technetium-tc-99m-medronate and Rhabdomyolysis

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

Topics: Female; Humans; Middle Aged; Positron-Emission Tomography; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate; Whole Body Imaging

This study evaluated the relationship between bone scintigraphy finding and clinical factors and assessed the prognostic value of bone scintigraphy finding in patients with rhabdomyolysis.. We retrospectively enrolled 143 patients with rhabdomyolysis who had undergone bone scintigraphy. Bone scintigraphy was classified into three groups: no or equivocal soft tissue uptake, a localized uptake, and a diffuse uptake. The relationship of bone scintigraphy findings with clinical factors was evaluated. Multiple logistic regression analysis was performed to identify the risk factors for acute renal failure (ARF) and renal replacement therapy (RRT).. Of 143 patients, 52 (36.4%) experienced ARF and 12 (8.4%) required RRT. Among cases caused by exercise, 83.7% showed localized soft tissue uptake. Diffuse soft tissue uptake was only shown among the patients with rhabdomyolysis caused by drug and toxin. Patients with localized or diffuse soft tissue uptake had higher levels of serum creatine kinase, myoglobin, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase compared with patients with no or equivocal uptake (P<0.05). Multiple logistic regression analysis showed that age, female sex, and serum phosphate level were associated with a risk for ARF and only serum creatinine level was associated with a risk for RRT (P<0.05). Bone scintigraphy findings failed to show significance for predicting ARF and RRT (P>0.05).. Soft tissue uptake on bone scintigraphy in patients with rhabdomyolysis was related to etiologies and showed limited value for predicting ARF and RRT.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone and Bones; Female; Humans; Male; Middle Aged; Prognosis; Radionuclide Imaging; Retrospective Studies; Rhabdomyolysis; Technetium Tc 99m Medronate; Young Adult

Topics: Adult; Bone and Bones; Humans; Male; Muscle, Skeletal; Radiopharmaceuticals; Rhabdomyolysis; Running; Technetium Tc 99m Medronate

A 22-year-old man with foot pain was referred for evaluation of sesamoiditis. A Tc-99m methylene-diphosphonate bone scan was performed which revealed increased radiopharmaceutical uptake in the big toes, but also showed curious abnormal thoracic activity. Normal activity at sternoclavicular joints and sternum mimics ears, head and body of a bat, and the pectorals mimic the wings. The patient mentioned that he had started lifting weights a few days earlier. Clinical and echographic evaluations were diagnostic of pectoral inflammation suggesting rhabdomyolysis.

Topics: Bone and Bones; Humans; Male; Pectoralis Muscles; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate; Young Adult

Topics: Acute Kidney Injury; Bone and Bones; Humans; Laparoscopy; Magnetic Resonance Imaging; Male; Middle Aged; Nephrectomy; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

This report describes a case of acute renal failure due to rhabdomyolysis that developed after prolonged exposure to cold. A 47-year-old man visited a mountain during winter wearing only casual clothes and became lost at temperatures below freezing for 8 hours. Upon admission, the patient complained of a tingling sensation and numbness in the both upper and lower extremities with anuria. The serum blood urea nitrogen, creatinine, creatinine kinase, and myoglobin levels were elevated. Bone scintigraphy on the second day revealed increased activity in the superficial muscle groups in the abdomen, back, buttock, thighs, legs, and arms, which was compatible with rhabdomyolysis.

