Three-Phase 99mTc-MDP Bone Scintigraphy and SPECT/CT in Pediatric Pseudodystrophy

Area of Science:

• Orthopedics
• Radiology
• Pediatrics

Background:

• Pseudodystrophy is a rare condition that presents symptoms similar to reflex sympathetic dystrophy.
• Differentiating between these two conditions is crucial and relies on clinical evaluation and bone scintigraphy.

Observation:

• A 12-year-old girl experienced pain, swelling, and reduced function in her left foot following minor trauma.
• Clinical examination showed left calf atrophy, and her left foot was cyanotic and cold. Initial laboratory tests, X-rays, and MRI were normal.

Findings:

• Bone scintigraphy demonstrated hypoperfusion and significantly reduced tracer uptake throughout the left lower leg and foot.
• These imaging findings, combined with the clinical presentation, led to the diagnosis of pseudodystrophy.

Implications:

• This case highlights the importance of bone scintigraphy in diagnosing pseudodystrophy, especially when other investigations are inconclusive.
• Accurate diagnosis is essential for appropriate management and distinguishing it from similar conditions like reflex sympathetic dystrophy.