Bone scan cold spot from separation of osseous fragments in pathologic fracture.
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
J D Slavin
Publications and source records attributed to J D Slavin.
Varied presentation of urinary extravasation detected on bone imaging.
Explore the source record for details and available documents.
Bone Neoplasms↗
Preleukemia following large dose radioiodide therapy for metastatic thyroid carcinoma.
A 67-yr-old woman had follicular thyroid carcinoma metastatic to several osseous sites. There was also evidence of functioning pulmonary metastases. She was treated by total thyroidectomy and multiple doses of radioiodide (131I). Approximately 2.5 yr after the initial ablative dose, and a total dose of 820 mCi of sodium iodide 131I, preleukemic changes were noted in the bone marrow. This appears to be the second case of preleukemia that bears a temporal relationship to radioiodide therapy of thyroid carcinoma, and the first in which radioiodide alone has been used in therapy (without additional external radiation).
Adenocarcinoma↗
"Matching" ventilation/perfusion images in fat embolization.
Forty-eight hours after fracture of the tibia and fibula, a 27-year-old man developed the triad of findings noted in the fat embolism syndrome (neurologic changes, respiratory distress, and petechiae). An initially normal chest-x-ray, which progressed to one of bilateral fluffy diffuse infiltrates, aided in making the diagnosis. Ventilation/perfusion lung images were performed at the time of the radiographic changes and showed "matching" defects. Transcapillary passage of lipid breakdown products was considered to be the cause. While all parts of the lung showed reduced ventilation/perfusion, the upper half of the lung fields was affected more prominently, as opposed to emboli of venous origin, which most frequently involve the lung bases.
Adult↗
Renocutaneous inflammatory tract shown during technetium-99m DTPA imaging.
During a Tc-99m DTPA study, activity simultaneously appeared in the kidneys and in a right lateral band. This was due to an inflammatory tract and not to urinary drainage.
Aged↗
Technetium-99m MDP demonstration of neoplastic lesions involving bone and adjacent soft tissue.
Four patients are presented with malignant tumors involving both bone and adjacent soft tissue. In each of these neoplasms (two representing adenocarcinoma of the prostate, and one each of squamous cell carcinoma of lung and chondrosarcoma), the lesions were detected by accumulation of Tc-99m MDP. Involvement of both bone and soft tissue was confirmed by CT examination or surgery. It is probable that the lesions originated in bone and then extended to soft tissue.
Adolescent↗
Multifocal osteogenic sarcoma in the seventh decade.
A 64-year-old man with right knee pain had uptake of Tc-99m MDP in the area as well as in the greater trochanter. Both sites were shown to contain osteogenic sarcoma. There was resection of the bone. Eight months later, radiogallium uptake was avid in the nearby soft tissue, indicating tumor spread.
Femoral Neoplasms↗
Bone imaging in the diagnosis of fractures of the femur and pelvis in the sixth to tenth decades.
A review was made of the records of 24 consecutive trauma patients (aged 55-94 years) who had under gone radiographic examinations and a positive bone image of the femur or pelvis. There was considerable discordance between the radiographs and the bone images. Initially, 25% of the radiographs were interpreted as positive. Even after additional radiographs and retrospective. review, only 38% of the x-ray studies were positive. Bone imaging was a useful adjunct in these patients, both to confirm or exclude suspected fractures and to detect occult fractures. The necessity of delaying bone imaging for several days after the trauma was discussed.
Aged↗
Bilateral "simultaneous" femoral neck fractures following minimal stress.
Following jogging, a 53-year-old man experienced bilateral hip discomfort. Two weeks later, after stepping backward suddenly, he had severe pain in the right hip. Radiographs showed a displaced fracture of the right femoral head; this was pinned. Bone imaging revealed intense uptake in the other femoral head as well. This also was believed to be fractured, and therefore was repaired. During the two operations, no pathological cause of the bilateral femoral neck fractures was noted. The literature on simultaneous bilateral femoral neck fractures, without underlying bone disease, was reviewed.
Athletic Injuries↗
Splenectomy for splenic metastasis from carcinoma of colon.
An 81-year-old woman with carcinoma of the colon had a normal liver-spleen radiocolloid image at the time of surgery. Two years later, a defect was noted in the spleen on a follow-up radiocolloid study. A repeat examination showed that the mass was increasing in size. An abdominal CT examination also revealed an intrasplenic mass with spring of the liver. After splenectomy for a metastatic carcinoma of the colon, the patient has survived for over a year without symptoms referable to tumor spread. Mention is made of the apparent splenic "immunity" from metastases.
