Asymmetric and Diffuse Uptake of Left Femur in a 3-Year-Old Child Bone Scan

Abstract

Acute leukemia is a severe disease frequently encountered in childhood, often diagnosed in later stages because of nonspecific symptoms. It is known to produce uptake in bone scan, and previously described patterns have shown symmetrical abnormalities. However, we report the unusual aspect of the bone scan in a 3-year-old child who was referred to explore an isolated pain of his lower left limb, with hyperthermia and markers of inflammation. A bone scan showed an intense, asymmetrical uptake of the entire left femur. A few days later, his blood count showed circulating blast cells, leading to the diagnosis of leukemia.

Multiple Primary Osseous B-Lymphoblastic Lymphoma/Leukemia Shown on Bone Scintigraphy

“…1,2 Usually, osseous lesion of the disease is osteolytic, [3][4][5] which can be obviously demonstrated on CT and x-ray images; however, bone scintigraphy may play an important role to detect the bone lesion for the patients with no finding on CT and x-ray images. 6,7 Besides increased MDP uptake, [7][8][9] photopenic area can also be noted on bone scintigraphy. 10 Interestingly, extraosseous uptakes can be shown.…”