EJMCR |

Case Report

Volume: 4 | Issue: 10 | Published: Oct 28, 2020 | Pages: 364 - 367 | DOI: 10.24911/ejmcr/173-1597812200

Physiologic Periostitis: Erroneous presentation on 99mTc MDP bone scintigraphy - a case report

Authors: Warda Ahmad , Muhammad Iqbal , Muhammad Naeem , Owais bin Qadeer , Muhammad Babar Imran , Muhammad Shahzad Afzal

Article Info

Authors

Warda Ahmad

Department of Nuclear Medicine, PINUM Cancer Hospital, Faisalabad, Pakistan

Muhammad Iqbal

Department of Nuclear Medicine, PINUM Cancer Hospital, Faisalabad, Pakistan

Muhammad Naeem

Department of Nuclear Medicine, PINUM Cancer Hospital, Faisalabad, Pakistan

Owais bin Qadeer

Department of Nuclear Medicine, PINUM Cancer Hospital, Faisalabad, Pakistan

Muhammad Babar Imran

Department of Nuclear Medicine, PINUM Cancer Hospital, Faisalabad, Pakistan

Muhammad Shahzad Afzal

Department of Nuclear Medicine, PINUM Cancer Hospital, Faisalabad, Pakistan

Publication History

Received: August 19, 2020

Revised: September 15, 2020

Accepted: September 24, 2020

Published: October 28, 2020

Abstract

Background: Physiologic periostitis (PP) is characterized by periosteal reaction without any inflammatory condition, and with a more common presentation in pediatric age group involving long bones. It can easily be misinterpreted for a pathological process due to asymmetrical presentation in some cases. 99mTc-methylene diphosphonate (MDP) bone scintigraphy is one of the effective tools for its diagnosis as it helps to localize multiple lesions in the whole skeleton. Case Presentation: A male child, 1 month of age, was referred to the nuclear medicine department of our hospital with swelling involving the right hip for 2 weeks with no history of fever and trauma. There was a mild skin discoloration at the site of swelling along with restricted leg movements. The 99mTc-MDP bone scan (BS) showed abnormal increased uptake in the proximal and distal ends of the right femur along with increased uptake in proximal right humerus. X-ray images showed periosteal reaction involving diaphyseal ends of respective long bones, and these findings together with the patients history and normal biochemical profile suggested the presence of PP in this case. The patients condition was improved later after treatment with non-steroidal antiinflammatory drugs (NSAIDs), thus confirming our diagnosis. Conclusion: PP is one of the differential diagnoses in children presenting with pain or swelling in upper or lower limbs. As the condition is self-limiting, it is important to accurately diagnose this condition before subjecting the child to vigorous testing and treatments. Exceptional behavior of this condition on BS should also be kept in mind.

Keywords: 99mTc-MDP bone scan, X-rays, physiological periostitis, case report, green

Pubmed Style

Warda Ahmad, Muhammad Iqbal, Muhammad Naeem, Owais bin Qadeer, Muhammad Babar Imran, Muhammad Shahzad Afzal. Physiologic Periostitis: Erroneous presentation on 99mTc MDP bone scintigraphy - a case report. EJMCR. 2020; 28 (October 2020): 364-367. doi:10.24911/ejmcr/173-1597812200

Web Style

Warda Ahmad, Muhammad Iqbal, Muhammad Naeem, Owais bin Qadeer, Muhammad Babar Imran, Muhammad Shahzad Afzal. Physiologic Periostitis: Erroneous presentation on 99mTc MDP bone scintigraphy - a case report. https://ejmcr.com/articles/1389 [Access: December 25, 2024]. doi:10.24911/ejmcr/173-1597812200

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Warda Ahmad, Muhammad Iqbal, Muhammad Naeem, Owais bin Qadeer, Muhammad Babar Imran, Muhammad Shahzad Afzal. Physiologic Periostitis: Erroneous presentation on 99mTc MDP bone scintigraphy - a case report. EJMCR. (2020), [cited December 25, 2024]; 28 (October 2020): 364-367. doi:10.24911/ejmcr/173-1597812200

Harvard Style

Warda Ahmad, Muhammad Iqbal, Muhammad Naeem, Owais bin Qadeer, Muhammad Babar Imran, Muhammad Shahzad Afzal (2020) Physiologic Periostitis: Erroneous presentation on 99mTc MDP bone scintigraphy - a case report. EJMCR, 28 (October 2020): 364-367. doi:10.24911/ejmcr/173-1597812200

Chicago Style

Warda Ahmad, Muhammad Iqbal, Muhammad Naeem, Owais bin Qadeer, Muhammad Babar Imran, Muhammad Shahzad Afzal. "Physiologic Periostitis: Erroneous presentation on 99mTc MDP bone scintigraphy - a case report." 28 (2020), 364-367. doi:10.24911/ejmcr/173-1597812200

MLA (The Modern Language Association) Style

Warda Ahmad, Muhammad Iqbal, Muhammad Naeem, Owais bin Qadeer, Muhammad Babar Imran, Muhammad Shahzad Afzal. "Physiologic Periostitis: Erroneous presentation on 99mTc MDP bone scintigraphy - a case report." 28.October 2020 (2020), 364-367. Print. doi:10.24911/ejmcr/173-1597812200

APA (American Psychological Association) Style

Warda Ahmad, Muhammad Iqbal, Muhammad Naeem, Owais bin Qadeer, Muhammad Babar Imran, Muhammad Shahzad Afzal (2020) Physiologic Periostitis: Erroneous presentation on 99mTc MDP bone scintigraphy - a case report. , 28 (October 2020), 364-367. doi:10.24911/ejmcr/173-1597812200