Adenocarcinoma↗
False-positive spleen imaging. Splenic cleft and accessory spleen.
Following trauma, a 35-year-old man had a falling hematocrit. Radiocolloid imaging showed a superior pole splenic defect with a bilobed appearance (suggesting nearly complete trans-section). There was a small quantity of function below the main portion of the spleen. At surgery, the spleen was noted to have marked lobulation (perhaps congenital) to account for the upper pole defect and trans-splenic appearance of a tear. A small accessory spleen was present below the main organ, mimicking the appearance of organ disruption. Cases of false-positive radiocolloid images, suggesting trauma, are rare but do occur.
Adult↗
Graves' disease. Initial presentation with exophthalmos and solitary hot nodule.
A 52-year-old man presented with left exophthalmos. A thyroid scan showed a right lobe hot nodule with suppression of the remainder of the gland. Thyroid function tests were normal. In less than two years, the patient had worsening of the exophthalmos. Thyroid indices then revealed hyperthyroidism and the thyroid image had markedly altered (with evidence of diffuse function). This change, initially showing a hot nodule and then diffuse thyroid overactivity, has been reported previously in three cases (all women). Characteristics of the disorder in these four individuals were reviewed. It is possible that the patients had two distinct diseases, separated temporally.
Graves Disease↗
Liver function tests. A study in patients with imaging-demonstrated metastases.
Thirty-eight consecutive patients with liver scan evidence of hepatic metastases (and confirmation by other modalities) had blood levels of lactate dehydrogenase and alkaline phosphatase performed within two weeks. In 38% of the patients with small liver metastases, both alkaline phosphatase and lactate dehydrogenase were in the normal range. Even with large metastases present (one or more lesions over 2.5 cm in diameter), 19% of the patients had both enzyme tests within the normal range. Despite the lower cost of these enzyme assays, they failed to detect hepatic metastases in an appreciable portion of our patients.
Alkaline Phosphatase↗
Hepatic angiosarcoma: mimicking of angioma on three-phase technetium-99m red blood cell scintigraphy.
A [99mTc]RBC study in a 63-yr-old man showed intrahepatic lesions which initially had less activity than surrounding liver tissue. When viewed 3 hr later, these had "reversed" and the lesions revealed increased uptake of the radiolabeled red cells. Some extrahepatic areas showed the same pattern (these were in the mesentery of the small bowel). The lesions proved to be angiosarcomas. Hence, the behavior of labeled red cells in these angiosarcomas mimicked that in benign hemangiomas.
Diagnosis, Differential↗
High incidence of gastric reflux during hepatobiliary imaging in pancreatitis.
A review of 100 consecutive hepatobiliary studies revealed eight cases in which there was prominent gastric reflux of the Tc-99m diisopropyl-IDA beginning 0.5 to 2.0 hours into the procedure. Five of these individuals had pancreatitis (four acute, one chronic). Hence, pancreatitis was involved in five out of eight of the studies with marked gastric reflux. A study of discharge records showed that a total of ten of the patients in this series had pancreatitis. Since only five showed prominent gastric reflux, the incidence was 50%. Other disorders accounted for the three remaining gastric reflux cases observed in 90 patients.
Adult↗
Radioisotope bone scanning in a case of sarcoidosis.
The application of radioisotope scanning to osseous involvement from systemic sarcoidosis has been infrequently described in the scientific literature. Most commonly, the small bones of the hands and feet are affected if sarcoidosis involves the skeleton. Nonetheless, there are also occasional manifestations of sarcoid in the skull, long bones, and vertebral bodies. This paper describes a case of sarcoid involving the lung parenchyma with multiple lesions in the skull and ribs demonstrated by bone scanning with Tc-99m MDP. Following treatment with steroids, the bone scan showed complete resolution of the rib lesions and almost complete resolution of the lesions in the calvarium.
Bone Diseases↗
Dual "hot spot" during combined hepatic imaging.
Explore the source record for details and available documents.
Gallbladder↗
Pulmonary ventilation/perfusion and reverse mismatches in an infant.
A male infant, with bronchopulmonary dysplasia and ventilator dependence, had lung ventilation (Xe-133 gas) and perfusion (Tc-99m MAA) imaging performed. The examination revealed a region that was ventilated but not perfused (mismatch) and a separate area that was perfused but not ventilated (reverse mismatch). The basis of both abnormalities is suspected to be related to bronchopulmonary dysplasia, atelectasis and/or mechanical ventilation. Ventilation/perfusion mismatches and reverse mismatches can occur in the same patient.
Bronchopulmonary Dysplasia↗