Joint Program in Nuclear Medicine
Findings, case of Diabetic with a Non-healing Ulcer
Imaging Findings
Radiography, three phase bone scan and gallium scan were performed.
Radiograph
The radiograph shows osteopenia of the first digit,
soft tissue swelling and bone resorption of the first toe.
Three Phase Bone Scan
The flow phase of the three-phase bone scan
demonstrates diffuse increased flow to the left foot with focal accumulation
in the first digit (the arrow shows the
accumulation). On the tissue phase, there is marked asymmetry with
increase activity in the left foot. In addition, there is mild localization
in the first digit (shown by arrow). The delayed images demonstrate focal
uptake at the left first MTP joint and first interphalangeal joint (shown
by arrows).
Gallium Scan
The gallium scan (bottom two images) demonstrates
focal increased tracer uptake in the left first toe (shown
by arrow). The intensity of the gallium uptake on the bottom two images
is greater than that of the delayed bone scan on the top two images.
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J. Anthony Parker, MD PhD, Tony_Parker@CareGroup.Harvard.edu