technetium-tc-99m-medronate and Syndrome

The rare coexistence of intramuscular myxoma (IM) and fibrous dysplasia (FD) is known as Mazabraud's syndrome. IM tends to occur multifocally and is associated most frequently with polyostotic FD in Mazabraud's syndrome. We present an extremely rare combination of a solitary IM and monostotic FD as a variant of Mazabraud's syndrome, and discuss the importance of recognizing this rare coexistence for appropriate management of the patient.

Topics: Biopsy; Contrast Media; Diagnosis, Differential; Female; Fibrous Dysplasia, Monostotic; Gadolinium DTPA; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Muscle Neoplasms; Myxoma; Radiopharmaceuticals; Syndrome; Technetium Tc 99m Medronate; Thigh; Tomography, Emission-Computed; Tomography, X-Ray Computed

Mazabraud's syndrome, though uncommon, is reported increasingly frequently. It represents an entity readily recognisable radiologically on MR imaging. Awareness of the syndrome, particularly when the myxoma is solitary, can prevent misdiagnosis of intramuscular myxomas (especially when large) as malignant mesenchymal tumors containing myxoid tissue. We review the 34 cases previously reported in the literature and include a recent case from our center.

Topics: Adult; Diagnosis, Differential; Femur; Fibrous Dysplasia, Polyostotic; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Muscle Neoplasms; Myxoma; Radiopharmaceuticals; Ribs; Sarcoma; Syndrome; Technetium Tc 99m Medronate; Thigh; Tomography, X-Ray Computed

Topics: Aged; Bone and Bones; Bone Neoplasms; Humans; Iodine Radioisotopes; Male; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate; Thyroid Gland; Thyroid Nodule; Urinary Bladder Neoplasms

Two cases of Erdheim-Chester disease are presented: a 26-year-old white male patient with lipoidgranulomatosis of numerous long and flat bones and infiltration of pericardium, pleura, liver, spleen, thyroid, skin, conjunctiva, gingiva, and false vocal cord; and a 54-year-old white male with involvement of bones, orbits, brain, pericardium, and retroperitoneum. The scintigraphic findings in this disease are described, and a comprehensive review of the 27 previously reported cases is given including an assessment of the value of scintigraphy for diagnosis and follow up of this rare disease.

Topics: Adult; Bone Diseases; Cholesterol; Follow-Up Studies; Granuloma; Humans; Lipidoses; Male; Middle Aged; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Sinus tarsi syndrome is a pain in the lateral side of the hind foot that is responsive to injection of local anesthetic agents. We report a case of a 42-year-old man who presented with pain over the lateral aspect of the right foot. Laboratory investigations and x-ray were normal. Bone scintigraphy showed hyperemia and increase tracer uptake in right hind foot. SPECT-CT localizes this uptake at the inferior aspect of the talus and superior aspects of the calcaneus. Diagnosis of sinus tarsi syndrome was made on the basis of history, clinical examination, and bone scintigraphy findings. Local conservative therapy was initiated.

Topics: Adult; Ankle Injuries; Foot Injuries; Humans; Male; Multimodal Imaging; Radiopharmaceuticals; Syndrome; Tarsal Bones; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

We report a case of posttransplant distal limb syndrome (PTDLS) representing a rare complication in kidney transplant recipients characterized by a pain syndrome of the distal extremities. A 68-year-old man with a history of kidney transplantation presented with symmetrical and incapacitating pain in the feet and knees and underwent whole-body Tc-methylene diphosphonate (MDP) scintigraphy for further evaluation. Planar scintigraphy demonstrated marked tracer uptake in the distal femoral and tibial epiphyses, and magnetic resonance imaging showed corresponding osteoedema. Tc-MDP scintigraphy is a valuable tool for evaluation of the etiology of musculoskeletal pain and may demonstrate typical findings in case of PTDLS.

Topics: Aged; Bone and Bones; Extremities; Humans; Kidney Transplantation; Male; Pain; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate

Dentists need to be aware of the relationship between malignancies and paresthesia or complete loss of sensation in a jaw segment. In particular, dentists should be aware of numb chin syndrome (NCS) and its clinical manifestations, as well as the limitations of using panoramic radiographs to detect the causative malignancy.. The authors report two cases of paresthesia in the mental region. No lesions were readily apparent on the patients' panoramic radiographs. To exclude the presence of disease in the mandible that could have been responsible for the NCS, the authors obtained computed tomographic (CT) images. They identified metastases to the mandible from primary malignant tumors elsewhere in the body.. To prevent misdiagnosis of NCS, dentists need to be aware of the clinical manifestations of NCS, the need for CT imaging, the shortcomings of panoramic radiographs and the value of obtaining detailed and accurate medical and dental histories from patients.

