The Usefulness of Bone Scintigraphy in the Evaluation of Hypertrophic Osteoarthropathy after Chemotherapy: A Case Report and Literature Review

Received 1/12/2010; revised 1/29/2010; accepted 2/1/2010. For correspondence and reprints contact: Wan-Yu Lin, M.D., Department of Nuclear Medicine, Taichung Veterans General Hospital. 160 Section 3, ChungGung Road, Taichung 407, Taiwan. Tel: (886)4-23741349, Fax: (886)4-23741348, E-mail:[email protected] Hypertrophic osteoarthropathy (HOA) is a rare syndrome and most HOA is related to malignancy. A 67year-old heavy smoking male with lung adenosquamous carcinoma was given bone scintigraphy before therapy. The bone scan showed uneven radioactivity at the bilateral femoral shafts, the bilateral tibial shafts, bilateral humeurs and bilateral forearms, which are compatible with the typical pattern of HOA. This patient had symptoms of severe pain in both lower limbs. Nevertheless, radiography revealed normal bony texture. Two months after therapy, the bone scintigraphy revealed complete resolution of the abnormal radioactivity. In addition, the symptoms of severe lower limbs pain disappeared. In conclusion, we consider bone scan is a better tool than planar radiography in monitoring the resolution of HOA.