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

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

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
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.

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.

Details

Subjects Health Care Sciences and Services
Journal Section Case Reports
Authors

Fadime Demir>


Taner Erselcan This is me


Bülent Turgut>


Zekiye Hasbek>


Ayşegül Özdal This is me


Perihan Kelkit This is me


Pelin Duman This is me


Sibel Berksoy Hayta>

Publication Date September 19, 2017
Published in Issue Year 2017, Volume 39Issue 3

Cite

APA Demir, F. , Erselcan, T. , Turgut, B. , Hasbek, Z. , Özdal, A. , Kelkit, P. , Duman, P. & Berksoy Hayta, S. (2017). Tc-99m MDP uptake in soft tissue calcification in systemic scleroderma (Crest syndrome) . Cumhuriyet Medical Journal , 39 (3) , 620-623 . DOI: 10.7197/223.v39i31705.347462