Transcript Slide 1 - AccessMedicine

Imaging differential diagnosis and pitfalls. (A,B) In patients with known carcinoma, 90% of solitary rib lesions on bone scintigraphy are due to benign
causes. (A) Solitary rib lesion on Tc-99m MDP bone scintigraphy (white arrow) in a patient with renal cell carcinoma corresponds to a healing rib fracture
(white arrow), (B). (C,D) A solitary sternal lesion in a patient with breast carcinoma has an 80% probability of representing a metastasis. (C) Solitary
sternal lesion (white arrow) on Tc-99m MDP bone scintigraphy in a patient with breast carcinoma is concerning. (D) CT through the sternum in this patient
shows a destructive lesion with a soft tissue component (white arrow) in the sternum. (E-H) Solitary lesions in the spine can also present a challenge on
planar imaging; however, the location of the focus of uptake can be better evaluated using SPECT and SPECT/CT fusion. Lesions in the facet
Source: Musculoskeletal, Introduction to Diagnostic Radiology
(apophyseal) joints, lesions beyond the vertebral body surface, lesions involving only the body, and lesions involving the body and posterior elements with
Citation:
Elsayes
KM,likely
Oldham
SA. whereas
Introduction
to Diagnostic
Radiology;
Available
at: http://mhmedical.com/
Accessed:
April
11,a 2017
sparing of the
pedicles
are most
benign,
those
involving the
body and2015
pedicle
are likely
malignant. (E) Posterior
projection
from
Tc-99m
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Education.
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MDP bone scintigram shows a solitary lesion in the lower cervical spine in a patient with breast cancer. In about 20% of patients with breast cancer,
disease relapses with a solitary bone lesion, most commonly in the spine. (F) CT (top) and SPECT-CT fusion (bottom) localizes the lesion to the right facet
joint, with CT imaging features characteristic of osteoarthritis. (G) Posterior projection from a bone scintigram shows a solitary lesion in the mid-thoracic