technetium-tc-99m-medronate and Rib-Fractures

Topics: Adult; Anorexia Nervosa; Bulimia; Female; Foot Injuries; Fractures, Stress; Humans; Osteoporosis; Radionuclide Imaging; Radiopharmaceuticals; Rib Fractures; Technetium Tc 99m Medronate; Whole-Body Counting

Topics: Biopsy; Female; Fracture Healing; Humans; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Rib Fractures; Ribs; Technetium Tc 99m Medronate

Topics: Battered Child Syndrome; Child, Preschool; Fractures, Bone; Humans; Male; Pelvic Bones; Radionuclide Imaging; Radiopharmaceuticals; Rib Fractures; Technetium Tc 99m Medronate

Topics: Aged; Airway Obstruction; Female; First Aid; Humans; Radionuclide Imaging; Rib Fractures; Technetium Tc 99m Medronate; Time Factors

Topics: Aged; Humans; Male; Radiography; Radionuclide Imaging; Rib Fractures; Technetium Tc 99m Medronate

Golf has become a popular sport in Taiwan recently. Some amateur golfers suffer from back or chest pain, and a few of them have stress fractures of the ribs. Six amateur golfers suffering from back pain or chest pain, all male and right-handed players, aged from 28 to 39, were included in our study. The initial chest roentgenograms, including special views focusing on ribs, were all negative. Tc-99m MDP bone scan confirmed the diagnosis of stress fractures of the ribs. The intervals between playing golf and time of diagnosis were from 1 month to 5 months. In five cases, fracture sites in the left side were prominently located in the posterior aspect, a condition which may result from traction of the serratus anterior. Three cases with fracture sites in the right side had fractures prominently located in the lateral aspect, which may result from the repercussive force produced by the clubhead hitting the ground. Tc-99m MDP bone scan, with its high sensitivity, is useful in establishing the diagnosis of stress fracture.

Topics: Adult; Fractures, Stress; Golf; Humans; Male; Radionuclide Imaging; Rib Fractures; Technetium Tc 99m Medronate

Topics: Cardiopulmonary Resuscitation; Female; Gallium Radioisotopes; Humans; Middle Aged; Radionuclide Imaging; Rib Fractures; Technetium Tc 99m Medronate

In the clinical staging of malignancy, radionuclide bone scanning has played an increasingly important role. An area of increased radionuclide uptake on technetium 99 (99Tc) bone scan which is not visualized on skeletal radiographs can present a significant diagnostic dilemma. This can be further compounded by nonrevealing percutaneous or open surgical biopsies. The authors present a method of definitively localizing the appropriate site for bone biopsy in such circumstances. Use of this technique has allowed us to ascertain that isolated rib lesions in two patients with extra-osseous malignancies were not due to metastatic disease.

Topics: Aged; Biopsy; Bone Neoplasms; Fibrous Dysplasia of Bone; Humans; Male; Middle Aged; Radionuclide Imaging; Rib Fractures; Technetium Tc 99m Medronate

Topics: Adult; Diagnosis, Differential; Humans; Male; Radionuclide Imaging; Rib Fractures; Technetium Tc 99m Medronate

A retrospective review of 2,851 bone scans done at a cancer center over a period of 4 yr revealed 41 patients having a single abnormality in a rib as their first abnormal scintigraphic finding. The scan findings in these cases were correlated with clinical, scintigraphic, and radiographic follow-up to ascertain their etiology and course. Four lesions (9.8%) were due to malignant disease, 16 (39%) were associated with benign fractures demonstrated on x-ray, 11 (27%) were associated with primary or postoperative radiation therapy. The remaining ten patients (24.2%) with normal x-rays and no association with radiation therapy or subsequent development of metastasis were assigned to benign etiology. This experience suggests that solitary rib lesions in cancer patients are uncommon and are most frequently (90%) associated with benign etiology.

Topics: Bone Diseases; Bone Neoplasms; Breast Neoplasms; Humans; Lung Neoplasms; Neoplasm Invasiveness; Neoplasms; Radionuclide Imaging; Radiotherapy; Retrospective Studies; Rib Fractures; Ribs; Technetium Tc 99m Medronate

A case of osteomalacia with multiple asymmetrically distributed pseudofractures (Looser's zones) simulating metastases is presented. Radiographic correlation is essential to increase specificity and avoid misinterpretation.

Topics: Aged; Bone Neoplasms; Diagnosis, Differential; Femoral Fractures; Fractures, Spontaneous; Humans; Male; Osteomalacia; Radionuclide Imaging; Rib Fractures; Scapula; Technetium Tc 99m Medronate

Topics: Bone Neoplasms; Diphosphonates; False Positive Reactions; Female; Humans; Middle Aged; Radionuclide Imaging; Resuscitation; Rib Fractures; Technetium; Technetium Tc 99m Medronate

When abnormally increased radioactivity is seen in a rib or ribs by bone imaging in a patient with suspected or known malignancy, it frequently is difficult to differentiate fracture from metastatic disease. Histological examination of the lesion is crucial for diagnosis, staging, and planning of therapy. To assess the value of external localization of the site or sites of abnormal uptake in a rib as a guide for open rib biopsy, 10 patients (7 men, 3 women; age range, 34 to 68 years) with known or suspected malignancy were studied. With reference to the oscilloscope image, a cobalt 57 marker was placed on the skin overlying the focus of increased uptake, and the area of increased activity was marked on the skin as a guide to surgical resection. Of ten resected ribs, four showed metastatic disease and five had fractures. (One patient underwent two external marking procedures and two surgical procedures.) Rib biopsy was not performed in 1 patient because prior to the surgical procedure, a small subcutaneous nodule adjacent to the skin marker was excised and confirmed to be carcinoma. Appropriate courses of management (operation, irradiation, chemotherapy) were taken after the biopsies. The surgeon responsible for the biopsy should be present during the skin-marking procedure, and the area beneath the scapula and the region adjacent to the spine should be avoided. Our results indicate that the technique is a very useful aid for approaching open rib biopsies more precisely.

Topics: Adenocarcinoma; Adult; Aged; Biopsy; Bone Neoplasms; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Diagnosis, Differential; Diphosphonates; Evaluation Studies as Topic; Female; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Rib Fractures; Ribs; Technetium; Technetium Tc 99m Medronate

A review of 13 cases of suspected child abuse in which radionuclide (RN) scans, radiographic skeletal surveys, and sufficient follow-up were available showed that the RN scans were insensitive, even though fractures were more than 48 hours old at the time of the scan. Frequently missed lesions included skull and extremity fractures. Furthermore, soft tissue and visceral abnormalities that were identified on radiographic examination went undetected on RN scan. We conclude that, although the RN scan may augment the radiographic examination, it should not be used alone to screen for the battered child.

Topics: Battered Child Syndrome; Child Abuse; Child, Preschool; Diphosphonates; False Negative Reactions; False Positive Reactions; Femoral Fractures; Humans; Infant; Infant, Newborn; Male; Radiography; Radionuclide Imaging; Retrospective Studies; Rib Fractures; Skull Fractures; Technetium; Technetium Tc 99m Medronate; Tibial Fractures

Topics: Aged; Diphosphonates; Humans; Male; Radionuclide Imaging; Rib Fractures; Seat Belts; Technetium; Technetium Tc 99m Medronate