Pathologic fractures in a patient with renal osteodystrophy. Failure of early detection on bone scans.

Abstract:

:A case of false-negative Tc-99m MDP bone scintigrams, taken at one and two weeks for pathologic fractures in a patient with metabolic bone disease and a super-scan appearance, is described. The patient had renal osteodystrophy, and postparathyroidectomy hypocalcemia. Postoperative seizures caused multiple pathologic fractures. Initial scans were negative for focal tracer localization in the presence of a continued super-scan appearance. After months of calcium and vitamin D replacement therapy, fracture sites became positive on Tc-99m MDP imaging. The observations in this case lend credence to the hypothesis of Tc-99m MDP binding by immature collagen in the production of a super scan in metabolic bone disease, as well as that of Tc-99m MDP chemisorption to calcium hydroxyapatite crystal in fracture healing. In addition, aluminum toxicity, common in chronic renal osteodystrophy, may have played a role in the delayed fracture healing.

journal_name

Clin Nucl Med

authors

Campeau RJ,Bellah RD,Varma DG

doi

10.1097/00003072-198707000-00004

subject

Has Abstract

pub_date

1987-07-01 00:00:00

pages

510-3

issue

7

eissn

0363-9762

issn

1536-0229

journal_volume

12

pub_type

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