Skip to main content

Advertisement

Log in

Osteonecrosis in an adolescent with non-Hodgkin lymphoma resembling a new metastatic lesion on 18F-FDG PET/CT

  • Case Report
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Osteonecrosis may result from complications in a variety of pediatric diseases and, in the early stages of healing, may be characterized by inflammation and hyperemia. While traditionally assessed by bone scintigraphy, osteonecrosis may also present upon [F-18]2-fluoro-2-deoxyglucose PET/CT. Differentiation of osteonecrosis from metastatic lesions is important to ensure accurate disease staging and to avoid unnecessary imaging and biopsy. Osteonecrosis typically presents at the interface of weight-bearing joints after prolonged chemotherapy with corticosteroid administration, although prevalence is greater in adults than in children. We describe a case of unilateral osteonecrosis in the tibia of an adolescent lymphoma patient, which first presented on FDG-PET/CT imaging after 2 months of combination chemotherapy with corticosteroid administration. This report should aid in recognizing rapid-onset osteonecrosis with atypical sites of involvement in pediatric patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Grigolon MV, Delbeke D (2001) F-18 FDG uptake in a bone infarct: a case report. Clin Nucl Med 26:613–614

    Article  PubMed  CAS  Google Scholar 

  2. Sohn MH, Jeong HJ, Lim ST et al (2007) F-18 FDG uptake in osteonecrosis mimicking bone metastasis on PET/CT images. Clin Nucl Med 32:496–497

    Article  PubMed  Google Scholar 

  3. Assouline-Dayan Y, Chang C, Greenspan A et al (2002) Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum 32:94–124

    PubMed  Google Scholar 

  4. Mattano LA Jr, Sather HN, Trigg ME et al (2000) Osteonecrosis as a complication of treating acute lymphoblastic leukemia in children: a report from the Children’s Cancer Group. J Clin Oncol 18:3262–3272

    PubMed  Google Scholar 

  5. Hanif I, Mahmoud H, Pui CH (1993) Avascular femoral head necrosis in pediatric cancer patients. Med Pediatr Oncol 21:655–660

    Article  PubMed  CAS  Google Scholar 

  6. Wang Y, Li Y, Mao K et al (2003) Alcohol-induced adipogenesis in bone and marrow: a possible mechanism for osteonecrosis. Clin Orthop Relat Res 213–224

  7. Love C, Tomas MB, Tronco GG et al (2005) FDG PET of infection and inflammation. Radiographics 25:1357–1368

    Article  PubMed  Google Scholar 

  8. Sakamoto M, Shimizu K, Iida S et al (1997) Osteonecrosis of the femoral head: a prospective study with MRI. J Bone Joint Surg Br 79:213–219

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amer Shammas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hong, T.S., Shammas, A., Navarro, O.M. et al. Osteonecrosis in an adolescent with non-Hodgkin lymphoma resembling a new metastatic lesion on 18F-FDG PET/CT. Pediatr Radiol 40 (Suppl 1), 27–29 (2010). https://doi.org/10.1007/s00247-010-1827-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-010-1827-z

Keywords

Navigation