- MeSH
- Androgens MeSH
- Estrogen Replacement Therapy MeSH
- Estrogens * pharmacology physiology therapeutic use MeSH
- Breast Feeding MeSH
- Pregnancy Complications MeSH
- Bone and Bones * physiology physiopathology MeSH
- Bone Density physiology MeSH
- Humans MeSH
- Menopause MeSH
- Vitamin D Deficiency MeSH
- Bone Diseases etiology classification physiopathology pathology MeSH
- Osteoporosis etiology classification pathology MeSH
- Osteoporosis, Postmenopausal drug therapy prevention & control MeSH
- Calcium therapeutic use MeSH
- Age Factors MeSH
- Vitamin D MeSH
- Malpractice MeSH
- Check Tag
- Humans MeSH
- Female MeSH
Cíl: Prezentovat obraz SPECT/CT náhodného nálezu kostního infarktu, který může imitovat kostní sarkom. Kazuistika: 84letá pacientka byla odeslána na naše pracoviště praktickým lékařem na scintigrafii skeletu pro frakturu L3. Vyšetření bylo provedeno standardně po aplikaci 700 MBq 99mTc-HDP na dvou detektorové gama kameře BrightView XCT s flat panelem (Phillips). Na celotělové scintigrafii byly patrné pouze mírné degenerativní změny páteře bez průkazu přestavbových změn v místě uváděné fraktury. Neočekávaná však byla detekce nepravidelně zvýšené akumulace radiofarmaka v proximální části pravé tibie. Proto bylo doplněno SPECT/CT zobrazení této oblasti. Na SPECT/low dose CT se intramedulárně zobrazují četná nepravidelná až serpiginozní cystická projasnění s jemným pravidelným sklerotickým lemem, bez patrné periostální reakce. Po konzultaci s radiology jsme nález uzavřeli jako stav po kostním infarktu. Závěr: V naší kazuistice prezentujeme obraz kostního infarktu, který může svým vzhledem na SPECT/low dose CT obrazu imitovat osteosarkom. Obraz kostního infarktu na scintigrafii se mění podle jeho průběhu od defektu akumulace až po zvýšenou akumulaci, kostní infarkt však může být i místem růstu osteosarkomu. Také je třeba ho odlišit od osteomyelitidy, zejména u pacientů se srpkovitou anémií.
Goal: To present a SPECT/CT pattern of an incidentally detected bone infarction possibly mimicking osteosarcoma. Case report: 84-y-old lady with a fracture of L3 was referred to our department for a bone scan. Images were acquired after injection of 800 MBq of 99mTc-HDP using a SPECT/CT gamma camera BrightView XCT with a flat panel (Phillips). We detected only mild degenerative changes of the spine without any increased bone metabolic turnover in the location of referred fracture. Unexpected patchy increased accumulation of the radiopharmaceutical was, however, clearly visible at the proximal part of the right tibia. SPECT/CT of this area was thus performed, which revealed intramedullary irregular well-defined shell-like sclerosis with relative central photopenia and well defined calcified margins without any periosteal reaction. We concluded this is and old bone infarction after consultation with radiologists. Conclusion: We present a pattern of bone infarction which can mimic osteosarcoma. Bone scan appearance of bone infarction changes according to its development from accumulation defect to increased accumulation. Nevertheless, there is a risk of osteosarcoma development at the location of bone infarction. It is also necessary to distinguish it from osteomyelitis especially in patients with a sickle cell disease.
- Keywords
- kostní infarkt,
- MeSH
- Diagnosis, Differential MeSH
- Infarction * diagnostic imaging diagnosis MeSH
- Humans MeSH
- Bone Diseases * diagnostic imaging classification MeSH
- Radionuclide Imaging methods instrumentation MeSH
- Sarcoma MeSH
- Aged, 80 and over MeSH
- Single Photon Emission Computed Tomography Computed Tomography MeSH
- Tibia diagnostic imaging pathology MeSH
- Check Tag
- Humans MeSH
- Aged, 80 and over MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Infections classification complications MeSH
- Infection Control methods MeSH
- Humans MeSH
- Aftercare * methods MeSH
- Endocrine System Diseases etiology classification prevention & control MeSH
- Bone Diseases etiology classification prevention & control MeSH
- Lung Diseases etiology prevention & control MeSH
- Hematopoietic Stem Cell Transplantation * adverse effects MeSH
- Urologic Diseases etiology prevention & control MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- Keywords
- benigní kostní léze, ortopedická onkologie, patologické zlomeniny,
- MeSH
- Bone Cysts, Aneurysmal diagnosis etiology classification therapy MeSH
- Biopsy utilization MeSH
- Diagnostic Imaging methods utilization MeSH
- Diagnosis, Differential MeSH
- Child * MeSH
- Adult MeSH
- Fibrous Dysplasia of Bone diagnosis etiology physiopathology radiography therapy MeSH
- Femoral Fractures etiology prevention & control therapy MeSH
- Fractures, Bone * etiology physiopathology therapy MeSH
- Bone Cysts classification complications physiopathology therapy MeSH
- Humans MeSH
- Adolescent * MeSH
- Bone Neoplasms diagnosis etiology classification MeSH
- Neoplasms, Bone Tissue diagnosis etiology classification therapy MeSH
- Bone Diseases diagnosis etiology classification MeSH
- Check Tag
- Child * MeSH
- Adult MeSH
- Humans MeSH
- Adolescent * MeSH
- MeSH
- Gastrointestinal Neoplasms MeSH
- Gastrointestinal Diseases classification MeSH
- Skin Diseases classification MeSH
- Humans MeSH
- Male Urogenital Diseases classification MeSH
- Central Nervous System Neoplasms MeSH
- Endocrine Gland Neoplasms MeSH
- Bone Neoplasms MeSH
- Skin Neoplasms MeSH
- Mediastinal Neoplasms MeSH
- Soft Tissue Neoplasms classification MeSH
- Pleural Neoplasms MeSH
- Central Nervous System Diseases classification MeSH
- Endocrine System Diseases classification MeSH
- Bone Diseases classification MeSH
- Mediastinal Diseases classification MeSH
- Pleural Diseases classification MeSH
- Otorhinolaryngologic Neoplasms MeSH
- Otorhinolaryngologic Diseases classification MeSH
- Urogenital Neoplasms MeSH
- Female Urogenital Diseases classification MeSH
- Check Tag
- Humans MeSH
- MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Drug Therapy methods utilization MeSH
- Humans MeSH
- Neoplasm Metastasis diagnosis drug therapy therapy MeSH
- Bone Neoplasms diagnosis etiology therapy MeSH
- Prostatic Neoplasms complications complications therapy MeSH
- Bone Diseases diagnosis etiology classification MeSH
- Nursing Diagnosis MeSH
- Nursing Care methods utilization MeSH
- Prognosis MeSH
- Risk Factors MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- MeSH
- BCG Vaccine classification adverse effects MeSH
- Child MeSH
- Drug Therapy MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Bone Diseases etiology classification radiography MeSH
- Infant, Newborn immunology MeSH
- Vaccination statistics & numerical data adverse effects MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Infant, Newborn immunology MeSH
- Female MeSH
- Geographicals
- Czech Republic MeSH
