title: Methotrexate osteopathy demonstrated by Technetium-99m HDP bone scintigraphy.
abstract: The authors report a case of methotrexate osteopathy as revealed by Tc-99m HDP bone scintigraphy in a patient with rheumatoid arthritis. Methotrexate is used widely in high doses as a chemotherapeutic agent. Lower doses are given in rheumatoid and psoriatric arthritis. Methotrexate affects bone metabolism, resulting in methotrexate osteopathy, characterized by osteoporosis, osseus pain, and even spontaneous (micro)fractures. Radiographic visualization of microfractures is difficult. Tc-99m HDP bone scans have been shown to be very sensitive in the visualization of changes in bone metabolism as a result of methotrexate osteopathy.
authors.affiliation: Department of Nuclear Medicine, University Medical Center, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands. stevens.henk@wxs.nl
authors.forename: H
authors.initials: H
authors.lastname: Stevens
authors.forename: J W
authors.initials: JW
authors.lastname: Jacobs
authors.forename: P P
authors.initials: PP
authors.lastname: Van Rijk
authors.forename: J M
authors.initials: JM
authors.lastname: De Klerk
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy; D001851:Bone Diseases, Metabolic / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects*; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate; D013977:Tibia
chemical_list: D018501:Antirheumatic Agents; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate; D008727:Methotrexate