Tc-99m MDP uptake in soft tissue calcification in systemic scleroderma (Crest syndrome)

Fadime Demir; Taner Erselcan; Bülent Turgut; Zekiye Hasbek; Ayşegül Özdal; Perihan Kelkit; Pelin Duman; Sibel Berksoy Hayta

doi:10.7197/223.v39i31705.347462

Case Report

Tc-99m MDP uptake in soft tissue calcification in systemic scleroderma (Crest syndrome)

Year 2017, Volume: 39 Issue: 3, 620 - 623, 19.09.2017

Fadime Demir , Taner Erselcan Bülent Turgut , Zekiye Hasbek , Ayşegül Özdal Perihan Kelkit Pelin Duman Sibel Berksoy Hayta

https://doi.org/10.7197/223.v39i31705.347462

Abstract

23-year-old female patient was referred for evaluation
of a 2-mounts history of discharge from the wound at the right gluteal region
with three-phase Tc-99m MDP bone
scintigraphy. The patient was diagnosed with scleroderma (SSc) five years
ago. A three-phase bone scan performed
after intravenous injection of 20 mCi Tc-99m-MDP, in early blood pool of blood supply period,
matching the right gluteal region showed findings consistent with perfusion and
hyperemia İn 3. Hr after late images three-phase bone scan increased
radiopharmaceutical uptake was observed in both the knee region extending from
the region proximal to the pelvic soft tissue. When assessed, calcification at
soft-tissue in bilateral knees was seen in the patient’ s direct radiography of
the both knees. Our goal in presenting this case is to demonstrate the
contribution of bone scintigraphy to the detection of calcinosis in patients
with scleroderma and to determine the prevalence of it in the body.

Keywords

Systemic scleroderma , Tc-99m MDP , soft tissue calcification

References

1. Avouac J, Guerini H, Wipff J, Assous N, Chevrot A, Kahan A et al. Radiological hand involvement in systemic sclerosis, Ann Rheum Dis 2006;65(8):1088–1092. doi: 10.1136/ard.2005.044602.
2. Tangri* N and Young BM. Soft-tissue infection and underlying calcinosis of CREST syndrome. CMAJ. 2006 October 24; 175(9): 1059,1061.
3. Hsu V, Bramwit M and Schlesinger N. Use of dual-energy computed tomography for the evaluation of calcinosis in patients with systemic sclerosis. Clin Rheumatol (2015) 34:1557–1561.
4. Ömür Ö, Kapulu C, Uğur Ö. Kas İskelet Sistemi Hastalıklarında Nükleer Tıp Yöntemleri. Türk Ortopedi ve Travmatoloji Birliği Derneği Dergisi 2007; 6 :1-2 .
5. Hwang GJ, Lee JD,Park CY and Lim SK. Reversible Extras- keletal Uptake of Bone Scanning in Primary Hyperparathyroidism. J Nucl Med 1996;37(3):469-471.
6. Peller PJ,Ho VB, Kransdorf MJ. Extraosseous Tc-99m MDP Uptake. A Pathophysiologic Approach1. RadioGraphics 1993; 13(4):715-734.
7. Jinnin M, Ihn H, Asano Y,Yamane K, Yazawa N, Tamaki K. A case of linea scleroderma with muscle calcification. British Journal of Dermatology 2002; 146(6): 1084–1086.
8. Schlenker JD, Clark DD and Weckesser EC. Calcinosis Circum- scripta of the Hand in Scleroderma. J Bone Joint Surg Am. 1973;55(5):1051-1056.