Topics: Cold Temperature; Humans; Hypothermia; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate

We tested whether bone scintigraphy could help in the etiological diagnosis in patients with mild rhabdomyolysis, because different patterns of soft tissue radiotracer uptake have been found on bone scintigraphy in patients presenting with severe rhabdomyolysis, with a localized asymmetric pattern in traumatic lesions and a more diffuse and symmetric pattern in nontraumatic lesions. However, the performance of bone scintigraphy in mild rhabdomyolysis is unknown. The etiological diagnosis of rhabdomyolysis can be difficult, particularly in alcohol abusers who deny a recent alcoholic binge.. Bone scintigraphy was performed in 16 patients presenting with acute renal failure secondary to mild rhabdomyolysis (creatinine kinase levels < or =36,000 IU), with obvious causes in 10 cases and with uncertain etiologies in the remaining 6 patients.. In 5 cases with evident traumatic rhabdomyolysis, and in 4 patients with uncertain etiologies, bone scintigraphy showed localized asymmetric soft tissue radiopharmaceutical uptake compatible with traumatic lesions. None of the 5 patients with nontraumatic rhabdomyolysis had significant soft tissue radiopharmaceutical uptake. In 1 patient with traumatic rhabdomyolysis, bone scintigraphy performed only 11 days after the initial insult was negative. One patient with an uncertain etiology also had a negative scintigraphy.. Bone scintigraphy, when performed early in the course of the disease, may contribute to the etiological diagnosis of rhabdomyolysis if it shows asymmetric localized soft tissue radiopharmaceutical uptake compatible with traumatic lesions. However, bone scintigraphy is often negative in mild nontraumatic lesions.

Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Muscle, Skeletal; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Rhabdomyolysis; Sensitivity and Specificity; Technetium Tc 99m Medronate

Topics: Exercise; Humans; Hypothermia; Male; Middle Aged; Near Drowning; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate

We report computed tomography (CT) findings that demonstrated early disappearance of ectopic calcification in the bilateral posterior paraspinal muscles in a patient with rhabdomyolysis. A 37-year-old man with acute renal failure due to rhabdomyolysis caused by neuroleptic malignant syndrome underwent studies with CT and bone scintigraphy. First, bone scintigraphy showed high radiotracer uptake in bilateral posterior paraspinal muscles; then CT demonstrated ectopic calcification in those muscles. After 2.5 months, CT showed that the calcification had completely disappeared. Bone scintigraphy anticipated calcification, and CT demonstrated a unique course of early disappearance of the calcification.

Topics: Acute Kidney Injury; Adult; Biomarkers; Bone and Bones; Calcinosis; Humans; Male; Muscle, Skeletal; Neuroleptic Malignant Syndrome; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate; Time Factors; Tomography, X-Ray Computed

Topics: Hip Joint; Humans; Male; Middle Aged; Muscle, Skeletal; Physical Exertion; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate

Topics: Acute Kidney Injury; Female; Humans; Middle Aged; Muscle, Skeletal; Myoglobinuria; Polymyositis; Radionuclide Imaging; Radiopharmaceuticals; Recurrence; Rhabdomyolysis; Technetium Tc 99m Medronate

A 41-year-old man experienced continuous convulsions, unconsciousness, and a high temperature. His laboratory findings revealed an increase in serum creatine phosphokinase, serum myoglobulin, and urinary myoglobulin levels. He had taken many psychotropic drugs as treatment for schizophrenia and was very dehydrated. Because a diagnosis of rhabdomyolysis was suspected, Tc-99m HMDP bone scintigraphy was performed. It showed diffusely increased soft tissue uptake in his shoulder girdles, vertebral area, psoas iliac muscles, and gluteofemoral muscles, leading to a diagnosis of rhabdomyolysis. Bone scintigraphy is useful in making an early diagnosis and evaluating the location and degree of muscle injury in rhabdomyolysis.

Topics: Adult; Bone and Bones; Humans; Male; Muscle, Skeletal; Psychotropic Drugs; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate

A case of a woman aged 46 years with signs of rhabdomyolysis and acute renal failure is presented. Coxsackie serum test was positive. Increased uptake of Technetium-99m methylene diphosphonate (99mTc-MDP) by muscles of thighs and calves was observed. After 1 year no increased accumulation of radiotracer in the muscles was found.

