title: Bone scintigraphy in acute renal failure with severe loin pain and patchy renal vasoconstriction.
abstract: To evaluate the patterns of renal images and the diagnostic value as a screening test of the whole-body bone and renal scintigraphy with technetium-99m-methylene diphosphonate (99mTc-MDP) or -pyrophosphate (99mTc-PYP), we performed bone scintigraphy in 6 patients with acute renal failure (ARF) with severe loin pain and patchy renal vasoconstriction on postcontrast renal computed tomography (CT). All 6 patients were young and previously healthy but experienced severe loin pain after track events. Five took analgesics. Postcontrast renal CT showed patchy low-density areas or diffuse enhancement immediately after radiocontrast injection and then patchy wedge-shaped enhancement 24 or 48 h later, which subsequently disappeared 72 h later. On the whole-body bone scintigrams with 99mTc-MDP or 99mTc-PYP before obtaining renal CT, there was no increased uptake of isotope in the soft tissue, and multiple patchy increased accumulations of the isotope in the kidney were observed in 5 patients. In 2 patients, renal scintigraphies with technetium-99m-dimercaptosuccinate showed photon-deficient areas in the same areas of patchy isotope accumulation in the whole-body bone scintigraphies. Whole-body image and renal scintigraphy with bone-seeking agents may be useful as a screening test and in the search for the theoretical evidence of ARF with severe loin pain and patchy renal vasoconstriction.
authors.affiliation: Department of Internal Medicine, Seoul National University, College of Medicine, South Korea.
authors.forename: J S
authors.initials: JS
authors.lastname: Han
authors.forename: Y G
authors.initials: YG
authors.lastname: Kim
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.forename: M C
authors.initials: MC
authors.lastname: Lee
authors.forename: J S
authors.initials: JS
authors.lastname: Lee
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
mesh_terms: D058186:Acute Kidney Injury / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D010146:Pain / Q000503:physiopathology*; D012079:Renal Circulation; D013669:Technetium Tc 99m Medronate; D016698:Technetium Tc 99m Pyrophosphate; D014055:Tomography, Emission-Computed; D014661:Vasoconstriction
chemical_list: D016698:Technetium Tc 99m Pyrophosphate; D013669:Technetium Tc 99m Medronate