Bone infarction as an accidental finding - a case report

Overview

Aim: Presentation of an incidental finding on bone scan indicated within a staging of oncological disease.

Case report: Case report: 73-year-old female patient was refered for a bone scan to exclude generalization of breast cancer. The examination did not reveal a metastatic proces but a high focal accumulation of a radiofarmaceutical in the femur and tibia near the left knee joint was visible. Osteomyelitis, fibrous bone dysplasia, or tumorous affection were considered at the differential diagnosis. Targeted SPECT/low-dose CT displayed increased accumulation of radiofarmaceutical at scintigraphic image, which contoured marrow cavity in distal metadiaphysis of the femur and proximal tibia. In addition, LDCT showed thickened corticalis of the dorsal part of the left femur. The differential diagnosis was thus extended by a bone infarction and aneurysmal bone cyst. The history connected with the left lower limb was negative. Etiology of these bone affections based on our examinations was ambiguous, we recommended targeted radiological investigation. At the oncologist-indicated CT, the lesions showed signs of a bone infarction.

Conclusion: Our case report confirms the importance of performing targeted SPEC/CT according to findings on bone scans and correlation with other examinations possibly radiological imaging methods.

Keywords:

SPECT/CT – bone infarction – incidental finding