Topics: Artifacts; Diagnosis, Differential; Female; Humans; Middle Aged; Muscle, Skeletal; Polymyositis; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate

Topics: Adult; Arm; Bone and Bones; Humans; Incidental Findings; Low Back Pain; Male; Military Personnel; Myofascial Pain Syndromes; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Shoulder Pain; Technetium Tc 99m Medronate

Topics: Aged; Anti-Bacterial Agents; Clarithromycin; Drug Interactions; Humans; Hyperlipidemias; Hypolipidemic Agents; Male; Radionuclide Imaging; Radiopharmaceuticals; Respiratory Tract Infections; Rhabdomyolysis; Simvastatin; Technetium Tc 99m Medronate

Topics: Adolescent; Humans; Magnetic Resonance Imaging; Male; Muscle, Skeletal; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Shoulder; Technetium Tc 99m Medronate

Topics: Aged; Female; Herpes Zoster; Humans; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate; Thigh

Topics: Abdomen; Aged; Female; Humans; Hyperlipidemias; Hypolipidemic Agents; Muscle, Skeletal; Pelvis; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Shoulder; Simvastatin; Technetium Tc 99m Medronate; Thigh; Whole-Body Counting

Topics: Adult; Clavicle; Employee Discipline; Humans; Male; Military Personnel; Muscle, Skeletal; Pain; Physical Exertion; Punishment; Radionuclide Imaging; Radiopharmaceuticals; Renal Insufficiency; Rhabdomyolysis; Technetium Tc 99m Medronate; Thigh; Tissue Distribution; Whole-Body Counting

Topics: Adult; Female; Humans; Muscle, Skeletal; Muscular Dystrophies; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate

Topics: Adolescent; Exercise; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate; Thigh

Clinical and scintigraphic findings are described in a patient with unexpected diffuse lung uptake on bone scan after a heroin overdose.. The patient's Tc-99m MDP bone scan is reviewed along with the pertinent clinical history and laboratory findings.. Marked diffuse and symmetric lung uptake is present on bone scintigraphy in a patient with a history of acute renal failure and a markedly elevated calcium-phosphate product but normal renal function and laboratory values at the time of the examination.. The incidental observation of metastatic calcification by bone scintigraphy is important, because it may aid in the diagnosis of a previously unsuggested elevated calcium-phosphate product, renal failure, or both. Furthermore, the intensity of tracer localization on bone tracer-specific imaging may help evaluate the activity of the metastatic calcification process.

Topics: Acute Kidney Injury; Adult; Bone and Bones; Calcinosis; Drug Overdose; Heroin; Heroin Dependence; Humans; Lung Diseases; Male; Narcotics; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate

Topics: Humans; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate

Topics: Acute Disease; Adult; Arm; Humans; Male; Muscle, Skeletal; Physical Exertion; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate; Track and Field; Weight Lifting

A 26-year-old man with a previous history of external twin bursitis was remitted to our Department for a bone scintigraphy. Before the study, the patient performed an elevated number of intense sprints. Bone scintigraphy showed a bilaterally increased activity in both anterior rectum muscles suggesting rhabdomyolysis. Biochemical studies and MRT confirmed the diagnosis.

Topics: Adult; Bone and Bones; Humans; Joint Diseases; Magnetic Resonance Imaging; Male; Muscular Diseases; Pain; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Running; Technetium Tc 99m Medronate

Uptake of technetium-99m methylene diphosphonate by the rectus abdominis muscle was unexpectedly found in a 29 year old man who had started to perform 30 to 40 sit ups a day for five days before the bone scan. After a week of rest, serum creatine kinase activity was still abnormal but muscle uptake of technetium-99m methylene diphosphonate had ceased. This specific muscle injury after short term sit ups as well as the resolution of the phenomenon within a week are of interest.

