Calf 'Arch Sign' Seen on a Tc-99m-MDP Bone Scan Is Indicative of Synovial Fluid Leak in Ruptured Baker’s Cysts: Case Reports and Analysis of Literature
| Autor: | Haim Golan, Evgeniya Fridburg |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Popliteal cyst
Leak medicine.medical_specialty medicine.diagnostic_test business.industry Case Report medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences Baker's cyst 0302 clinical medicine Pathognomonic 030220 oncology & carcinogenesis Orthopedic surgery parasitic diseases medicine Synovial fluid Radiology Nuclear Medicine and imaging Cyst Nuclear medicine business Emission computed tomography |
| Zdroj: | Nucl Med Mol Imaging |
| Popis: | The authors present two cases in which the ruptured popliteal (Baker’s) cysts remained undetected and were diagnosed only during an isotope investigation. The aim was to describe a specific imaging sign, the “arch sign”, that is indicative of ruptured Baker’s cysts. In both cases, the whole-body imaging was performed 2 hours after injection of 706.7 MBq of Tc-99m-MDP. Single-photon emission computed tomography (SPECT) imaging was performed to localize an accumulation of the radiopharmaceutical. An analysis of literature was performed to connect these cases with previously reported data and to detect the pathognomonic radio image sign of ruptured popliteal cysts. The arch-shaped distribution of the radiopharmaceutical below the knee joints was seen already on the whole-body bone scan image in both cases. An anterior view of SPECT MIP images showed the arched accumulation of the Tc-99m-MDP bone tracer along the postero-medial aspect of the right calf secondary to synovial fluid leak from a ruptured Baker’s cyst. The similar arthroscintigrams were published since 1971 without recognizing this sign as pathognomonic. Tc-99m-MDP bone scanning is sensitive for a Baker’s cyst with synovial effusion, and distribution of a radiopharmaceutical in the medial posterior calf in a shape of an arch, the arch sign, may serve as an indicator of a ruptured popliteal cyst. |
| Databáze: | OpenAIRE |
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