title: Multifocal Pott's disease (tuberculous spondylitis) incidentally detected on Tc-99m MDP bone and Ga-67 citrate scintigraphy in a patient with diabetes.
abstract: Pott's disease is an uncommon extrapulmonary form of tuberculosis. Delay in diagnosis and management may cause serious complications. The authors describe Pott's disease incidentally detected on Tc-99m MDP bone and Ga-67 imaging in a patient with diabetes. Tc-99m MDP bone scintigraphy showed intensely increased uptake in the lower cervical spine and lumbosacral regions. Ga-67 scintigraphy revealed intensely increased uptake corresponding to the areas noted on Tc-99m MDP bone scintigraphy. Magnetic resonance imaging showed destructive lesions in the C5-C6 and L5-S1 intervertebral discs with destruction of adjacent end plates. Biopsy of the lumbosacral area was guided by computed tomography, and histologic examination of the bone specimen showed caseation, giant cells, and acid-fast bacilli. Posterior decompression and posterolateral spinal fusion with bone grafts were performed. Antituberculous chemotherapy with isoniazid, rifampicin, pyrazinamide, and ethambutol was started. The patient showed remarkable relief of symptoms during a period of 9 months of therapy. Both Tc-99m MDP bone and Ga-67 imaging can offer the convenience of screening the entire body to detect multiple sites of Pott's disease.
authors.affiliation: Department of Nuclear Medicine, College of Medicine, Pusan National University, Korea.
authors.forename: Seong-Jang
authors.initials: SJ
authors.lastname: Kim
authors.forename: Ju-Won
authors.initials: JW
authors.lastname: Seok
authors.forename: In-Ju
authors.initials: IJ
authors.lastname: Kim
authors.forename: Yong-Ki
authors.initials: YK
authors.lastname: Kim
authors.forename: Dong-Soo
authors.initials: DS
authors.lastname: Kim
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology; D002951:Citrates; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D005708:Gallium; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging; D033162:Incidental Findings; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000209:etiology; D008161:Lumbosacral Region / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D018908:Muscle Weakness / Q000000981:diagnostic imaging / Q000209:etiology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate; D014399:Tuberculosis, Spinal / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D014915:Whole-Body Counting / Q000379:methods
chemical_list: D002951:Citrates; D019275:Radiopharmaceuticals; D005708:Gallium; C103850:gallium citrate; D013669:Technetium Tc 99m Medronate