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Radionuclide Bone Scintigraphy
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Kanhaiyalal Agrawal, Gopinath Gnanasegaran
A bone scan is useful in evaluating sacroiliitis (Figure 11.17), bone non-union (Figure 11.18), bone graft viability and, usually, SPECT-CT is more specific in such scenarios. A Bone scan is also extremely sensitive in identification of a pain generator in unexplained bone pain in the back, hip, knee, and foot (Figure 11.19) [17–21]. Often the fractures are seen early in a bone scan in comparison to conventional radiographs. Aseptic loosening and hip and knee prostheses infection can be differentiated with high sensitivity on a three-phase bone scan.
Pagetoid Skull
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Most patients require no treatment. Bone pain may be controlled by simple analgesics (aspirin/non-steroidal). More severe cases may require the use of alternative drugs. Those commonly used are: diphosphonates, calcitonin (salmon or porcine), sodium fluoride, actinomycin-D. Treatment of complications involves treatment of neural compression, high output cardiac failure, repeated fractures and hypercalcaemia.
Radioisotopes in Biology and Medicine
Published in Kedar N. Prasad, Handbook of RADIOBIOLOGY, 2020
Bone metastases will eventually develop in 50% of patients with breast and prostate carcinoma. Management of bone pain is a significant problem in these patients. Phosphorus-32 (32P) has been used as systemic therapy for the management of bone pain for over 40 years, but it causes hematologic depression. Recently, the bone-seeking radioactive compounds, such as strontium-90, samarium-153-ethylenediaminetetramethylene phosphoric acid, and rhenium-186-hydroxyethylidene diphosphonate, have been useful in the management of bone pain with acceptable hematological toxicity.17
Colony stimulating factors for prophylaxis of chemotherapy-induced neutropenia in children
Published in Expert Review of Clinical Pharmacology, 2022
22% of pegfilgrastim arm patients and 33% of filgrastim arm patients experienced adverse events due to growth factor use. The most common adverse event reported was mild to moderate bone pain. There was no evidence of showing differences in toxicity across different age groups [28]. A 2002 filgrastim study had no reports of adverse events during the study [38]. Both 2006 and 2009 studies witnessed no significant adverse events secondary to pegfilgrastim [35,40]. Clinical adverse events attributed to pegfilgrastim were limited to bone pain and there wasn’t an association between bone pain and pegfilgrastim dose. However, both studies were retrospective in nature where pegfilgrastim was given in an outpatient cancer clinic. It is possible that pegfilgrastim-induced adverse events were under-reported.
Incapacitating pain from Tenofovir Induced Hypophosphatemic Osteomalacia in a Hemophilia Patient – A Case Report
Published in Canadian Journal of Pain, 2020
Emma Woo, Dinesh Kumbhare, Paul Winston
There is a growing database of literature on the assessment and management of pain in hemophilia.3,4 This literature, however, primarily addresses acute and chronic pain as it relates to arthropathy from hemarthrosis and does not specifically address the need to accurately diagnose the pathology of the underlying pain. Though the differential diagnosis for pain in hemophilia is usually limited to acute pain from arthropathies, there are other pathological entities that account for pain in people with hemophilia (see Table 1). Downstream effects of hemarthrosis and hematomas can also lead to chronic pain from synovitis, degenerative arthropathy, and pseudotumors.5,6 Hemophilia pain can also have extrinsic associations, including deconditioning, associated illnesses, neurological injuries/impairments, medication side effects, and trauma. Determining the characteristics of the pain is important in distinguishing arthropathies from other causes. Specifically, pain with arthropathies tends to be initially acute, localized, and severe and become “arthritic” with time and increased joint damage.4 Bone pain, on the other hand, will typically present as a dull aching pain unless due to a fracture, which will cause sharp, radiating pain.7
Magnetic resonance imaging as a diagnostic modality in a child with acute lymphoblastic leukemia
Published in Baylor University Medical Center Proceedings, 2019
Nishath Farhad, Krista Birkemeier, Lea H. Mallett
ALL is the most common form of childhood cancer. The peak incidence occurs between the ages of 2 and 5 and is more common among boys than girls. ALL typically presents with nonspecific symptoms and can therefore be difficult to distinguish from other pediatric pathologies. Some early signs and symptoms of ALL include hepatosplenomegaly, lymphadenopathy, musculoskeletal pain, mediastinal mass, and peripheral blood abnormalities.1 Bone pain is a presenting symptom in 20% to 40% of cases of acute leukemia2 but is also a common symptom in metastatic cancers and multiple other nonmalignant conditions. Blood work in ALL patients typically reveals anemia and/or thrombocytopenia with a normal to elevated white blood cell count, and a peripheral smear can contain lymphoblasts. The presence of atypical cells in peripheral blood, cytopenia in more than one cell line, and/or concerning symptoms such as hepatosplenomegaly, lymphadenopathy, or bone pain warrant a bone marrow examination.