Hallazgo con gammagrafía con citrato de galio-67 de enfermedad de Paget en mujer con linfoma gástrico / Finding with scintigraphy with 67-gallium citrate of Paget’s disease in a woman with gastric lymphoma

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Gammagrafía ósea en la valoración de la enfermedad de Paget monostótica / Bone scintigraphy in the evaluation of monostotic Paget’s disease

Analizamos la utilidad de la gammagrafía ósea (GO) en el diagnóstico de enfermedad de Paget monostótica. Se realizó GO a 16 pacientes con enfermedad de Paget monostótica entre los años 2003 y 2004, realizando posteriormente radiografía simple a 8 pacientes y tomografía axial computarizada (TAC) a uno. Se estudiaron 16 pacientes con sospecha clínica y/o analítica de enfermedad de Paget. Ocho pacientes estaban asintomáticos, mientras que tres presentaron dolor e impotencia funcional. Tres pacientes refirieron únicamente dolor, y los restantes mostraban deformidades. Nuestra casuística mostró afectación monostótica en un 15% de las GO solicitadas para el diagnóstico de enfermedad de Paget. La afectación ósea más frecuente fue el fémur (37,5%). La GO fue el único estudio de imagen realizado en 7 casos, siendo en 4 la primera técnica solicitada para el diagnóstico. La GO fue una técnica útil para confirmar el diagnóstico y establecer la extensión de la enfermedad, por lo que puede ser solicitada de modo rutinario en la clínica diaria

We analyze the utility of the bone scintigraphy (BS) to diagnose monostotic Paget's disease. BS was used in 16 patients suffering monostotic Paget's disease during the years 2003 and 2004. After that 8 patients were examined with a simple X-ray and 1 with CT scan. Sixteen patients suspected of suffering monostotic Paget's disease from a clinical and/or analytical point of view were studied. Eight patients had no symptoms and 3 others had pain and functional impotence. Three patients reported only pain and the rest of the patients had deformities. Our casuistry showed that about 15% of the BS requested to diagnose the Paget's disease were monostotic. The most frequent bone affected was the femur (37.5%). BS was the only image study made in 7 cases, this being the first technique requested for the diagnosis of 4 of them. The BS was a useful technique to confirm the correct diagnosis and to know the extension of the illness, so it can be requested in the routine daily clinical practice

[Spontaneous intracranial hypotension: the value of isotope cisternoscintigraphy using 99mTc-DTPA]. / Síndrome de hipotensión intracraneal espontánea: utilidad de la cisternogammagrafía isotópica con 99mTc-DTPA.

INTRODUCTION: Spontaneous intracranial hypotension (SIH) is an infrequent clinical entity that is found predominantly in young adults and is characterised by the presence of acute or subacute headaches that appear on standing up and subsides on lying down. CASE REPORT: A 35-year-old female with a three-month history of holocranial headaches, accompanied by dizziness and gait instability, which increase on standing up and diminish to a certain extent on lying down, associated to bilateral tinnitus. The patient's history included a slight strain made 4 months earlier, with a sudden non-irradiated pain in the back of the neck that got better spontaneously. On the basis of the clinical and radiological findings from an MRI scan of the head and neck, our service was asked to perform a cisternoscintigraphy. CONCLUSIONS: Isotope cisternoscintigraphy using 99mTc-DTPA confirmed the diagnosis of the process and enabled us to locate the CSF leak. We therefore think it advisable to highlight its value in the diagnosis of SIH syndrome so as to be able to avoid the use of other invasive complementary explorations that entail a certain degree of morbidity and mortality.