Differential diagnosis of skeletal tuberculosis and malignant skeletal disease with bone scintigraphy based on pathology

ZHANG Yan-yan; ZHANG Wei-fang; MA Jing

Journal of China Clinic Medical Imaging ›› 2009, Vol. 20 ›› Issue (4) : 267-270.

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Differential diagnosis of skeletal tuberculosis and malignant skeletal disease with bone scintigraphy based on pathology

ZHANG Yan-yan, ZHANG Wei-fang, MA Jing

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Abstract

Objective: To search the specific features that can differentiate malignant skeletal disease and skeletal tuberculosis on bone scintigraphy and compare with pathology. Materials and Methods: For 1817 patients with pain of bone underwent bone scan. Fifty-six cases of skeletal malignant disease and skeletal tuberculosis were confirmed by pathology. Patients were divided into 3 groups according to the results of pathology: skeletal tuberculosis; bone metastasis and primary malignant bone tumors. Results: Bone metastasis and primary malignant bone tumors multiple lesions were more than solitary lesions. In bone tuberculosis 73% had joint involvement. The foci of bone metastasis bone disease were found in axial skeleton or extremities or both simultaneously, but skeletal tuberculosis were found in axial skeleton only in this study. Adjacent bone involvement was found in 90% of skeletal tuberculosis and in metastatic bone tumor, were distributed diversely. Seventy percent of bone tuberculosis absorbed imaging agent uniformly. The foci was irregular in 82% of metastatic bone tumors and in 94% of primary malignant bone tumors. Conclusion: Multiple lesions in malignant bone diseases could be seen diversely in axial skeleton and extremity bone. Foci were irregular and radioactive uptake not uniform in most malignant bone diseases. Most foci of bone tuberculosis distributed in axial bones, and they were regular and uniform as well as after accompanied by joint involvement.

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Tuberculosis / osteoarticular / Bone neoplasms / Radionuclide imaging

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ZHANG Yan-yan;ZHANG Wei-fang;MA Jing. Differential diagnosis of skeletal tuberculosis and malignant skeletal disease with bone scintigraphy based on pathology[J]. Journal of China Clinic Medical Imaging. 2009, 20(4): 267-270