Decreased Tc-99m MDP Uptake in Myelonecrosis

Abstract

A 29-year-old man was admitted to the hospital with bone pain and pancytopenia. Multiple bone marrow biopsies and aspirations were performed. Pathologic and morphologic examination of the bone marrow revealed myelonecrosis. Myelonecrosis was diagnosed resulting from excessive administration of diclofenac sodium for renal colic. Large areas of decreased Tc-99m-methylene diphosphonate (MDP) uptake in multiple ribs and eyeglasses-shaped large hypoactive areas in both sacroiliac joints were seen on Tc-99m MDP bone scintigraphy at the third week. It was seen that large areas of decreased Tc-99m MDP uptake in the anterior region of the right second and third ribs and defective small focal areas in the posterior region of the left fourth and fifth ribs persisted, whereas other findings of the ribs and sacroiliac joints improved. Slightly increased activity was seen in the iliac crest biopsy regions on Tc-99m MDP bone scintigraphy at the fourth month.