Bone Scan With Pulmonary Uptake in Scleroderma

Area of Science:

• Nuclear Medicine
• Pulmonary Medicine
• Rheumatology

Background:

• Scleroderma is an autoimmune disease affecting connective tissue, potentially involving lungs.
• Osteomyelitis evaluation often uses 3-phase bone scans with methylene diphosphonate (MDP).

Observation:

• A 61-year-old woman with scleroderma presented with suspected left wrist osteomyelitis.
• A 3-phase bone scan was performed for osteomyelitis assessment.

Findings:

• The bone scan incidentally revealed bilateral pulmonary MDP uptake, predominantly in the lower lobes.
• This pulmonary uptake was confirmed to be caused by the nonfibrotic form of nonspecific interstitial pneumonia.

Implications:

• 3-phase bone scans can incidentally detect pulmonary abnormalities.
• Pulmonary MDP uptake may indicate interstitial lung disease, such as nonspecific interstitial pneumonia, in patients with scleroderma.