Topics: Aged; Chin; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Hypesthesia; Male; Mandibular Neoplasms; Multiple Myeloma; Paresthesia; Prostatic Neoplasms; Radiography, Panoramic; Radiopharmaceuticals; Syndrome; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Calciphylaxis is a highly morbid syndrome of vascular calcification and skin necrosis, the pathophysiology of which remains largely elusive. We report a patient with end-stage renal disease and multiple painful skin lesions who underwent a bone scan for extremity pain. Increased tracer accumulation was seen in the subcutaneous tissues of the trunk and lower extremities. In this case, the bone scan aided in the diagnosis and treatment of calciphylaxis for a patient who experienced a relatively short hospital stay.

Topics: Aged; Bone and Bones; Calcinosis; Calciphylaxis; Female; Humans; Kidney Failure, Chronic; Necrosis; Radionuclide Imaging; Radiopharmaceuticals; Skin Ulcer; Syndrome; Technetium Tc 99m Medronate; Vascular Diseases

The case of a 12-year-old girl with Jaffé-Lichtenstein-Uehlinger syndrome is presented. A bone scan pattern exhibits clinical symptoms, X ray images and histological findings are described in a case of polyostotic form of the fibrous dysplasia. A biopsy with histology was performed in consideration of bone scan findings and a confirmed final diagnosis.

Topics: Bone and Bones; Bone Neoplasms; Child; Female; Fibrous Dysplasia of Bone; Humans; Radionuclide Imaging; Radiopharmaceuticals; Syndrome; Technetium Tc 99m Medronate; Whole-Body Counting

Topics: Athletic Injuries; Femur; Humans; Knee Joint; Muscle, Skeletal; Muscular Diseases; Periostitis; Radioisotopes; Rheumatic Diseases; Running; Syndrome; Technetium Tc 99m Medronate; Tomography, Emission-Computed

We report a case of transient bone marrow edema syndrome migrating within two different compartments of the same knee. This unusual pattern of migration of the marrow edema, which has been previously described only in three cases of transient osteoporosis, may raise the suspicion of an aggressive disease. Radiologists should be aware of this phenomenon in order to avoid an aggressive management of this self-limiting disease.

Topics: Bone Marrow Diseases; Disease Progression; Edema; Humans; Knee; Magnetic Resonance Imaging; Male; Middle Aged; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Syndrome; Technetium Tc 99m Medronate

A 17-year-old woman presented with pain over the sacral region. Plain radiographs of the sacrum demonstrated a bony deformity of the sacrococcygeal region in the shape of a scimitar. Magnetic resonance imaging showed a cystic mass of the presacral region which appeared to be continuous with the dural sac. An anteroposterior view myelogram revealed caudal elongation of the dural sac, and on the lateral view it was recognized as an anterior meningocele. At surgery, we confirmed a connection between the presacral mass and the rectum. In light of the combination of a sacral bony deformity, presacral mass including meningocele, and mass-rectum connection, we made the diagnosis of the Currarino triad, which is a rare complex of congenital caudal anomalies. The patient underwent excision of the presacral mass. Histologic examination of the resected specimen revealed features of an epidermoid cyst.

Topics: Abnormalities, Multiple; Adolescent; Anal Canal; Contrast Media; Epidermal Cyst; Female; Gadolinium DTPA; Humans; Magnetic Resonance Imaging; Meningocele; Myelography; Pain; Sacrum; Staphylococcal Infections; Syndrome; Technetium Tc 99m Medronate

Topics: Adolescent; Ankle Injuries; Female; Fractures, Bone; Humans; Radionuclide Imaging; Radiopharmaceuticals; Swimming; Syndrome; Talus; Technetium Tc 99m Medronate

Topics: Accidents, Traffic; Adult; Aged; Bone and Bones; Female; Fractures, Bone; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Seat Belts; Sternum; Syndrome; Technetium Tc 99m Medronate

A case is presented of metastatic tumor causing Jacod's syndrome: total ophthalmoplegia, blindness, and trigeminal neuralgia. Abnormal soft tissue invading the orbital apex, anterior clinoid process, and cavernous sinus was difficult to assess by CT and MRI, but dual-isotope SPECT including Tc-99m HMDP bone imaging and Tl-201 tumor imaging strongly suggested that the cause of this rare syndrome was a small metastatic tumor. Although the therapeutic effect was also difficult to assess by anatomic imaging alone, dual-isotope SPECT after radiation therapy showed a decline of tumor viability.

