FDG PET/CT was found to have high performance indices for evaluation of the diabetic foot. The PET component identified FDG-avid foci in sites of acute infection which were precisely localized on fused PET/CT images allowing correct differentiation between osteomyelitis and soft-tissue infection.

F-PET had higher sensitivity for the diagnosis of bone metastases from breast cancer compared with WB-SPECT, showing a statistically significant 32% increase on lesion-based analysis.

Bone scintigraphy is a sensitive technique to detect altered bone mineralization but has limited specificity. The use of SPECT/CT has improved significantly the diagnostic accuracy of bone scintigraphy, in patients with cancer as well as in evaluation of benign bone disease. It provides precise localization and characterization of tracer-avid foci, shortens the diagnostic workup, and decreases patient anxiety. Through both the SPECT and the CT components, SPECT/CT has an incremental value in characterizing benign bone lesions, specifically in the appendicular skeleton, as illustrated by present case series.

SUMMARYHow often are we faced with a tragic diagnosis in a young patient whose life is completely changed? Often in medicine the tragedy is short-lived: the patients never stabilise, they succumb early to their injuries or complications. We present the case of a young man in whom the exact cause of a spinal cord infarct has never been confirmed. As it transpires, regardless of the sequence of events and the time elapsed between injury and the onset of paralysis, his symptoms came with no warning, were life-threatening and terrifying. He could have had no time to understand what had happened and is now faced with what must seem an eternity to come to terms with a life of quadriplegia. He gives an account of his life for the last 7 years as he has remained at home, while life for his siblings has moved on and he watches from his bed. The triumph is his adjustment to his life now, the vigilance and care of his family and the dedication of the medical staff of a local clinic in a small village in the mountains in the north of Israel. BACKGROUND

We report the case of a 56-year-old female who had recently been examined for back and epigastric pain, and was diagnosed in the internal medicine ward as having an aggressive rare form of multiple myeloma with diffuse osteoblastic bone lesions. She also had high levels of breast tumor marker (CA 15-3), severe tumor lysis syndrome, and pleural and central nervous system involvement. A few cases of multiple myeloma with diffuse osteosclerosis that are not part of POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changeshave) have been described. None of these cases were as aggressive as our case. To our knowledge it is the first report describing an elevation in CA 15-3 in conjunction with multiple myeloma.