In-111 labeled leukocyte imaging in a case of pseudogout.
In-111 labeled leukocyte scintigraphy was performed on a 90-year-old woman who had a fever and left lower extremity pain for 3 days. Leukocyte images demonstrated abnormal activity in the left knee and ankle. Aspiration of the left knee joint yielded cloudy yellow fluid with a leukocyte count of 30,000 per mm3 (75% polymorphonuclear leukocytes, 1% lymphocytes, and 24% monocytes). Cultures of the aspirate were reported as no growth. Microscopic examination of the aspirate revealed the presence of rod-shaped crystals of calcium pyrophosphate dihydrate, confirming the diagnosis of calcium pyrophosphate deposition disease, also known as pseudogout. The acute arthritis of pseudogout stimulates an intense leukocyte response; therefore, labeled leukocyte images performed on patients suspected of having this condition must be interpreted cautiously because scintigraphically it may not be possible to distinguish pseudogout from septic arthritis.
Palestro
C J
CJ
Department of Physics-Nuclear Medicine, Mt. Sinai School of Medicine, Mt. Sinai Medical Center, New York, New York.
Goldsmith
S J
SJ
D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000000981:diagnostic imaging; D002805:Chondrocalcinosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D007719:Knee Joint / Q000000981:diagnostic imaging; D007962:Leukocytes; D011877:Radionuclide Imaging
D007205:Indium Radioisotopes