a cases of acute chest syndrome that was originally thought to be due to pneumonia, in which bone imaging obtained 4 weeks later for knee pain showed a secondary finding of multiple rib infarcts that clarified the etiology of the patient's chest manifestations and led to a change in the management of the patient. Bone scintigraphy should be considered in the work-up of patients with sickle cell anemia and concurrent chest symptoms.

Topics: Adult; Anemia, Sickle Cell; Bone and Bones; Chest Pain; Diagnosis, Differential; Female; Gallium Radioisotopes; Humans; Infarction; Pneumonia; Radionuclide Imaging; Ribs; Technetium Tc 99m Medronate

Metastatic pulmonary calcification (MPC), a complication of chronic renal failure, is uncommonly diagnosed antemortem, yet may be a significant etiology of pulmonary dysfunction in patients with renal failure. The degree of respiratory distress often does not correlate with the degree of macroscopic calcification. Patients with extensive calcification may be asymptomatic, while others with subtle calcification or normal chest radiographs may have severe respiratory compromise. Additionally, the findings on chest radiographs may be confused with air-space disease, including pulmonary edema and pneumonia. Radionuclide imaging may detect MPC in the setting of normal chest radiographs, and confirm the diagnosis when there are radiographic findings of air-space disease without macroscopic calcification. We present a patient with bilateral upper lobe disease suspected to represent edema or pneumonia, proven to represent MPC on 99mTc MDP scintigraphy with single photon emission computed tomography (SPECT), CT, and later at transbronchial biopsy.

Topics: Bone and Bones; Calcinosis; Diagnosis, Differential; Humans; Kidney Failure, Chronic; Lung Diseases; Male; Middle Aged; Pneumonia; Pulmonary Edema; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed