Case Author(s): Scott Winner, M.D. and Tom R. Miller, M.D., Ph.D. , 01/10/97 . Rating: #D3, #Q5
Diagnosis: Multiple fractures
Brief history:
54-year old woman with
left-sided chest wall pain
Images:
Anterior and posterior whole body images
View main image(bs) in a separate image viewer
Full history/Diagnosis is available below
Diagnosis: Multiple fractures
Full history:
54-year old woman with
hypophosphatasia, now with left-sided chest wall pain.
Radiopharmaceutical:
21.4 mCi Tc-99m
MDP i.v.
Findings:
There are multiple foci of
abnormal tracer accumulation consistent with fractures.
Discussion:
The severe congenital form of
hypophosphatasia is recognizable at birth with
a "boneless" skull, severe deformities and
shortness of the limbs. The infantile form
shows symptoms after the first few months of
life with failure to thrive, wide cranial sutures
and angulation of the limbs. The childhood
form shows delayed onset of walking,
myopathy, dental caries and premature loss of
deciduous teeth. The adult form presents with
bone pain, osteoporosis, and a tendency to
fracture.
Followup:
None
Major teaching point(s):
None
Differential Diagnosis List
Metastatic disease
ACR Codes and Keywords:
- General ACR code: 45
- Skeletal System:
4.593 "Hypophosphatasia"
References and General Discussion of Bone Scintigraphy (Anatomic field:Skeletal System, Category:Metabolic, endocrine, toxic)
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Case number: bs070
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