Sternal uptake on bone scintigraphy: age-related variants.
BACKGROUND
When reporting bone scans, it is important to distinguish between normal variants and skeletal pathology involving the sternum. There are only limited reports dealing with age-related normal variants of the sternum on bone scintigraphy.


METHODS
We have studied the age-related variants of sternal uptake on bone scintigraphy. In a prospective study, 152 consecutive patients (66 males and 86 females) undergoing whole-body bone scanning, and who had no symptoms associated with the sternum, were evaluated for patterns of normal sternal uptake. Three hours after intravenous injection of (99m)Tc-methylene diphosphonate ((99m)Tc-MDP), whole-body bone scans in the anterior and posterior projections were acquired. Patterns of sternal uptake, including the sites and distribution of increased and decreased uptake, were analysed using age-related groups.


RESULTS
Three patterns of tracer uptake in the sternum were recognized: a uniform pattern was most common in children (< or =12 years); a heterogeneous uptake pattern was frequently seen in adolescents, young adult and adult groups; and a segmented pattern was commonly seen in the geriatric group (>60 years). A predominant focal finding was a hot spot at the angle of Louis. In addition, there were focal spots of decreased tracer uptake in the lower sternum, just above the xiphoid process, and spots of increased tracer uptake in the body of the sternum. Such focal spots were not seen in subjects of less than 12 years of age.


CONCLUSIONS
Evolutionary changes of the sternum appear to exist throughout life. There are age-related normal variants of sternal uptake on bone scintigraphy.
Syed
Ghulam M
GM
Department of Nuclear Medicine, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait. gmshahsyed@hotmail.com
Fielding
Henry W
HW
Collier
Bert D
BD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000378:metabolism*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D013249:Sternum / Q000000981:diagnostic imaging* / Q000378:metabolism*; D013669:Technetium Tc 99m Medronate / Q000493:pharmacokinetics*; D014018:Tissue Distribution; D014915:Whole-Body Counting
D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate