Case Report Bone and spleen uptake of technetium-99m-methylene diphosphonate in a patient with sickle-cell disease: A case report from Sudan Suliman Salih, PhD National Cancer Institute, University of Gezira, Wedmedani, Sudan Department of Diagnostic Radiologic Technology, Taibah University, Almadinah Almunawwarah, Kingdom of Saudi Arabia Received 11 July 2013; revised 24 September 2013; accepted 24 September 2013 ﺍ ﻟ ﻤ ﻠ ﺨ ﺺ ﻳ ﻮ ﺿ ﺢ ﻫ ﺬ ﺍ ﺍ ﻟ ﺘ ﻘ ﺮ ﻳ ﺮ ﺍ ﻟ ﺪ ﻭ ﺭ ﺍ ﻟ ﻬ ﺎ ﻡ ﺍ ﻟ ﺬ ﻱ ﻳ ﻘ ﻮ ﻡ ﺑ ﻪ ﻗ ﻴ ﺎ ﺱ ﻧ ﺸ ﺎ ﻁ ﺍ ﻟ ﺘ ﻜ ﻨ ﺸ ﻴ ﻮ ﻡ99 ﻡ ﺍ ﻟ ﻤ ﻮ ﺳ ﻮ ﻡ ﺑ ﺎ ﻟ ﻤ ﻴ ﺜ ﺎ ﻧ ﻴ ﻞ ﺛ ﻨ ﺎ ﺋ ﻲ ﺍ ﻟ ﻔ ﻮ ﺳ ﻔ ﻮ ﻧ ﺎ ﺕ) Tc-99m MDP ( ﻓ ﻲ ﺍ ﻟ ﺘ ﺸ ﺨ ﻴ ﺺ ﺍ ﻷ ﻭ ﻟ ﻲ ﻟ ﻶ ﻓ ﺎ ﺕ ﺍ ﻟ ﻌ ﻈ ﻤ ﻴ ﺔ ﺍ ﻟ ﺘ ﻲ ﺗ ﻨ ﺘ ﺞ ﺑ ﺴ ﺒ ﺐ ﻓ ﻘ ﺮ ﺍ ﻟ ﺪ ﻡ ﺍ ﻟ ﻤ ﻨ ﺠ ﻠ ﻲ ﻭ ﻣ ﺘ ﺎ ﺑ ﻌ ﺔ ﻫ ﺬ ﻩ ﺍ ﻟ ﺤ ﺎ ﻻ ﺕ. ﺑ ﻴٰ ﻦ ﺗ ﻔ ﺮ ﺱ ﺍ ﻟ ﺠ ﺴ ﻢ ﺍ ﻟ ﻜ ﻠ ﻲ ﺑ ﺎ ﺳ ﺘ ﺨ ﺪ ﺍ ﻡ ﺍ ﻟ ﺘ ﻜ ﻨ ﺸ ﻴ ﻮ ﻡ99 ﻡ ﺍ ﻟ ﻤ ﻮ ﺳ ﻮ ﻡ ﺑ ﺎ ﻟ ﻤ ﻴ ﺜ ﺎ ﻧ ﻴ ﻞ ﺛ ﻨ ﺎ ﺋ ﻲ ﺍ ﻟ ﻔ ﻮ ﺳ ﻔ ﻮ ﻧ ﺎ ﺕ ﻓ ﻲ ﺍ ﻟ ﺤ ﺎ ﻟ ﺔ ﺍ ﻟ ﺘ ﻲ ﺑ ﻴ ﻦ ﺃ ﻳ ﺪ ﻳ ﻨ ﺎ ﺯ ﻳ ﺎ ﺩ ﺓ ﻣ ﻠ ﺤ ﻮ ﻇ ﺔ ﻓ ﻲ ﺍ ﻟ ﻨ ﺸ ﺎ ﻁ ﻓ ﻲ ﻣ ﻨ ﻄ ﻘ ﺔ ﺍ ﻟ ﻄ ﺤ ﺎ ﻝ، ﻭ ﻓ ﻲ ﺍ ﻟ ﺰ ﻧ ﺪ ﺍ ﻷ ﻳ ﻤ ﻦ ﻭ ﺭ ﺃ ﺱ ﺍ ﻟ ﻔ ﺨ ﺬ ﺍ ﻷ ﻳ ﺴ ﺮ ﻣ ﺘ ﺴ ﻘ ﺔ ﻣ ﻊ ﺍ ﺣ ﺘ ﺸ ﺎ ﺀ ﺍ ﺕ ﺍ ﻟ ﻌ ﻈ ﺎ ﻡ. ﻣ ﻦ ﺃ ﻛ ﺜ ﺮ ﻃ ﺮ ﻕ ﺍ ﻟ ﺘ ﺼ ﻮ ﻳ ﺮ ﺍ ﻟ ﻤ ﻮ ﺛ ﻮ ﻕ ﺑ ﻬ ﺎ ﻓ ﻲ ﺍ ﻟ ﻜ ﺸ ﻒ ﺍ ﻟ ﻤ ﺒ ﻜ ﺮ ﻭ ﺗ ﺸ ﺨ ﻴ ﺺ ﺃ ﺯ ﻣ ﺎ ﺕ ﻓ ﻘ ﺮ ﺍ ﻟ ﺪ ﻡ ﺍ ﻟ ﻤ ﻨ ﺠ ﻠ ﻲ ﺍ ﻟ ﻌ ﻈ ﻤ ﻴ ﺔ ﻭ ﺍ ﻟ ﻼ ﻋ ﻈ ﻤ ﻴ ﺔ. ﻫ ﻲ ﻋ ﻤ ﻠ ﻴ ﺔ ﺗ ﻔ ﺮ ﺱ ﺍ ﻟ ﻌ ﻈ ﺎ ﻡ. ﺍ ﻟ ﻜ ﻠ ﻤ ﺎ ﺕ ﺍ ﻟ ﻤ ﻔ ﺘ ﺎ ﺣ ﻴ ﺔ: ﺁ ﻓ ﺎ ﺕ ﻓ ﻘ ﺮ ﺍ ﻟ ﺪ ﻡ ﺍ ﻟ ﻤ ﻨ ﺠ ﻠ ﻲ; ﺍ ﻷ ﺛ ﺮ ﻏ ﻴ ﺮ ﺍ ﻟ ﻄ ﺒ ﻴ ﻌ ﻲ ﻓ ﻲ ﺍ ﻟ ﻌ ﻈ ﺎ ﻡ ﻭ ﺍ ﻟ ﻄ ﺤ ﺎ ﻝ; ﺗ ﻔ ﺮ ﺱ ﺍ ﻟ ﻌ ﻈ ﺎ ﻡ ﺑ ﺎ ﻟ ﺘ ﻜ ﻨ ﺸ ﻴ ﻮ ﻡ99 ﻡ ﺍ ﻟ ﻤ ﻮ ﺳ ﻮ ﻡ ﺑ ﺎ ﻟ ﻤ ﻴ ﺜ ﺎ ﻧ ﻴ ﻞ ﺛ ﻨ ﺎ ﺋ ﻲ ﺍ ﻟ ﻔ ﻮ ﺳ ﻔ ﻮ ﻧ ﺎ ﺕ Abstract This case report demonstrates that measurement of the activity of technetium-99m-methylene diphosphonate in bone can play an important role in the diagnosis and fol- low-up of bone lesions