No abstract available.
Bone Marrow/*pathology/radiography/radionuclide imaging ; Carcinoma, Adenoid Cystic/*diagnosis ; Eye Neoplasms/*diagnosis ; Female ; Humans ; Lacrimal Apparatus/*pathology/radiography/radionuclide imaging ; Lacrimal Apparatus Diseases/*diagnosis ; Maxilla ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; *Positron-Emission Tomography ; *Tomography, X-Ray Computed

Malignant bone tumors would be classified as primary malignant bone tumors, secondary malignant bone tumors, and metastatic bone tumors. Primary malignant bone tumors are rare diseases occupying 1% of adult cancers, and 6% of pediatric cancers. The chief complaint of malignant bone tumor patients is pain different from that of malignant soft tissue tumor patients. Diagnostic procedures start with clinical evaluation including current illness, past medical history, family history, and physical examination. Then we take a radiograph first and obtain important and diagnostic clues from it. However pathological diagnosis and information about the extent of tumor are required to obtain a more definite diagnosis and staging. Examinations for detection of local and systemic tumor extent are scintigraphy, computed tomography (CT), magnetic resonance imaging, and positron emission tomography-CT. If the clinical and radiographic information suggests aggressive or malignant bone tumor, the patient should be referred to a bone tumor specialist without further evaluations.
Adult ; Biopsy ; Bone Neoplasms ; Diagnosis ; Electrons ; Humans ; Magnetic Resonance Imaging ; Physical Examination ; Radionuclide Imaging ; Rare Diseases ; Specialization

Multiple extramedullary (soft tissue) plasmacytoma is a rare neoplasm of plasma cells. This is a case of a 63-year-old male who presented with back pain and a one month history of a painful, progressively growing mass at the right anterior chest wall. Since radiographs and computed tomography of the chest showed lytic lesions on the ribs and L4 compression deformity, the patient was referred for whole body bone scintigraphy to evaluate the remainder of the skeleton. Bone scintigraphy revealed osteoblastic lesions and osteolytic lesions in the thoracic cage. Diagnosis of plasmacytoma was established by biopsy and confirmation of microscopic characteristics and immunohistochemical staining.

Human ; Male ; Middle Aged ; Neoplasms ; Neoplasms By Histologic Type ; Neoplasms, Plasma Cell ; Radionuclide Imaging ; Diagnosis ; Diagnostic Techniques And Procedures ; Diagnostic Imaging ; Back Pain ; Biopsy ; Bone Diseases ; Plasma Cells ; Plasmacytoma ; Thoracic Wall ; Tomography ; Whole Body Imaging

BACKGROUND: We compared indomethacin therapy with the more aggressive approaches of anti-cancer chemotherapy and surgery in the treatment of isolated Langerhans cell histiocytosis (LCH) of bone in children. METHODS: Comparisons were made with respect to healing of the lesion without recurrence, time to radiological healing of the lesion, time to functional recovery, and complications related to treatment. RESULTS: Complete radiologic healing of the lesion (mean, 15.3 months) and functional recovery (mean, 5.6 months) were observed in all patients treated with either approach. No significant differences were noted in the time to complete radiologic healing or the time to functional recovery between the two groups. There were no recurrences with either approach until the last follow-up (mean, 56 months). Complications were common with anti-cancer chemotherapy, but indomethacin was well-tolerated. CONCLUSIONS: Indomethacin seems to be effective for treating isolated LCH of bone in children. Hence, morbidities associated with aggressive treatment approaches such as anti-cancer chemotherapy or surgery can be avoided.
Adolescent ; Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use ; Bone Diseases/*drug therapy/radiography/radionuclide imaging ; Child ; Child, Preschool ; Cyclooxygenase Inhibitors/*therapeutic use ; Eosinophilic Granuloma/*drug therapy/radiography/radionuclide imaging ; Female ; Humans ; Indomethacin/*therapeutic use ; Infant ; Male ; Recurrence