Topics: Aged; Blindness; Carcinoma, Non-Small-Cell Lung; Cavernous Sinus; Follow-Up Studies; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Male; Ophthalmoplegia; Orbital Neoplasms; Radiopharmaceuticals; Skull Base Neoplasms; Sphenoid Bone; Syndrome; Technetium Tc 99m Medronate; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Trigeminal Neuralgia

A prospective study was performed to compare the results of quantitative radionuclide bone scanning with those of sacroiliac joint anesthetic block in patients with unilateral low back pain. Thirty-four subjects, forming the control group, underwent quantitative radionuclide bone scanning of the sacroiliac joints. The normal values in sacroiliac uptake difference were taken to be between -1.7% and +6.2%. Thirty-two patients with chronic unilateral low back pain underwent sacroiliac bone scanning and sacroiliac joint block. Six of the seven patients with increased uptake > 6.2% on the painful side had at least 75% pain reduction in response to the block. The sensitivity, specificity, and positive and negative predictive values of the quantitative bone scanning in the unilateral mechanical sacroiliac joint syndrome were 46.1%, 89.5%, 85.7%, and 72%, respectively.

Topics: Adolescent; Adult; Aged; Back Pain; Female; Humans; Male; Middle Aged; Nerve Block; Predictive Value of Tests; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Sacroiliac Joint; Syndrome; Technetium Tc 99m Medronate

The role of planar dynamic scintigraphy in the diagnosis and staging of reflex sympathetic dystrophy (RSD) is presented. Bone and vascular tracers are used for this purpose. The bone scan assessment corresponded closely to the clinical diagnosis and appeared excellent to exclude RSD. Accurate staging is important for therapy decisions. Staging by the early phases of bone and vascular scans were concordant in about three quarters of patients, but vascular scintigraphy led to a restaging in the remaining quarter of patients. Both scintigraphic procedures (bone and vascular) are indicated in diagnosing and monitoring upper extremity RSD.

Topics: Adult; Aged; Arm; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Syndrome; Technetium Tc 99m Medronate

Topics: Adult; Fascia Lata; Female; Humans; Knee Injuries; Radionuclide Imaging; Running; Syndrome; Technetium Tc 99m Medronate

This study compares the bone scan appearances in 32 patients with medial tibial syndrome (MTS) with the appearance in 28 patients with confirmed chronic compartment syndrome (CCS). A distinctive pattern of uptake was seen in 30 patients, 24 of whom had MTS and 6 of whom had CCS. Of the patients with normal scans, only 4 had MTS, the remaining 15 had CCS. Both of these findings are statistically significant and confirm that bone scans are a useful diagnostic tool in the differential diagnosis of exercise-induced lower leg pain.

Topics: Adult; Anterior Compartment Syndrome; Athletic Injuries; Diagnosis, Differential; Exercise; Female; Fractures, Stress; Humans; Male; Pain; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate; Tibia

Stress fracture of the hand is uncommon but can be a significant source of morbidity if not promptly diagnosed. The authors present a case of metacarpal stress fracture in which the occupational history was key to the diagnosis and management of long-standing hand pain.

Topics: Female; Fractures, Stress; Humans; Metacarpus; Middle Aged; Occupational Diseases; Radiography; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate

Patients (n = 181) with the irritable hip syndrome were reviewed. Four of these were found to have Perthes disease and 3 cases had septic arthritis. Ultrasonography provides accurate information as to the presence or absence of an effusion in children with an irritable hip syndrome. The likelihood of a positive result is higher in the early course of the disease process (i.e. within 3 days). Bone scanning, if done routinely will help in the early diagnosis of Perthes disease. Recurrence of the symptoms occurred in 18% of patients and most of them were within 12 months of the first onset of symptoms.

Topics: Adolescent; Child; Child, Preschool; Female; Follow-Up Studies; Hip Joint; Humans; Infant; Joint Diseases; Legg-Calve-Perthes Disease; Male; Pain; Radionuclide Imaging; Recurrence; Retrospective Studies; Syndrome; Technetium Tc 99m Medronate; Ultrasonography

A case of Kashin-Beck's disease is presented. It is an acquired, disabling, polyarthritic, degenerative condition of early onset, sometimes leading to a variable degree of dwarfism. It occurs endemically in certain Asian areas. Treatment is, if possible, preventive. In the established disease the therapy is that of any other form of secondary osteoarthritis. Reconstructive surgery and removal of loose bodies may be needed in severe cases (11). Early detection, facilitated by careful family history taking, is a prime requisite, especially in non-endemic areas (7).