in sickle-cell anaemia. In this case, the whole-body scan revealed remarkably increased activity in the spleen region, in the right ulna and in the left femoral head, consistent with bone infarcts. Bone scanning is a reli- able imaging method for early detection and diagnosis of osseous and extraosseous crises in sickle-cell anaemia. Keywords: 99mTc MDP bone scintigraphy; Bone and spleen abnormality; Sickle-cell disease crises Ó 2014 Taibah University. Production and hosting by Elsevier Ltd. All rights reserved. Introduction Sickle-cell disease is one of the most common chronic haemo- globinopathies in the world. 1 It is highly prevalent in Africa and the Mediterranean region 2,3 and is strongly associated with Plasmodium falciparum malaria. 4,5 Technetium-99m-methylene diphosphonate (Tc-99m MDP) bone scintigraphy has been used to detect sickle-cell disease involving the bones. Bone uptake varies in cases of bony in- farcts, with decreasing activity due to vascular occlusion and increasing uptake during the healing phase of bone infarction. 6,7 Corresponding address: Department of Diagnostic Radiologic Technology, Faculty of Applied Medical Sciences, Taibah University, P.O. Box: 30001, Kingdom of Saudi Arabia. Tel.: +966 148460008x3619, mobile: +966 597883039; fax: +966 148475970. E-mail: salim_suliman@hotmail.com (S. Salih) Peer review under responsibility of Taibah University. Production and hosting by Elsevier Journal of Taibah University Medical Sciences (2014) 9(1), 78–80 Taibah University Journal of Taibah University Medical Sciences www.sciencedirect.com 1658-3612 Ó 2014 Taibah University. Production and hosting by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jtumed.2013.09.008