title: Findings of bone scintigraphy after leech theraphy.
abstract: In this case report, we present a 70 year old female patient who had recieved Leech therapy (hirudotherapy) on her leg without informing referring physician. In dynamic bone scintigraphy there was increased perfusion and hyperemia in her left ankle and leg, also in late static images moderate increased uptake was seen in soft tissue region and at the fracture site of ankle. We learned that she had Leech therapy applied on her leg, which could explain the increased perfusion and hyperemia in dynamic and blood pool phases of bone scintigraphy because of Leech therapy's dilatory effects on superficial veins. Leech therapy may lead to an increase in perfusion and hyperemia in blood pool phase of bone scintigraphy, which may cause confusion in differential diagnosis. To our best knowledge this report is the first case that shows the scintigraphic findigs after Leech therapy.
  
  
  BACKGROUND
  None declared.
authors.affiliation: Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey.
authors.forename: Sinem
authors.initials: S
authors.lastname: Ozyurt
authors.affiliation: Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Koca
authors.affiliation: Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey.
authors.forename: Koray
authors.initials: K
authors.lastname: Demirel
authors.affiliation: Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Baskın
authors.affiliation: Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey.
authors.forename: Meliha
authors.initials: M
authors.lastname: Korkmaz
keywords: Leech therapy; Tc-99m MDP; hirudo medicinalis; hyperemia; scintigraphy