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An audit of paediatric technetium-99m methylene diphosphonate bone scans.

Eighty-nine Technetium-99m-MDP scans performed between January 1987 and June 1990 at the Leicester Royal Infirmary were reviewed with regard to the indication, patient outcome and value of the scans in the patients' management. The significant finding was the value of a normal scan in the management of children with chronic pain.

Acute Disease↗

Extensive soft tissue uptake of 99Tcm methylene diphosphonate in a patient with multiple myeloma.

Bone scintigraphy is not usually performed in multiple myeloma (MM), as marrow deposits characteristically show no tracer uptake. However, metastatic bone disease often mimics MM both clinically and biochemically, resulting in a substantial number of MM patients undergoing bone scintigraphy. Variable appearances in these cases have been reported, ranging from normal to a superscan, the latter a result of massive tracer uptake within bone. Soft tissue uptake has been documented, often when MM is complicated by secondary amyloidosis. This usually results in mainly solid organ uptake of tracer. We report a case of MM where massive soft tissue uptake occurred, primarily within muscles, with very little isotope elsewhere.

Aged↗

The calcium antagonist diltiazem inhibits calcification enhanced by calcitonin in growth cartilage of rats in ethane-1-hydroxy-1,1-diphosphonate (EHDP)-induced rickets.

In an animal model of human rickets developed by giving a short-term administration of large doses of EHDP to young rats, concomitant administration of [Asu1,7]eel calcitonin (CT) with EHDP resulted in the promotion of calcification in growth cartilage. In an attempt to clarify the mechanisms related to the accelerated calcification due to CT, the effects of diltiazem, a calcium antagonist, were studied. Diltiazem suppressed, in a dose-dependent manner, the accelerated calcification due to CT in the growth cartilage, as determined by findings on the soft X-ray photos, contact microradiograph and light microscopic histology of the proximal region of the tibia. This suppression was only evident when diltiazem and CT were given concomitantly. If it is assumed that diltiazem inhibits the entry of calcium ion into the cells of growth cartilage, in the same manner as seen in case of smooth muscle and myocardial cells, then our results indicate that intracellular concentrations of calcium might play an important role in the occurrence of accelerated calcification due to CT.

Animals↗

Extensively calcified hemangioma of the diaphragm with increased 99mTc-hydroxymethylene diphosphonate uptake.

A 31-year-old woman visited an out-patient clinic, because of low-grade fever and general fatigue. She was referred to our hospital and admitted for examination of an abnormal shadow which had been found on the chest radiograph. She had experienced faint right lateral chest pain several times on the deep inspirations. Chest radiography showed a mass shadow with calcification in the right lower lung field on the mediastinal side. Chest radiographic computed tomography showed a 6x6 cm tumor in the right lung field. There were low-density areas with septae inside the tumor. Bone scintigraphy showed extremely high uptake of (99m)Tc-HMDP in the tumor. After surgical resection and pathological examination, we concluded that the tumor was an extensively calcified benign hemangioma of the diaphragm.

Adult↗