Topics: Ankle; Hip Joint; Humans; Male; Medical History Taking; Middle Aged; Osteoarthritis; Radiography; Shoulder Joint; Syndrome; Technetium Tc 99m Medronate

The authors describe the radiographic-scintigraphic features of an unusual craniotubular dysplasia characterized by diffuse osteopenia with bone expansion and a "ground glass" appearance, markedly increased skeletal turnover, myelofibrosis, hypophosphatemia, and pigmented "coast-of-Maine" patches. This syndrome, termed panostotic fibrous dysplasia, is distinct from previously reported disorders.

Topics: Adolescent; Bone Diseases, Metabolic; Fibrous Dysplasia of Bone; Humans; Male; Phosphates; Primary Myelofibrosis; Radiography; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate

Over a 4-year period, 192 patients with a typical transient synovitis syndrome underwent radionuclide scintigraphy shortly after presentation. Three different patterns were found suggesting that all the cases may not be of the same etiology. Fifteen patients had evidence of ischemia of the femoral head, but only 4 patients went on to develop the typical radiographic features of Perthes' disease. The other 11 patients are thought to represent a minor, radiographically silent form of Perthes' disease.

Topics: Adolescent; Child; Child, Preschool; Female; Hip Joint; Humans; Infant; Joint Diseases; Legg-Calve-Perthes Disease; Male; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate

A bone scan and red blood cell scan in the rare epidermal naevus syndrome, associated with multiple haemangiomas of the bone and hypophosphataemic osteomalacia in a 20-year-old man are reported. The typical pattern of osteomalacia on the bone scan was associated with lesions of increased bone metabolism in the peripheral bones. The haemangiomas did not pool labelled red blood cells. Thus, the bone scan seems to be suitable for diagnosing the complete extent of haemangiomas in bone, but they could not be specifically proven by red blood cell pooling.

Topics: Adult; Bone and Bones; Bone Neoplasms; Erythrocytes; Hemangioma; Humans; Male; Neoplasms, Multiple Primary; Nevus, Pigmented; Osteomalacia; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate

Topics: Female; Follow-Up Studies; Humans; Middle Aged; Osteochondritis; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate; Wrist Injuries

Five patients with polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLO-SL) were investigated using bone scintigraphy. Abnormal findings were detected in hands, wrists, knees, ankles and feet of all five patients.

Topics: Adult; Bone and Bones; Bone Diseases, Developmental; Brain Diseases; Female; Humans; Lipodystrophy; Male; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate

Shin splints is a defined clinical entity resulting from extreme tension on muscles inserting on the tibia, resulting in periosteal elevation which is detectable by bone scanning. The clinical equivalent in the thigh has been described. We found scintigraphic changes in the femurs of seven short, female, basic trainees at the Fort Dix Army base, most of whom were referred for stress fractures elsewhere in the lower extremities. The scan findings were generally noted in the upper or mid femurs, always involved the anteromedial cortex, and were bilateral in five of the seven subjects. The abnormalities were linear and suggested periosteal elevation, and did not have the typical appearance of stress fracture. Since the findings correspond to the insertion of one or more adductor muscle groups, the descriptive term "adductor insertion avulsion syndrome" or "thigh splints" is proposed for this entity.

Topics: Adolescent; Adult; Female; Femur; Humans; Military Personnel; Muscles; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate

Sternocostoclavicular hyperostosis is a rare syndrome that is characterized by hyperostosis and soft tissue ossification between the clavicles and the anterior part of the upper ribs. This syndrome frequently is found in the case of palmoplantar pustulosis (PPP), especially in Japan. There have been few published reports, however, of Tc-99m MDP bone imaging findings in PPP. Eleven patients with PPP who were suspected to have sternocostoclavicular hyperostosis were studied with Tc-99m MDP whole body bone imaging. Bone images were abnormal in 11 patients. Abnormal radionuclide concentrations were observed in the sternoclavicular, sternocostal, and manubriosternal joints, in the ribs, and in the sternum. Whole body imaging revealed radionuclide accumulations unexpectedly in other bones such as the vertebrae, femur, tibia, or sacroiliac joints in five of 11 cases. Radiographs were available in nine patients. Three chest radiographs were negative, and six showed various degrees of hyperostosis or sclerotic changes in sternoclavicular, sternocostal, or manubriosternal joints, or in the sternum or anterior upper ribs. These bone lesions usually were more prominent and more easily recognized with bone scintigraphy. Bone scintigraphy should be used as a routine procedure in patients with PPP who are suspected to have sternocostoclavicular hyperostosis.

