Contribution of a Three-Phase 99m Tc-HMDP Bone Scintigraphy Protocol Completed by SPECT-CT Scan in the Diagnosis and Management of Langerhans Cell Histiocytosis of Bones in an Adolescent

Abstract

Langerhans Cell Histiocytosis (LCH) or Histiocytosis X is a rare disorder of the reticuloendothelial system due to the accumulation of Langerhans cells in the tissues, most often organized into granulomas. The bone is the most affected organ. It can be a single osteolytic lesion or a multi-systemic form with organ dysfunction. We report herein the case of a 15-yearold adolescent male with bone pain in the hip evolving for two months in whom the diagnosis of unifocal bone langerhansian Histiocytosis was confirmed by a triple phase bone scintigraphy supplemented by SPECT CT objectifying a single focus of the disease at the greater left trochanter of the femoral bone without any other pathological bone fixation clearly identifiable on the other parts of the skeleton. This clinical case allows us to clarify the key role of a triple phase bone scan supplemented by SPECT CT in the diagnosis and management of Langerhans Cell Histiocytosis of bone in our context.