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Stippled ribs: a potential pitfall in bone scan interpretation.

D Fink-Bennett, J Johnson

    Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
    |February 1, 1986
    PubMed
    Summary
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    Rib stippling, an uncommon finding on bone scans, represents increased uptake in the erector spinae muscles. Recognizing this normal finding is crucial to avoid misinterpreting scans for trauma or tumors.

    Area of Science:

    • Nuclear Medicine
    • Radiology
    • Anatomy

    Background:

    • Bone scans are essential diagnostic tools.
    • Increased radiotracer uptake can indicate pathology.
    • Normal anatomical variants may mimic abnormal findings.

    Purpose of the Study:

    • To determine the incidence of rib stippling on bone scans.
    • To evaluate the clinical significance of rib stippling.
    • To differentiate rib stippling from pathological uptake.

    Main Methods:

    • Retrospective analysis of 100 bone scans.
    • Defined rib stippling as focal increased technetium-99m methylene diphosphonate uptake in the posterior angle of consecutive ribs.
    • Assessed uptake intensity relative to adjacent ribs and scapular tips.

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    Main Results:

    • Rib stippling observed in 7% of patients (7/100).
    • Uptake intensity was greater than adjacent ribs but less than scapular tips.
    • No patients had history of trauma, pain, or abnormal radiographs.

    Conclusions:

    • Rib stippling is an uncommon but normal bone scan finding.
    • Characteristic appearance and location aid differentiation from trauma or tumor.
    • Awareness of this finding prevents misinterpretation of bone scans.