Une ostéomalacie liée à un diabète phosphoré – rôle de la scintigraphie osseuse couplée à la TEMP-TDM |
| |
| Authors: | A Ruyer P Granier M Mourad |
| |
| Institution: | 1. Service de médecine nucléaire, hôpital Huguenin, Institut Curie, 35, rue Dailly, 92210 Saint-Cloud, France;2. Université Versailles Saint-Quentin, 2, avenue de la Source-de-la Bièvre, 78180 Montigny-le-Bretonneux, France;3. Service de médecine nucléaire, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France;4. Université Paris-Diderot, Inserm U944/CNRS UMR7212, 75000 Paris, France;1. Service d’oncologie médicale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie;2. Service d’endocrinologie, CHU Hédi-Chaker, 3029 Sfax, Tunisie;1. Service de néphrologie et exploration fonctionnelle rénale, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d’Arsonval, 69437 Lyon, France;2. Université Lyon 1, 43, boulevard du 11-Novembre-1918, 69100 Villeurbanne, France;3. Inserm U1060 OPeRa, Carmen, 59, boulevard Pinel, 69500 Bron, France;1. Service de médecine nucléaire, CHU Saint-Étienne, 42055 Saint-Étienne, France;2. Service de médecine vasculaire et thérapeutique, CHU Saint-Étienne 42055 Saint-Étienne, France;3. Service de radiologie, CHU Saint-Étienne, 42055 Saint-Étienne, France |
| |
| Abstract: | We report the case of a 59-year-old woman, investigated for disabling pain of the left thigh, unrelated to any traumatic event. Interrogation had found diffuse pain of myalgia-type and arthralgia-type for approximately a year without local inflammatory signs and insufficiency fractures of both calcaneus two years before. The Technetium 99m-labeled hydroxymethylene diphosphonate (99mTc-HDP) whole-body bone scintigraphy evidenced multiple hot spots on the higher third of left femur, rib cage, sternum, scapulae, pelvis, right hip and both calcaneus. Moreover, a more diffuse and heterogeneous prominent uptake appeared on rib cage, spine and pelvis. These images suggested a diffuse metastatic disease of the skeleton. The single photon emission computerized tomography guided by computerized tomography (SPECT/CT), centered on lumbar spine, pelvis and the upper end of femurs showed that the multiple hot spots were infact bone fractures. These findings pointed diagnosis to a metabolic disease. The clinical context was in favour of an osteomalacia. Further explorations showed an osteomalacia related to phosphate diabetes. A thorough work-up did not reveal any known aetiology. To date, idiopathic phosphate diabetes seems the most likely diagnosis. Nuclear medicine input in osteomalacia is discussed. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
