Biomedical subjects
Publications and source records attributed to B K Adams.
Four cases are presented to show the value of bone scintigraphy as an aid in the diagnosis of benign bone tumours. Scintigraphy is not only capable of localising these tumours but is also a useful monitor of local recurrence after surgery. In addition, a whole-body bone scan done at the same time will exclude active multifocal disease.
99mTc-HSA millimicrospheres were used to detect a site of extra medullary hematopoiesis in the chest of a patient with severe osteopetrosis, anemia, thrombocytopenia and splenomegaly causing renal complications. These problems led to the consideration of splenectomy which necessitated a search for other extra medullary hematopoietic sites.
Skeletal, reticuloendothelial and renal images were obtained on a patient with osteopetrosis using Tc-99m MDP, Tc-99m HSA millimicrospheres and Tc-99m DTPA respectively. The bone scan showed increased uptake in multiple fracture sites, in the frontal bone, and in the splayed metaphyses of long bones while the remainder of the skeleton appeared normal. Reticuloendothelial images demonstrated an absence of bone marrow activity, hepatosplenomegaly and a site of extramedullary hematopoiesis. A renogram demonstrated a left kidney displaced and distorted by the massive splenomegaly.
A 19-year-old girl suffering from the nephropathic form of cystinosis presented with the full clinical and biochemical picture of Fanconi's syndrome. Polyuria, polydipsia and photophobia associated with severe growth retardation and rickets were the main clinical features. The essential biochemical abnormalities consisted of hypophosphataemia, hypokalaemia and hypo-uricaemia together with a systemic acidosis and a reduced creatinine clearance rate. There was generalized amino-aciduria, glycosuria and bicarbonaturia. In addition, the fractional excretion of potassium, phosphate and uric acid was significantly increased. Slit-lamp examination of the cornea and histological examination of the conjuctiva, liver, bone marrow and kidney demonstrated cystine crystals.
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