Arthrography ; Bone Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Bone and Bones ; diagnostic imaging ; pathology ; Diagnosis, Differential ; Diagnostic Errors ; Humans ; Immunohistochemistry ; Joint Diseases ; diagnosis ; diagnostic imaging ; pathology ; Joints ; diagnostic imaging ; pathology ; Radionuclide Imaging

Scurvy is very rare disease in industrialized societies. Nevertheless, it still exists in higher risk groups including economically disadvantaged populations with poor nutrition, such as the elderly and chronic alcoholics. The incidence of scurvy in the pediatric population is very low. This study reports a case of scurvy in a 5-year-old girl with cerebral palsy and developmental delay based on MRI findings.
Ascorbic Acid/blood/therapeutic use ; Bone Diseases, Metabolic/etiology ; Cerebral Palsy/complications ; Child, Preschool ; Cholecalciferol/blood ; Developmental Disabilities/complications ; Drainage ; Female ; Femur/pathology/radionuclide imaging/surgery ; Fever/etiology ; Follow-Up Studies ; Hematoma/diagnosis/etiology/surgery ; Humans ; Knee/radiography ; Magnetic Resonance Imaging/*methods ; Muscle Weakness/etiology ; Rare Diseases ; Scurvy/complications/*diagnosis/drug therapy ; Thigh/pathology ; Vitamins/therapeutic use

Infectious and inflammatory bone diseases include a wide range of disease process, depending on the patient's age, location of infection, various causative organisms, duration from symtom onset, accompanied fracture or prior surgery, prosthesis insertion, and underlying systemic disease such as diabetes, etc. Bone infection may induce massive destruction of bones and joints, results in functional reduction and disability. The key to successful management is early diagnosis and proper treatment. Various radionuclide imaging methods including three phase bone scan, Ga-67 scan, WBC scan, and combined imaging techniques such as bone/Ga-67 scan, WBC/bone marrow scan add complementary role to the radiologic imaging modalities including plain radiography, CT and MRI. F-18 FDG PET imaging also has recently been introduced in diagnosis of infected prosthesis and chronic active osteomyelitis. Selection of proper nuclear medicine imaging method will improve the diagnostic accuracy of infectious and inflammatory bone diseases, based on understading of pathogenesis and radiologic imaging findings.
Bone Diseases ; Bone Diseases, Infectious* ; Bone Marrow ; Diagnosis* ; Early Diagnosis ; Joints ; Magnetic Resonance Imaging ; Nuclear Medicine* ; Osteomyelitis ; Prostheses and Implants ; Radiography ; Radionuclide Imaging

OBJECTIVE: Insufficiency fracture (IF) occurs when normal or physiological muscular activity stresses a bone that is deficient in mineral or elastic resistance. We studied clinical characteristics of IF in patients with chronic inflammatory joint diseases in Korea. METHODS: Between Aug. 1997 and Feb. 2003, thirty five patients with 77 fractures were studied at the authors' institution when they were being treated for their rheumatic diseases. The clinical and laboratory data were collected by review of medical record retrospectively. RESULTS: All patients except four were postmenopausal women (mean age 63.0+/-10.0 years) with long disease duration (mean 14.2+/-11.6 years). Thirty three patients had rheumatoid arthritis, 1 ankylosing spondylitis and 1 systemic lupus erythematosus. Twenty nine patients (85.7%) were receiving regular steroid treatment (mean dose 4.0+/-2.3 mg/day, mean duration 6.1+/-4.2 years). Twenty four patients were treated with methotrexate. The significant reduction in their bone mineral density was found 27 patients based on BMD or QCT. Eight patients without osteoporosis were treated with steroid or MTX. Twenty three patients were ever used for osteoporosis treatment. Most patients except four presented with pain in the low back, groin, hip, pelvic, leg and knee. Initial simple radiography was positive in only 7 patients, with vertebral compression fracture in 11 patients and no effect on mobility except ten. Diagnosis was delayed (mean duration of symptom until diagnosis was 45.6+/-64.5 days). IF was confirmed using the bone scan. Sacrum and pelvic bone was most frequently affected site. The other sites were SI joint, iliac wing, symphysis pubis, acetabulum and femur neck. Twenty nine patients required in-patient stay (mean 17.4 days). All but one patient showed an uneventful recovery with conservative treatment. CONCLUSION: The low grade nature of symptoms, minimal effect on mobility, absence of significant trauma and missed on initial plain radiography make diagnosis difficult and delayed. IF should be suspected in cases of unexplained pain with local tenderness in patients of chronic inflammatory joint diseases. The technetium-99m diphosphonate bone scintigraphy was valuable diagnostic tool in the early recognition of IF.
Acetabulum ; Arthritis, Rheumatoid ; Bone Density ; Diagnosis ; Female ; Femur Neck ; Fractures, Compression ; Fractures, Stress* ; Groin ; Hip ; Humans ; Joint Diseases* ; Joints* ; Knee ; Korea ; Leg ; Lupus Erythematosus, Systemic ; Medical Records ; Methotrexate ; Osteoporosis ; Pelvic Bones ; Radiography ; Radionuclide Imaging ; Retrospective Studies ; Rheumatic Diseases ; Sacrum ; Spondylitis, Ankylosing