Sistemik sklerodermada yumuşak doku kalsifikasyo- nunda Tc-99m MDP tutulumu

Year 2017, Volume: 39 Issue: 3, 620 - 623, 19.09.2017

Fadime Demir , Taner Erselcan Bülent Turgut , Zekiye Hasbek , Ayşegül Özdal Perihan Kelkit Pelin Duman Sibel Berksoy Hayta

https://doi.org/10.7197/223.v39i31705.347462

Abstract

23 yaşındaki bayan hasta, sağ gluteal bölgede ve uyluk
lateralinde yer alan akıntılı yara şikayetleri üzerine, osteomyelit ön tanısı ile tüm vücut kemik
sintigrafisi içinkliniğimize gönderildi. Hasta beş yıl önce Skleroderma tanısı
almıştı. 20 mCi Tc-99m-MDP nin iv. Enjeksiyonu sonrası yapılan
üç fazlı kemik sintigrafisinde; sağ gluteal bölgede perfüzyon artışı ve
hiperemi ile uyumlu bulgular izlendi. Tc-99m MDP Üç fazlı kemik
sintigrafisi 3. Saat geç görüntülerinde her iki diz bölgesi proksimalinde olmak
üzere pelvik bölgeye uzanan yumuşak dokuya uyan alanda artmış radyofarmasötik
tutulumu izlenmiştir. Hastanın direk radyografi görüntülerinde aynı alanlarda
yumuşak doku kalsifikasyonu ile uyumlu görünüm izlendi. Hastanın direk
radyografi görüntüleri incelendiğinde her iki diz bölgesinde yumuşak doku
kalsifikasyonu ile uyumlu görünüm izlendi. Bu vakayı
sunmaktaki amacımız, kemik sintigrafisinin sklerodermalı hastalardaki
kalsinozisi göstermede ve vücuttaki yaygınlığının saptanmasındaki katkısını
göstermektir.

Keywords

sistemik skleroderma , Tc-99m MDP , yumuşak doku kalsifikasyonu

References

1. Avouac J, Guerini H, Wipff J, Assous N, Chevrot A, Kahan A et al. Radiological hand involvement in systemic sclerosis, Ann Rheum Dis 2006;65(8):1088–1092. doi: 10.1136/ard.2005.044602.
2. Tangri* N and Young BM. Soft-tissue infection and underlying calcinosis of CREST syndrome. CMAJ. 2006 October 24; 175(9): 1059,1061.
3. Hsu V, Bramwit M and Schlesinger N. Use of dual-energy computed tomography for the evaluation of calcinosis in patients with systemic sclerosis. Clin Rheumatol (2015) 34:1557–1561.
4. Ömür Ö, Kapulu C, Uğur Ö. Kas İskelet Sistemi Hastalıklarında Nükleer Tıp Yöntemleri. Türk Ortopedi ve Travmatoloji Birliği Derneği Dergisi 2007; 6 :1-2 .
5. Hwang GJ, Lee JD,Park CY and Lim SK. Reversible Extras- keletal Uptake of Bone Scanning in Primary Hyperparathyroidism. J Nucl Med 1996;37(3):469-471.
6. Peller PJ,Ho VB, Kransdorf MJ. Extraosseous Tc-99m MDP Uptake. A Pathophysiologic Approach1. RadioGraphics 1993; 13(4):715-734.
7. Jinnin M, Ihn H, Asano Y,Yamane K, Yazawa N, Tamaki K. A case of linea scleroderma with muscle calcification. British Journal of Dermatology 2002; 146(6): 1084–1086.
8. Schlenker JD, Clark DD and Weckesser EC. Calcinosis Circum- scripta of the Hand in Scleroderma. J Bone Joint Surg Am. 1973;55(5):1051-1056.

There are 8 citations in total.

Details

Subjects	Health Care Administration
Journal Section	Case Reports
Authors	Fadime Demir Taner Erselcan Bülent Turgut Zekiye Hasbek Ayşegül Özdal Perihan Kelkit Pelin Duman Sibel Berksoy Hayta
Publication Date	September 19, 2017
Acceptance Date	July 5, 2017
Published in Issue	Year 2017 Volume: 39 Issue: 3

Cite

AMA	Demir F, Erselcan T, Turgut B, et al. Tc-99m MDP uptake in soft tissue calcification in systemic scleroderma (Crest syndrome). CMJ. September 2017;39(3):620-623. doi:10.7197/223.v39i31705.347462