Concentration of Tc-99m MDP in ovarian carcinoma and its soft tissue metastases.

A patient with ovarian carcinoma was evaluated for skeletal metastasis with a routine whole body bone scan. Although no bone metastases were visualized, there was dramatic accumulation of tracer in the soft tissues of the abdomen. CT revealed calcifying soft tissue metastases on the liver surface, the bowel serosa, and in the pelvis corresponding to the abnormal areas of Tc-99m MDP uptake. Tumor necrosis and ongoing calcification within the metastatic sites are possible explanations for this unusual soft tissue concentration of the bone-seeking radiopharmaceutical. In patients with metastatic ovarian carcinoma, careful review of extraosseous regions on bone scan images may provide valuable diagnostic information.

Scintigraphic demonstration of a soft tissue cavernous hemangioma with Valsalva maneuver.

Hemangiomas are congenital vascular tumors frequently referred for Tc-99m RBC imaging. A case of soft tissue cavernous hemangioma located in the right side of the face and neck is presented. The importance of the Valsalva maneuver in outlining this lesion is described, and a brief review of the literature is presented.

Unusual stress fracture of the scapula in a jogger.

A case of fracture of the right scapula in the superomedial portion with no history of direct trauma is presented. It is most likely due to jogging with weights in both hands. A brief review of scapular fractures is also reported.

Chondromalacia of the patella. Bone imaging correlated with arthroscopic findings.

One hundred adult sports medicine patients with clinical findings suggesting chondromalacia of the patella underwent bone imaging. Of these patients, 50 eventually underwent arthroscopic surgery and the remaining 50 were treated conservatively. The intensity of abnormally increased scintigraphic activity in the patella correlated closely with the grade of chondromalacia observed by the arthroscopist. Bone imaging also was of value in directing the arthroscopist to clinically unsuspected torn menisci. In conclusion, for sports medicine patients with clinical findings suggestive of chondromalacia of the patella, bone imaging contributes to an accurate diagnosis and appropriate surgical planning.

Chronic knee pain assessed by SPECT: comparison with other modalities.

Twenty-seven patients with chronic knee pain were examined prospectively using conventional radiography, radionuclide angiography, planar bone scintigraphy, and single-photon emission computed tomographic (SPECT) bone scintigraphy. When the results of subsequent arthroscopic examination of all three compartments of the knee were correlated with those of the noninvasive methods, SPECT bone scintigraphy was found to be most sensitive for evaluating the extent of osteoarthritis. Differences in detection sensitivity for articular cartilage damage and synovitis were greatest in the patellofemoral compartment. The frequency with which hyperemia was present in association with cartilage damage and synovitis indicates that osteoarthritis of the knee is capable of producing hyperemia and further implies that increased perfusion cannot be used to distinguish with confidence between osteoarthritis and septic processes involving the knee. SPECT (1.00) and planar (0.91) bone scintigraphy were highly sensitive indicators of torn menisci in a subgroup of 14 patients, each having a prearthroscopic clinical diagnosis of a torn meniscus. This result suggests that for patients with chronic knee pain and clinical suggestion of a torn meniscus, bone scintigraphy has significant potential as a high-sensitivity, prearthroscopic screening examination.

Scintigraphic skeletal "doughnut" sign due to giant cell tumor of the fibula.

Although the "doughnut" sign in brain scintigraphy is a well known phenomenon, similar findings have recently been reported in bone scintigraphy in osseous and nonosseous lesions. A skeletal doughnut sign in bone scintigraphy caused by giant cell tumor of the proximal fibula is presented with a brief review of literature.

Eimeria beldingii n. sp. and other Coccidia (Apicomplexa) of the ground squirrel Spermophilus beldingi.

Fecal samples of 36 ground squirrels, Spermophilus beldingi, from Tioga Pass (elev. ca. 3315 m) in the Sierra Nevada, California, yielded oocysts of Eimeria beckeri in nine squirrels, E. citelli in four squirrels, E. beldingii n. sp. in two squirrels, and degenerated, unidentifiable oocysts in ten squirrels. Eimeria beldingii n. sp. oocysts are ellipsoidal, 30-34 X 24-30 (mean 32 X 26) micron with a two-layered, rough, striated wall, without a micropyle or residuum, with polar granules; they contain ellipsoidal or ovoid sporocysts 11-15 X 9-12 (mean 13 X 10) micron with a Stieda body and residuum.