Abstract
A 37-year-old man and a 40-year-old woman were referred for evaluation of skeletal complaints. Tc-99m MDP bone scans were obtained. Tc-99m MDP bone scanning of the man revealed a metabolic super-scan pattern. Tc-99m MDP images of the woman mimicked autoimmune arthritis. A thyroid workup was performed at a substantial interval after bone scanning. Thyroid laboratory indices in both patients suggested Graves' Disease. I-123 scanning revealed diffuse increased uptake in both patients, confirming the diagnosis of Graves' Disease. Successful treatment was eventually achieved with I-131. We conclude that nuclear medicine physicians should be aware that hyperthyroidism may present either as a pattern of metabolic superscan or may resemble an autoimmune arthritic process; in other words, it should be understood that insofar as bone imaging, Graves' Disease is the 'Great Imitator.' Similarly, referring clinicians need to be aware of these relationships, and appropriately screen patients with skeletal complaints. This is especially important in an era when generalists and ancillary medical personnel are involved in the screening of patients with complex and misleading disease processes.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 241-242 |
| Number of pages | 2 |
| Journal | Clinical Nuclear Medicine |
| Volume | 23 |
| Issue number | 4 |
| DOIs | |
| State | Published - 1998 |
| Externally published | Yes |
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Keywords
- Graves' Disease
- Metabolic Bone Disease
- Nuclear Bone Scan
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Radiological and Ultrasound Technology
Cite this
Hyperthyroidism : An underappreciated cause of diffuse bone disease. / Swislocki, Arthur L; Barnett, C. A.; Darnell, P.; Noth, R. H.
In: Clinical Nuclear Medicine, Vol. 23, No. 4, 1998, p. 241-242.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hyperthyroidism
T2 - An underappreciated cause of diffuse bone disease
AU - Swislocki, Arthur L
AU - Barnett, C. A.
AU - Darnell, P.
AU - Noth, R. H.
PY - 1998
Y1 - 1998
N2 - A 37-year-old man and a 40-year-old woman were referred for evaluation of skeletal complaints. Tc-99m MDP bone scans were obtained. Tc-99m MDP bone scanning of the man revealed a metabolic super-scan pattern. Tc-99m MDP images of the woman mimicked autoimmune arthritis. A thyroid workup was performed at a substantial interval after bone scanning. Thyroid laboratory indices in both patients suggested Graves' Disease. I-123 scanning revealed diffuse increased uptake in both patients, confirming the diagnosis of Graves' Disease. Successful treatment was eventually achieved with I-131. We conclude that nuclear medicine physicians should be aware that hyperthyroidism may present either as a pattern of metabolic superscan or may resemble an autoimmune arthritic process; in other words, it should be understood that insofar as bone imaging, Graves' Disease is the 'Great Imitator.' Similarly, referring clinicians need to be aware of these relationships, and appropriately screen patients with skeletal complaints. This is especially important in an era when generalists and ancillary medical personnel are involved in the screening of patients with complex and misleading disease processes.
AB - A 37-year-old man and a 40-year-old woman were referred for evaluation of skeletal complaints. Tc-99m MDP bone scans were obtained. Tc-99m MDP bone scanning of the man revealed a metabolic super-scan pattern. Tc-99m MDP images of the woman mimicked autoimmune arthritis. A thyroid workup was performed at a substantial interval after bone scanning. Thyroid laboratory indices in both patients suggested Graves' Disease. I-123 scanning revealed diffuse increased uptake in both patients, confirming the diagnosis of Graves' Disease. Successful treatment was eventually achieved with I-131. We conclude that nuclear medicine physicians should be aware that hyperthyroidism may present either as a pattern of metabolic superscan or may resemble an autoimmune arthritic process; in other words, it should be understood that insofar as bone imaging, Graves' Disease is the 'Great Imitator.' Similarly, referring clinicians need to be aware of these relationships, and appropriately screen patients with skeletal complaints. This is especially important in an era when generalists and ancillary medical personnel are involved in the screening of patients with complex and misleading disease processes.
KW - Graves' Disease
KW - Metabolic Bone Disease
KW - Nuclear Bone Scan
UR - http://www.scopus.com/inward/record.url?scp=0031893163&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031893163&partnerID=8YFLogxK
U2 - 10.1097/00003072-199804000-00015
DO - 10.1097/00003072-199804000-00015
M3 - Article
C2 - 9554201
AN - SCOPUS:0031893163
VL - 23
SP - 241
EP - 242
JO - Clinical Nuclear Medicine
JF - Clinical Nuclear Medicine
SN - 0363-9762
IS - 4
ER -