EURORAD ESR

Case 15857

Multiple sites of heterotrophic ossification in an infant mimicking multifocal osteomyelitis - Importance of SPECT/CT in pediatric imaging

Author(s)
Evbuomwan Osayande, Jaleelat Momodu, Khushica Purbhoo, Mboyo Di Tamba Vangu

Department of Nuclear Medicine and Molecular Imaging, UNIVERSITY OF WITWATERSRAND; 17 Jubilee Road 2193 Johannesburg, South Africa; Email:moreli14@yahoo.com
 
Patient
male, 2 month(s)
 
 
  • Figure 1
    2-phase bone scan
     

    Anterior planar static blood pool image of a 2-phase bone scan showing multiple sites of increased vascularity.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: Nuclear medicine conventional; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    Posterior planar static blood pool image of a 2-phase bone scan showing multiple sites of increased vascularity.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Nuclear medicine conventional; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    Anterior planar static delayed image of a 2-phase bone scan showing multiple sites of increased osteoblastic activity.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: Nuclear medicine conventional; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    posterior planar static delayed image of a 2-phase bone scan showing multiple sites of increased osteoblastic activity.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: Nuclear medicine conventional; Procedure: Localisation; Special Focus: Calcifications / Calculi;
     
     
  • Figure 2
    SPECT/CT
     

    CT only image showing soft tissue calcification in the left wrist adjacent to the radius

     
    Area of Interest: Musculoskeletal system; Imaging Technique: CT; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    SPECT/CT image localizing the intense foci to soft tissue adjacent to the left radius

     
    Area of Interest: Musculoskeletal system; Imaging Technique: SPECT-CT; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    CT only image showing soft tissue calcification in the left elbow

     
    Area of Interest: Musculoskeletal system; Imaging Technique: CT; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    SPECT/CT image localizing the intense foci to soft tissue adjacent to the left elbow

     
    Area of Interest: Musculoskeletal system; Imaging Technique: SPECT-CT; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    CT only image showing soft tissue calcification in the right arm adjacent to the right humerus

     
    Area of Interest: Musculoskeletal system; Imaging Technique: CT; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    SPECT/CT image localizing the intense foci to soft tissue adjacent to the right humerus

     
    Area of Interest: Musculoskeletal system; Imaging Technique: SPECT-CT; Procedure: Localisation; Special Focus: Calcifications / Calculi;
     
     
  • Figure 3
    SPECT/CT
     

    CT only image of the skull showing soft tissue calcification adjacent to the frontal bone.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: CT; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    SPECT/CT image localizing the intense foci to soft tissue adjacent to the frontal bone.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: SPECT-CT; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    CT only image of the skull showing soft tissue calcification adjacent to the right pareital bone.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: CT; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    SPECT/CT image localizing the intense foci to soft tissue adjacent to the right parietal bone.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: SPECT-CT; Procedure: Localisation; Special Focus: Calcifications / Calculi;
     
     
  • Figure 4
    X ray
     

    X-ray of the right arm showing soft tissue calcification adjacent to bones.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: Plain radiographic studies; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    X-ray of the left elbow showing soft tissue calcification adjacent to bones.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: Plain radiographic studies; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    X-ray of the skull showing soft tissue calcification adjacent to the right parietal bone.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: Plain radiographic studies; Procedure: Localisation; Special Focus: Calcifications / Calculi;

    X-ray of the skull showing soft tissue calcification adjacent to the frontal bone.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: Plain radiographic studies; Procedure: Localisation; Special Focus: Calcifications / Calculi;
     
     
  • Figure 5
    Photos
     

    Picture of the left elbow taken on the day of the bone scan post incision and drainage

     
    Area of Interest: Soft tissues / Skin; Imaging Technique: Digital radiography; Procedure: Drainage; Special Focus: Infection;

    Picture of the right arm taken on the day of the bone scan post intravenous drip insertion

     
    Area of Interest: Soft tissues / Skin; Imaging Technique: Digital radiography; Procedure: Puncture; Special Focus: Calcifications / Calculi;
     
     
Anterior planar static blood pool image of a 2-phase bone scan showing multiple sites of increased vascularity.
 
Posterior planar static blood pool image of a 2-phase bone scan showing multiple sites of increased vascularity.
 
Anterior planar static delayed image of a 2-phase bone scan showing multiple sites of increased osteoblastic activity.
 
posterior planar static delayed image of a 2-phase bone scan showing multiple sites of increased osteoblastic activity.
 
CT only image showing soft tissue calcification in the left wrist adjacent to the radius
 
SPECT/CT image localizing the intense foci to soft tissue adjacent to the left radius
 
CT only image showing soft tissue calcification in the left elbow
 
SPECT/CT image localizing the intense foci to soft tissue adjacent to the left elbow
 
CT only image showing soft tissue calcification in the right arm adjacent to the right humerus
 
SPECT/CT image localizing the intense foci to soft tissue adjacent to the right humerus
 
CT only image of the skull showing soft tissue calcification adjacent to the frontal bone.
 
SPECT/CT image localizing the intense foci to soft tissue adjacent to the frontal bone.
 
CT only image of the skull showing soft tissue calcification adjacent to the right pareital bone.
 
SPECT/CT image localizing the intense foci to soft tissue adjacent to the right parietal bone.
 
X-ray of the right arm showing soft tissue calcification adjacent to bones.
 
X-ray of the left elbow showing soft tissue calcification adjacent to bones.
 
X-ray of the skull showing soft tissue calcification adjacent to the right parietal bone.
 
X-ray of the skull showing soft tissue calcification adjacent to the frontal bone.
 
Picture of the left elbow taken on the day of the bone scan post incision and drainage
 
Picture of the right arm taken on the day of the bone scan post intravenous drip insertion
 
 
 
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