Topics: Adult; Arthritis; Bone and Bones; Creatine Kinase; Exercise; Humans; L-Lactate Dehydrogenase; Male; Muscle Contraction; Radiopharmaceuticals; Rectus Abdominis; Rest; Rhabdomyolysis; Sacroiliac Joint; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

A 6-year-old boy had an Addisonian crisis with hyponatremic shock and required resuscitation after cardiac arrest. Severe renal failure necessitated continuous dialysis. Rhabdomyolysis was identified because of myoglobinuria and gross elevation of creatinine kinase. In the course of his treatment, bone infection was suspected. A bone scan with Tc-99m MDP showed intense uptake in numerous major muscle groups throughout the body in keeping with massive rhabdomyolysis. Similar gross muscle uptake of Ga-67 citrate was less expected. In an additional bone scan obtained 15 days later, the MDP uptake showed less intense accumulation.

Topics: Bone and Bones; Child; Citrates; Gallium; Gallium Radioisotopes; Humans; Male; Muscle, Skeletal; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate

A 85-year-old man was admitted with a history of right upper arm pain following trauma. Laboratory studies included an initial CPK level of 5,385 IU/liter. Other laboratory values were GOT, 114 IU/L; LDH, 701 IU/L; myoglobin, 1,100 ng/ml; aldolase, 13.8 IU/L. The patient was presumed to have have rhabdomyolysis. A 99mTc-hydroxy methylene diphosphonate (99mTc-HMDP) scan revealed an increased uptake in the right shoulder area. 99mTc-HMDP scan is a sensitive indicator of local skeletal muscle injury in rhabdomyolysis.

Topics: Acute Disease; Aged; Aged, 80 and over; Arm; Humans; Male; Muscles; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

During the examination of a young patient with acute renal failure, bone imaging was performed for evaluation of possible osteomyelitis. Marked soft tissue activity was seen on the bone scan. The patient admitted to recent intravenous cocaine use. Vasoconstriction from cocaine use was thought to induce rhabdomyolysis, which led to acute renal failure with myoglobulinuria.

Topics: Acute Kidney Injury; Adult; Bone and Bones; Cocaine; Humans; Male; Radionuclide Imaging; Rhabdomyolysis; Substance Abuse, Intravenous; Technetium Tc 99m Medronate

Six patients with soft tissue injury secondary to different etiologic factors are presented. The degree and extent of tissue necrosis was precisely identified by scintigraphy. In two of these, radionuclide imaging helped to establish accurately the level of amputation that resulted in appropriate wound healing.

Topics: Adult; Burns, Electric; Child Abuse; Child, Preschool; Diabetic Neuropathies; Diphosphates; Humans; Male; Radionuclide Imaging; Rhabdomyolysis; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

A case of rhabdomyolysis induced by exertional heat stroke in a police officer recruit is reported. Technetium-99m methylene diphosphonate scintigraphy demonstrated marked uptake of the injured skeletal muscle. This bone-scanning agent provided an excellent means of localizing and evaluating the muscle injury of rhabdomyolysis. Nuclear medicine physicians should be aware of the special conditions and causes in which bone scan may demonstrate striking findings.

Topics: Adult; Heat Exhaustion; Humans; Male; Physical Exertion; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

We performed bone scans with 99mTechnetium phosphates in 15 cases of clinically suspected rhabdomyolysis admitted to Chigasaki Tokushukai Hospital. Whole body scans were performed within 5 days from the onset of illness or admission. Accumulation of the radioactivity in the skeletal muscle was revealed in 13 of the 15 cases and the involved muscle groups were visualized vividly. Etiologies of rhabdomyolysis were diverse, ranging from malignant syndrome to sepsis. Myocardial concentration was absent in all of the cases. Renal concentration of the isotope was seen in cases where the degree of rhabdomyolysis was higher and renal impairment was present. We conclude that 99mTechnetium phosphate bone scan is useful in clinically suspected rhabdomyolysis as a diagnostic test and as a test to localize and quantitate the muscular involvement.

