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Szintigraphische Befunde bei einem Patienten mit Sichelzell-Thalassämie und rezidivierenden Schmerzattacken

Bone and bone marrow scintigraphy in a patient with sickle cell-thalassemia and recurrent pain attacks

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Zusammenfassung

Vorgestellt wird der Fall eines 8jährigen Knaben aus Schwarzafrika mit Sichelzellanämie und Thalassämiekomponente, bei dem es zu rezidivierenden Schmerzattacken abdominal und im Bereich des Bewegungsapparates kam. Lokale Schmerzen, bei einzelnen Schmerzkrisen in Kombination mit lokaler Schwellung und positive Ergebnisse im Entzündungslabor machen eine rein klinische Unterscheidung zwischen Knocheninfarkten und Osteomyelitis nicht möglich. Knochenszintigraphien, eventuell in Kombination mit Knochenmarkszintigraphien, können dem Kliniker eine Hilfestellung bei der Differenzierung zwischen Knocheninfarkt und Osteomyelitis geben. An Hand des Fallberichts werden szintigraphische Befunde bei Knocheninfarkt, Osteomyelitis und szintigraphische Besonderheiten bei Sichelzellkrankheit vorgestellt sowie Probleme betreffend der zeitlichen Durchführung der Szintigraphien diskutiert.

Summary

The case of an eight years old African boy who suffers from sickle cell-thalassemia is presented. In the course of the disease frequent pain attacks occurred within the abdomen and extremities, recently also within the trunk. Local pain, at some occasions in combination with local swelling and always positive laboratory parameters for inflammation, hindered a solely clinical differentiation between bone infarcts and osteomyelitis. Bone scintigraphy, eventually in combination with bone marrow scintigraphy, can assist the clinician in the differentiation of aseptic bone infarcts versus secondary osteomyelitis. Based on the presented case scintigraphic results for bone infarcts, osteomyelitis and special scintigraphic pattern seen in sickle cell disease are presented. Furthermore, problems regarding the interpretation of the scintigraphies in relation to the delayed time after the beginning of pain attacks are discussed.

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Authors and Affiliations

  1. Abteilung für Nuklearmedizin und Endokrinologie des Landeskrankenhauses Klagenfurt, Landeskrankenhaus Klagenfurt, St. Veiterstraße 47, A-9020, Klagenfurt

    Peter Mikosch, Hans-Jürgen Gallowitsch & Peter Lind

  2. Abteilung für Kinder- und Jugendheilkunde, Landeskrankenhaus Klagenfurt, St. Veiterstraße 47, A-9020, Klagenfurt

    Barbara Jauk & Wilhelm Kaulfersch

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  1. Peter Mikosch
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  2. Barbara Jauk
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  3. Wilhelm Kaulfersch
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  4. Hans-Jürgen Gallowitsch
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  5. Peter Lind
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Correspondence to Peter Mikosch.

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Mikosch, P., Jauk, B., Kaulfersch, W. et al. Szintigraphische Befunde bei einem Patienten mit Sichelzell-Thalassämie und rezidivierenden Schmerzattacken. WMW 153, 83–88 (2003). https://doi.org/10.1046/j.1563-258X.2003.02006.x

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  • DOI: https://doi.org/10.1046/j.1563-258X.2003.02006.x

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