Mixed "hot" and "cold" lesions on bone scans.
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Biomedical subjects
Publications and source records attributed to C D Teates.
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Although reduced gonadal steroid hormone concentrations appear to play a major role in lower trabecular bone mineral density (BMD) in women with athletic amenorrhea, dietary deficiencies and eating behaviors may also affect BMD in women runners. To investigate this possibility, dietary patterns (7-d records), eating-disorders inventory (EDI), and BMD were examined in nine nonrunning eumenorrheic control (Contl) and 32 women runners classified as eumenorrheic (n = 19, Eumen) and oligo/amenorrheic (a group in which some were oligomenorrheic and some were amenorrheic; Ol/Am, n = 13). Runner groups had similar cardiorespiratory fitness, body composition, and training characteristics. Lumbar spine BMD was lower in the Ol/Am runners (-12%, P less than 0.05) but proximal femur BMD did not differ. Dietary intake and EDI subscale scores were similar among the groups. However, there was an inverse trend between EDI subscale scores for bulimia and ineffectiveness and femoral BMD in the Ol/Am runners (r = -0.62 to -0.71, P less than 0.05). These results suggest that self-reported dietary intake and/or eating behaviors do not predict reproductive-function alterations in women runners, but eating behaviors may be associated with lower BMD in Ol/Am runners.
We examined the relationships among reproductive hormone concentrations and bone mineral density (BMD) in 43 women runners classified as eumenorrheic (n = 24), oligomenorrheic (n = 8), or amenorrheic (n = 11). Results were compared with a eumenorrheic nonrunner control group (n = 11). Serum 17 beta-estradiol, progesterone, and dehydroepiandrosterone sulfate concentrations were determined in daily blood samples for 21 days, and integrated concentrations (areas under the curve) were calculated. BMD was assessed at the lumbar spine and proximal femur by dual-photon absorptiometry. As expected, 17 beta-estradiol, progesterone, and lumbar spine BMD were higher in the control and eumenorrheic runner groups than in the oligomenorrheic and amenorrheic runner groups (P less than 0.05). Progesterone concentration was significantly correlated with lumbar spine BMD in the eumenorrheic runners (r = 0.61). None of the steroid hormones was significantly related to BMD in the oligomenorrheic/amenorrheic group. The present data suggest that circulating levels of gonadal steroid hormones affect axial BMD in eumenorrheic runners.
In adult rabbits, a unilateral subcapital osteotomy of the femoral neck was performed to induce avascularity. One half of the osteotomy sites were fixed with a magnetic resonance imaging (MRI) compatible absorbable pin and the other osteotomies had no fixation. The femoral heads were studied at three, five, and 12 days with roentgenographs, bone scintigraphy, and MRI, and MRI only at four weeks and six weeks after osteotomy. Histologic studies were performed after imaging to evaluate the viability of the femoral heads. At three, five, and 12 days after osteotomy, bone scintigraphy showed a decrease in uptake of radioisotope in the region of the femoral head on the operated side relative to the acetabulum and greater trochanter in 17 of 18 rabbits. A comparison of the surgically treated hip to the normal hip in fixed and unfixed osteotomies showed no change in the signal behavior of T1- or T2-weighted images in all rabbits Days 3, 5, and 12 (n = 18) after operation. The rabbit femoral heads with fixation of the osteotomy 28 days after operation showed a decrease in signal intensity in the subcapital region of the femoral head. Six weeks after operation, the fixed femoral head shows a loss of signal in a portion of the femoral head near the osteotomy. The MRI signal intensity appears to increase in the unfixed femoral heads six weeks after operation.(ABSTRACT TRUNCATED AT 250 WORDS)
Despite the widespread clinical acceptance of new imaging modalities in the evaluation of acutely ill patients, there are still a number of applications for radionuclide scintigraphy. The unique ability of tracers to evaluate organ function or localized tissue dysfunction often can provide more useful information than strictly anatomic imaging modalities. Although the ventilation-perfusion study probably remains the dominant emergency procedure in most nuclear medicine laboratories, other procedures, such as those described herein, play an important role and should be available for acutely injured or ill patients.
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Twenty patients with 23 painful total hip prostheses were examined by radionuclide imaging (20 cases), arthrography (11 cases), needle aspiration (9 cases), and surgery (19 cases) for the purpose of assessing loosening and/or infection. Bone imaging was most accurate, showing three main distributions of activity: (a) ectopic calcification, (b) focal increased activity at the upper and lower ends of the femoral prosthesis, and (c) diffuse activity. These findings suggest that infection and loosening can be differentiated in many instances. None of the patients with focal activity had infection, compared to 2 of the 3 patients with diffuse uptake.
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Idiopathic regional migratory osteoporosis is a self-limited entity of unknown origin, which has received little attention in the nuclear medicine literature. It is characterized by severe joint pain, typically in a hip, with normal laboratory and normal early radiographic findings. Spontaneous recovery occurs, but recurrence is frequent in another joint, often the opposite hip. Recurrence in the same joint has never been reported. The bone scan is shown to be positive with first symptoms and is important in the diagnosis and management of this entity. Three cases are presented.
A misleading appearance of placenta previa was observed in three sonographic examinations of pregnant women. In these women the fetuses were in a transverse lie and the placentas were implanted on the anterior uterine wall. In these circumstances it appears possible for the lower anterior portion of the uterine wall and the attached portion of the placenta to falsely simulate placenta previa.
After a photon-deficient area in the region of the stomach under the ribs on the left side was noted in some bone-scanning patients, a successful attempt was made to produce the artifact by having a cooperative patient eat a large lunch. The comparison of the scans before and after lunch showed the presence of a postprandial artifact in the area in question. It is important not to confuse this artifact with a space-occupying avascular mass in that part of the abdomen.
Superior sagittal sinus thrombosis is a serious condition requiring early diagnosis. This paper presents our experience with two cases and describes the findings. In one case radionuclide brain imaging was the first study performed. In the other, the diagnosis was made at arteriography with scanning used for follow-up.
The LeVeen shunt has proved valuable in relieving intractable ascites. It is however subject to failure in about 5--8% of cases. To our knowledge there are only three reports in the literature describing the use of nuclides to assess patency; two using 99mTc-sulfur colloid and one using 99mTc-albumin. The purpose of this paper is to add our experience to the data currently published and stress that late liver visualization may occur with an obstructed shunt.
Metastatic soft tissue calcification is known to occur in hypercalcemia and is usually present in the kidneys, stomach and lungs. 1--3 This case presents two unusual features: 1) ectopic parathormone production in association with poorly differentiated lymphocytic lymphoma; and and 2) uptake of 99mTc-pyrophosphate in the liver in the absence of demonstrable abnormality at autopsy. The more usual sites of metastatic calcification also showed uptake of the radionuclide. We will discuss metastatic soft tissue calcification, ectopic parathyroid hormone production, hypercalcemia in malignancy and bone scan agent localization in soft tissues.
Gallium scan detection of various neoplasms is tabulated by anatomic and histologic categories. The experience with many neoplasms is sufficient to accurately predict the likelihood of detection with gallium. This tabulation helps to point out other areas where the cumulative experience is insufficient to accurately predict sensitivity rates.