Diagnostic role of technitium-99m bone scan in severe COVID-19-associated myositis.

Coronavirus disease 2019 (COVID-19), initially appreciated as a respiratory illness, is now known to affect many organs in the human body. Significant data has become available on muscle involvement, with creatinine kinase elevations present in a significant percentage of patients. For those with suspected COVID-19-associated myositis, the imaging modality of choice has been gadolinium-enhanced magnetic resonance imaging; however, the use of technitium-99 m bone scan has not been previously reported. Here, we report two cases of COVID-19 patients with severe elevation in creatinine kinase who underwent technitium-99 m bone scan. The resulting images showed diffuse symmetrical muscle involvement. Both patients developed acute renal injury due to rhabdomyolysis. To our knowledge, this is the first report of bone scan as a diagnostic imaging modality for COVID-19-associated myositis.

Sonographic evaluation of a uterine angiolipoleiomyoma.

We report the case of a 51-year-old postmenopausal woman with an angiolipoleiomyoma, a rare mesenchymal uterine tumor, and describe its sonographic appearance. The clinical presentation of these invariably benign tumors often mimics that of uterine leiomyomas, making angiolipoleiomyomas difficult to diagnose correctly before histopathologic evaluation. In this case, sonography performed to determine the cause of the patient's vaginal bleeding showed a sharply marginated, brightly echogenic solid mass adjacent to the echogenic endometrium, without associated shadowing. Histopathologic examination revealed that this tumor was composed of smooth muscle, adipose tissue, fibrous connective tissue, and blood vessels. These sonographic findings, which are unusual for tumors of the uterus, suggest the diagnosis of angiolipoleiomyoma. Accurate diagnosis of these benign tumors could prevent patients from undergoing surgery and would allow appropriate counseling of patients.