By Kevin J. Donohoe, Annick D. Van den Abbeele
In the educating ATLAS OF NUCLEAR medication, you will discover finished assurance of the whole box of nuclear drugs via a chain of sincerely awarded circumstances. Following the board examination structure, the circumstances are awarded as unknowns, with a picture and short medical description; you're then requested to reach at your personal differential analysis. entire with suggestions, pearls, pitfalls, and a short dialogue of every case, this can be the precise e-book for self-testing and maximizing your research time.
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Additional resources for Teaching atlas of nuclear medicine
15 TEACHING ATLAS OF NUCLEAR MEDICINE Case 6 Clinical Presentation 72-year-old man with a history of metastatic prostate cancer referred for pain in the left shoulder and lower neck. Fig. A Technique • 20 mCi technetium-99m–labeled methylene diphosphonate (MDP) intravenously. • Whole-body or spot images of the skeleton obtained 3 hours after tracer administration. • Emphasize the importance of oral hydration to improve soft tissue and bladder clearance. Image Interpretation Whole-body views (Fig.
There is also periosteal thickening, endosteal scalloping, and fluffy calcifications in the distal femur. Differential Diagnosis • Bone/bone marrow infarction • Osteomyelitis Diagnosis and Clinical Follow-up The diagnosis was bone infarction. Fine needle aspiration of the left femur was consistent with sickle cell disease. No organisms were seen on special stains. Discussion Patients with sickle cell anemia are susceptible to infarction in the bone and bone marrow. If the involvement is primarily in the bone marrow space, the bone scan may be normal in the acute phase but typically shows increased tracer uptake during the healing phase.
C 36 SKELETAL SCINTIGRAPHY PEARLS/PITFALLS • Bone scintigraphy of an infarcted area usually shows a clear sharp edge, unless superimposed by infection. • Indium-111–labeled white blood cells (WBC) or gallium-67 citrate are probably better modalities for differentiating between infection and infarction. • The differential diagnosis between bone infarction and osteomyelitis cannot be made on the bone scan alone, and dual imaging with technetium-99m– labeled MDP and indium-111– labeled WBC or technetium99m–labeled sulfur colloid and indium-111–labeled WBC may be helpful in this context.