Topics: Adult; Aged; Aged, 80 and over; Diphosphates; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Rhabdomyolysis; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Technetium-99m phosphate compounds are useful for bone scintigraphy. Furthermore they occasionally demonstrated acute myocardial infarction and myocarditis as positive lesions. Also accumulations in the extraskeletal muscle have been reported using these compounds. This case was a 47-year-old male and had localized rhabdomyolysis, caused by compartment syndrome. We report the usefulness of technetium-99m methylene diphosphonate to diagnose the location of rhabdomyolysis.

Topics: Compartment Syndromes; Humans; Male; Middle Aged; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

A case is reported of acute renal failure occurring after prolonged abdominal aortic bypass surgery in an overweight 69-year-old male patient. Preoperative serum creatinine concentration was normal. Surgery lasted for 6 h, and infrarenal aortic cross-clamping 2 1/2 h. The patient complained of important lumbar pain immediately after the operation. In the same time, oliguria and acute renal failure also developed (creatinine: 464 mumol.l-1; urea: 13 mmol.l-1). Rhabdomyolysis caused by the kidney-bridge was confirmed by the elevated blood creatine phosphokinase levels (16,000 IU.l-1 on the second postoperative day). A 99 m-Technetium methylene-diphosphonate imaging on the 10th postoperative day exhibited diffuse fixation in the paravertebral lumbar and thoracic muscles, extending from Th8 to L3. The acute renal failure regressed completely after haemodialysis.

Topics: Acute Kidney Injury; Aged; Back Pain; Beds; Blood Vessel Prosthesis; Humans; Intraoperative Complications; Lumbosacral Region; Male; Posture; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

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

Topics: Adult; Diphosphonates; Humans; Male; Muscles; Rhabdomyolysis; Technetium; Technetium Tc 99m Medronate; Tomography, Emission-Computed

We used technetium Tc 99m medronate (methylene diphosphonate) scanning in the treatment of seven patients with rhabdomyolysis. In three patients the intense, diffuse, symmetric nature of the scans was suggestive of an underlying metabolic muscle disorder. The scans defined the extent of the muscle injury in three patients and demonstrated muscle injury that was not initially suspected in two patients. The scan also demonstrated clinically unsuspected metastatic pulmonary and gastric calcifications in one patient. All scans showed evidence of renal dysfunction. In conclusion, these cases demonstrate that Tc 99m medronate scanning helps to define the extent and location of muscle injury in rhabdomyolysis, and that diffuse muscle uptake of Tc 99m medronate may be associated with metabolic muscle disease.

Topics: Acute Kidney Injury; Adult; Aged; Bone and Bones; Follow-Up Studies; Humans; Male; Middle Aged; Muscles; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

Topics: Bone and Bones; Humans; Male; Middle Aged; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

We report a case of myoglobinuria secondary to prolonged seizures. The child showed "hot kidneys" with bone scintigraphy. The disease entity and etiologies of nontraumatic rhabdomyolysis are discussed.

Topics: Acute Kidney Injury; Adolescent; Bone and Bones; Diphosphonates; Female; Humans; Kidney; Radionuclide Imaging; Rhabdomyolysis; Seizures; Technetium; Technetium Tc 99m Medronate

In 24 patients with biochemically proven rhabdomyolysis 34 scans with 99mTc-MDP were performed to detect regional as well as generalized myolysis. When performing the scan within 10 days after the maximum of myolysis, scintigraphic detection was possible in 95% of the patients, but after 20 days in none. Regional tracer accumulation in muscles was more frequent (89%) than generalized diffuse accumulation (31%). Predominantly muscles of the thigh, the buttocks and the upper arm were involved. Diffuse tracer accumulation in both kidneys occurred in 75% of patients with significant renal dysfunction. The results show that in addition to regional muscle damage generalized myolysis may be detected by scintigraphy with 99mTc-MDP. In cases of regional muscle damage scintigraphy proved to be more sensitive than clinical signs.

Topics: Alcoholism; Diphosphonates; Glycogen Storage Disease Type V; Humans; Radionuclide Imaging; Rhabdomyolysis; Technetium; Technetium Tc 99m Medronate