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Two patients with abnormal skeletal muscle uptake of Tc-99m hydroxymethylene diphosphonate following liver transplant: nephrogenic fibrosing dermopathy and graft vs host disease.

Tc-99m hydroxymethylene disphosphonate administered for skeletal scintigraphy may be seen in the extraosseous tissues for various etiologies. This report presents similar abnormal lower extremity skeletal muscle uptake in 2 patients status postorthotopic liver transplant. Although the history and scintigraphic appearance of the 2 were similar, subtle differences in cutaneous lesions and histology led to disparate diagnoses.

Fibrosis↗

99mTc-methylene diphosphonate single photon emission tomography of the knees: intensity of uptake and its correlation with arthroscopic findings.

OBJECTIVE: To examine whether single photon emission computed tomography (SPECT) can determine the severity of knee pathology, based on intensity of uptake and, therefore, possibly substituting this technique for more invasive and expensive diagnostic procedures, such as arthroscopy, in certain patient populations. METHODS: The study results of patients referred for knee SPECT followed by an arthroscopy at our institution were evaluated retrospectively. The scintigraphic and arthroscopic findings for the menisci and femoral condyles were each graded on a numeric scale. One numeric scale corresponded to the level of uptake in the SPECT and the other to the severity of the pathology visualized at arthroscopy. Statistical correlation between both scales, representing the SPECT and arthroscopy findings, was performed. RESULTS: Forty-one patients were included in the study. A positive and statistically significant correlation was found between the intensity of uptake on the SPECT and the severity of the arthroscopic findings in the menisci and medial femoral condyle. CONCLUSION: The degree of uptake in the knee, as determined by SPECT, positively correlates with the severity of pathology seen at arthroscopy. The data can potentially be used to assist in decision-making before proceeding to surgery, especially where there is severe pathology that may be less amenable to arthroscopic therapy.

Adolescent↗

Value of whole-body turbo short tau inversion recovery magnetic resonance imaging with panoramic table for detecting bone metastases: comparison with 99MTc-methylene diphosphonate scintigraphy.

OBJECTIVE: The objectives of this study were to assess the efficacy and reliability of whole-body turbo short tau inversion recovery (STIR) magnetic resonance imaging (MRI) for detecting skeletal metastasis and to compare the results with those of bone scintigraphy. METHODS: Twenty-six patients with primary cancer (mean age=56 years, age range: 34-75 years) were assessed for bone metastasis with whole-body MRI and bone scintigraphy. Eight bone regions in each patient were assessed (total of 208 sites) with each of these 2 techniques. A turbo STIR sequence and panoramic table were used during MRI. Whole-body MRI and scintigraphy findings were compared with biopsy or follow-up imaging results. RESULTS: After at least 12 months of follow-up, 9 patients had bone metastases in a total of 31 sites. Whole-body MRI showed 29 metastases (94%) in the total 208 skeletal sites investigated in the 26 patients. Bone scintigraphy revealed metastases in 16 (52%) of the 208 sites. CONCLUSION: Whole-body turbo STIR MRI is a reliable method for screening patients with suspected skeletal metastases. This technique is also advantageous in that it reveals extraskeletal organ and soft tissue metastases.

Adult↗

Multifactorial uptake of Tc-99m methylene diphosphonate in chronic renal failure.

Soft-tissue calcifications are a frequent complication in patients with chronic renal failure. Numerous underlying factors are thought to favor their formation. A case is presented of a patient who was in end-stage renal failure, secondary to glomerulonephritis. A renal transplant had not been successful. She was on long-term dialysis and had suffered aluminum toxicity (positive desferrioxamine test). She complained of proximal myopathy and bone pain.

Bone and Bones↗

Paradoxic technetium-99 methylene diphosphonate localization in malignant mesothelioma.

The literature is replete with cases of Tc-99m bone imaging agent uptake in pleural effusions. Far rarer is the report of photopenia in a pleural effusion. In this case of malignant mesothelioma, we describe a unique case of unilateral hemithoracic photopenia from a pleural effusion with concomitant uptake in the contralateral lung resulting from calcified pleural plaques. Although initially perplexing clinically, this case can be readily explained with an understanding of basic physiological principles.

Aged, 80 and over↗

Inhibition of calcification of bioprosthetic heart valves by local controlled-release diphosphonate.

Bioprostheses fabricated from porcine aortic valves are widely used to replace diseased heart valves. Calcification is the principal cause of the clinical failure of these devices. In the present study, inhibition of the calcification of bioprosthetic heart valve cusps implanted subcutaneously in rats was achieved through the adjacent implantation of controlled-release matrices containing the anticalcification agent ethanehydroxydiphosphonate dispersed in a copolymer of ethylene-vinyl acetate. Prevention of calcification was virtually complete, without the adverse effects of retarded bone and somatic growth that accompany systemic administration of ethanehydroxydiphosphonate.

Animals↗