Topics: Adult; Bone Diseases; Clavicle; Female; Humans; Keratoderma, Palmoplantar; Male; Middle Aged; Radionuclide Imaging; Ribs; Sternum; Syndrome; Technetium Tc 99m Medronate

Imaging features of a case of sternoclavicular hyperostosis are described, and the pathologic and clinical features of this uncommon entity are discussed.

Topics: Bone Diseases; Clavicle; Gallium Radioisotopes; Humans; Male; Middle Aged; Radiography; Radionuclide Imaging; Ribs; Sternum; Syndrome; Technetium Tc 99m Medronate

A case is reported of an infected popliteal (Baker's) cyst demonstrated with triple phase skeletal scintigraphy. Although double-contrast arthrography and ultrasonography are currently the modalities most frequently employed to diagnose the presence of popliteal cysts, they may also be detected utilizing this radionuclide technique in the course of evaluation for knee joint disease or septic arthritis. Radionuclide studies may be more sensitive for the evaluation of associated inflammatory disease involving the knee joint.

Topics: Aged; Clostridium Infections; Clostridium perfringens; Diphosphonates; Humans; Knee Joint; Male; Radionuclide Imaging; Staphylococcal Infections; Syndrome; Synovial Cyst; Technetium; Technetium Tc 99m Medronate

This is the first report in the nuclear medicine literature of the scintigraphic appearance of the piriformis muscle syndrome. This syndrome previously has been thought to be a purely clinical diagnosis and imaging modalities have been ignored. However, its confusing clinical presentation can lead to unnecessary surgical exploration. This case is presented to illustrate the characteristic scintigraphic pattern and suggest the role of nuclear medicine scanning in establishing the diagnosis.

Topics: Adult; Back Pain; Diphosphonates; Humans; Male; Muscles; Radionuclide Imaging; Sciatica; Syndrome; Technetium; Technetium Tc 99m Medronate

The os trigonum is an accessory bone of the foot found in 7% of the normal adult population. It is located at the posterolateral projection of the talus, and can occasionally give rise to symptoms of acute and chronic unexplained ankle pain. We report three patients, one with acute fracture and two with chronic ankle symptoms. Technetium 99 methylene diphosphonate showed intense focal uptake at the posterior talus pointing to the os trigonum as the site of symptoms. It was excised in two patients with complete relief. The third went on to develop an asymptomatic nonunion. We recommend bone scanning as a procedure that is helpful in delineating obscure pain in the ankle that may be due to chronic irritative nonunion of the os trigonum.

Topics: Adolescent; Adult; Ankle; Diphosphonates; Fractures, Bone; Humans; Male; Pain; Radiography; Radionuclide Imaging; Syndrome; Talus; Technetium; Technetium Tc 99m Medronate

Topics: Diphosphonates; Humans; Male; Postoperative Complications; Pressure; Prostatic Hyperplasia; Radionuclide Imaging; Syndrome; Technetium; Technetium Tc 99m Medronate; Urethra; Urinary Bladder Neck Obstruction

Topics: Acne Vulgaris; Adolescent; Arthritis, Rheumatoid; Body Weight; Diphosphonates; Fever; Humans; Male; Radiography; Radionuclide Imaging; Sacroiliac Joint; Syndrome; Technetium; Technetium Tc 99m Medronate

A computer macro-program was developed for standardized, semiquantitative measurement of radiotracer uptake. The method uses profiles of selectable length, width, and inclination according to the anatomical structures of the pathological and the corresponding healthy region. The ratio of the two curves is calculated automatically and shown as an 'uptake curve'. The essential use of osteoscintimetry is in the follow-up examination if small changes of regional uptake have to be identified. The profile-technique rather than the ROI-technique was selected, because the main benefit of the profile-technique is that the results of follow-up examinations are comparable to previous examinations with a standard deviation of +/-5%.

Topics: Adolescent; Adult; Bone Diseases; Child; Child, Preschool; Computers; Diphosphonates; Humans; Infant; Male; Methods; Osteitis; Osteomyelitis; Radionuclide Imaging; Syndrome; Technetium; Technetium Tc 99m Medronate; Tuberculosis, Osteoarticular

Topics: Adult; Brain Injuries; Coma; Diphosphonates; Humans; Male; Myositis Ossificans; Radionuclide Imaging; Syndrome; Technetium; Technetium Tc 99m Medronate