BACKGROUND/AIMS: Liver scintigraphy is a useful tool in evaluating the chronic liver disease, even though it is less sensitive to detect a mass lesion in the liver than ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI). We evaluate the clinical usefulness of liver scintigraphy in patients with liver cirrhosis by comparing with the clinical and biochemical indices. METHODS: Liver scintigraphy was taken beginning 20 minutes after the intravenous injection of 370 MBq of Tc-99m phytate. Images were obtained in multiple views with a gamma camera (Basicam(R), Siemens). The size of the liver, left lobe enlargement, inhomogeneity of radioactivity, the size of the spleen, the extrahepatic uptake were evaluated on liver scintigraphy. The compared clinical indices were serum albumin level, serum bilirubin level, INR (international normalized ratio) for prothrombin time, the presence of hepatic coma, and esophageal varix. RESULTS: Forty four patients (M:F=24:20) were included. The extrahepatic uptake such as bone marrow and splenic uptake was positively correlated with the level of serum bilirubin and negatively correlated with the level of serum albumin. The size of the spleen, inhomogenous liver uptake, hypertrophy of left lobe was positively correlated with the degree of esophageal varix. The size of the liver was negatively correlated with that of esophageal varix. CONCLUSION: We suggest that scintigraphic findings in liver scintigraphy could be used in the evaluation of patients with liver cirrhosis not only to diagnose cirrhosis but also to know the severity of cirrhosis.
Bilirubin ; Bone Marrow ; Esophageal and Gastric Varices ; Fibrosis ; Gamma Cameras ; Hepatic Encephalopathy ; Humans ; Hypertrophy ; Injections, Intravenous ; International Normalized Ratio ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Magnetic Resonance Imaging ; Phytic Acid ; Prothrombin Time ; Radioactivity ; Radionuclide Imaging* ; Serum Albumin ; Spleen ; Ultrasonography

Hypercalcemia in accelerated phase of chronic myelogenous leukemia (CML) is very rare. Its pathogenesis is considered humoral hypercalcemia of malignancies mediated by parathyroid hormone-related protein (PTHrP). In severe hypercalcemia, calcifications in kidneys, skin, vessels, heart, and stomach may occur. Our two cases were admitted because of severe hypercalcemia in accelerated phase of CML. On Tc-99m methylene diphosphonate (MDP) bone scintigraphies, a marked tracer accumulation was seen in the lung, heart, stomach and kidney. We report increased tracer accumulation of multiple organs on Tc-99m MDP bone scintigraphy in two rare hypercalcemic patients with CML.
Adult ; Bone Diseases/radionuclide imaging* ; Bone Diseases/etiology* ; Calcinosis/radionuclide imaging ; Calcinosis/etiology ; Case Report ; Human ; Hypercalcemia/radionuclide imaging* ; Hypercalcemia/etiology* ; Leukemia, Myeloid, Chronic/metabolism ; Leukemia, Myeloid, Chronic/complications* ; Male ; Middle Age ; Proteins/metabolism ; Technetium/diagnostic use