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Relapsing polychondritis diagnosed by Tc-99m MDP bone scintigraphy
Y Imanishi1, Y Mitogawa, M Takizawa
1Department of Radiology, St. Marianna University Tohyoko Hospital, Kanagawa-ken, Japan.
Clinical Nuclear Medicine
|July 13, 1999
Summary
Relapsing polychondritis, a rare cartilage disease, was diagnosed in a patient presenting with cold symptoms and chest pain. Tc-99m MDP bone scintigraphy aided diagnosis, while Ga-67 citrate scintigraphy identified the optimal biopsy site.
Area of Science:
- Rheumatology
- Medical Imaging
Background:
- Relapsing polychondritis is a rare, systemic autoimmune disease characterized by progressive cartilage destruction.
- It affects various cartilaginous structures, including costal cartilages, and can be associated with other autoimmune conditions.
Observation:
- A 29-year-old male presented with persistent cold-like symptoms and anterior chest pain.
- The patient had a prior history of hyperthyroidism treated with thyroid therapy 15 years earlier.
Findings:
- Technetium-99m methylene diphosphonate (Tc-99m MDP) bone scintigraphy revealed increased radiotracer uptake in costocartilages and sternoclavicular joints, suggesting active inflammation.
- Gallium-67 citrate scintigraphy assisted in pinpointing the ideal site for cartilage biopsy.
- Histological examination of the biopsy confirmed the diagnosis of relapsing polychondritis.
Implications:
- Tc-99m MDP bone scintigraphy can be a valuable tool for diagnosing relapsing polychondritis, particularly when costochondritis is a prominent symptom.
- Ga-67 citrate scintigraphy may help guide biopsy procedures for definitive diagnosis.
- Early and accurate diagnosis of relapsing polychondritis is crucial for timely management and preventing disease progression.