Incidental findings in traditional nuclear medicine practice
Published on: 28th July, 2018
OCLC Number/Unique Identifier: 7802611730
The presence of an incidental finding, defined as an abnormality which is unrelated to the initial scanning indication, is widely increases due to the access to new devices and imaging modalities. This growing number of incidental findings can lead to additional medical care including unnecessary tests nevertheless, in a minority of patients, can lead to diagnosis of an important and unexpected condition that could be crucial for the patient. We reported three cases in which nuclear medicine imaging, performed for different reasons and showed a relevant and unexpected pathology. In the case 1, a bone scan, performed in a 66 aged woman for breast cancer staging, allowed the diagnosis of a uterine fibroma. In the case 2, a HMPAO labeled-WBC scintigraphy performed because of a suspect of osteomyelitis, showed a remarkable heart-shaped photopenic area, highly suggestive of cardiac global dilatation. In the case 3, a 62 aged man referred to bone scintigraphy for the staging of recent diagnosed lung cancer. The bone scan allowed the diagnosis of a meningioma. Therefore, the occurrence of incidental findings could lead to reveal relevant abnormalities for the diagnostic pathway.
Bilateral Parasymphyseal Osteoma
Published on: 20th January, 2017
OCLC Number/Unique Identifier: 7317598560
Osteoma is a benign osteogenic tumor arising from the proliferation of cancellous or compact bone. In the facial bones, both central and peripheral osteomas have been described in the literature. Peripheral type of osteoma is the most common variant in the mandible, which occurs on the cortical bone surface. We present a case of a fourteen year old boy who had swelling on right and left parasymphyseal region. Radiographs revealed radiopacity having onion-peel appearance and histopathology gave the final diagnosis of osteoma. Periosteal reaction giving rise to onion peel appearance on the radiograph has been reported in Ewing sarcoma, Garre’s osteomyelitis and infantile cortical hyperostosis in the literature but our case shows that similar appearance can be there in osteoma as well.
Masquelet Technique for Reconstruction of a Fourth Metatarsal Defect Following a Low-velocity Gunshot Wound: A Case Report
Published on: 2nd November, 2023
The Masquelet technique has become increasingly popular in reconstruction scenarios such as osteomyelitis, cancer, and nonunions. The procedure is a two-staged approach: first, a polymethylmethacrylate (PMMA) cement spacer is inserted to fill a bone void. The spacer induces a membrane to form around it, and 6-9 weeks later, the second stage involves carefully extracting the spacer and filling the membrane with bone graft. Most of the current literature has published either femoral or tibial involvement for Masquelet studies, with limited published data on foot reconstruction. Here, the authors used the procedure for the fourth metatarsal. Despite complications, this case proves a more excellent utility and warrants further investigation into Masquelet techniques in the foot.
Persistent Lumbar Pain and Fever: Osteomyelitis as Diagnosis Challenge
Published on: 28th March, 2024
Objective: This study aimed to evaluate the clinical characteristics and diagnostic challenges associated with osteomyelitis in patients presenting with persistent lumbar pain and fever.Methods: We conducted a descriptive observational study, reviewing four cases of osteomyelitis diagnosed at our hospital’s Emergency Department in 2022. Data on patient demographics, medical history, clinical presentation, diagnostic methods, and treatment outcomes were analyzed.Findings: The cases included middle-aged to elderly men, with predisposing factors such as urological interventions and immunodeficiency. Imaging studies, particularly CT-scan and MRI, were instrumental in diagnosing lumbar spondylodiscitis. Biopsies revealed lymphoplasmacytic infiltrates and treatment responses were positive in all cases after eight months of follow-up. The study highlights the importance of considering osteomyelitis in the differential diagnosis of lumbar pain and fever, necessitating multidisciplinary collaboration for timely management.
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