Clinical nuclear medicine
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Clinical nuclear medicine · Jun 1999
Case ReportsAutonomic regulation of lymphatic flow in the lower extremity demonstrated on lymphoscintigraphy in patients with reflex sympathetic dystrophy.
Nuclear medicine techniques were used to show that the peripheral lymphatics are under autonomic control in much the same way as the blood vessels that supply the same anatomic region. ⋯ Peripheral lymphatic function is controlled by the autonomic nervous system. In reflex sympathetic dystrophy, peripheral edema may be caused by an increased sympathetic stimulus to the lymphatics. Further study of this phenomenon may show that nuclear medicine studies, such as bone scintigraphy and lymphoscintigraphy, can be used to distinguish patients who will benefit from sympathectomy from those who will not, thereby obviating invasive testing and unnecessary invasive treatment.
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Clinical nuclear medicine · Jun 1999
Case ReportsAnterior chest wall pain in postpartum costochondritis.
Costochondritis is a common diagnosis in patients with anterior chest wall pain in whom serious disease has been excluded. The diagnosis is usually made on clinical grounds, because laboratory and imaging investigations usually provide little information. The authors describe a young woman with postpartum costochondritis and discuss the role of bone scintigraphy in confirming the clinical diagnosis.
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It may be difficult to evaluate back pain in patients who have undergone spinal surgery, because symptoms may be secondary to all the possible abnormalities in patients who have not had surgery plus postoperative complications, including infection, unstable fusion sites, or transfer of biomechanical stresses to other regions. ⋯ Bone SPECT was useful in evaluating these patients to exclude bony lesions or to identify pseudarthrosis, abnormal facets, disc space-centered lesions, and sacroilitis.