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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A technetium 99m diphosphonate scan is a sensitive detector of bony metastases of breast, prostate, and lung cancer. For these particular neoplasms, a negative bone scan in an asymptomatic patient is adequate evidence for absence of bony metastases and a correlative roentgenographic examination may not be necessary. Positive studies demonstrating multiple characteristic discrete areas of increased activity should be considered strong evidence for metastases. Single equivocal lesions require roentgenographic and occasionally biopsy correlation. If roentgenography fails to reveal the source of increased uptake, (e.g., degenerative disease) the scan lesion should remain suspicious for metastases.
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PMID:Accuracy of 99mTC-diphosphonate bone scans and roentgenograms in the detection of prostate, breast and lung carcinoma metastases. 123 61

Solitary abnormalities in bone scintigrams of cancer patients are a finding causing special diagnostic problems. In a prospective study the value of MRI imaging of the bone marrow was to be ascertained when compared to recognized X-ray studies, as a method of clarifying suspect bone scintigraphy findings. 25 cancer patients presenting with a solitary suspect abnormality in bone scintigrams were examined by X-rays and MRI. In 15 patients, MRI showed that metastases were the probable cause of the hot spot. In 7 patients, radiography, the routinely used method to confirm or exclude the presence of metastases, failed to detect these metastases. In the remaining 10 patients other causes of increased activity in the bone scintigrams could be demonstrated, e.g. fracture, degenerative disease, benign tumour. The results were confirmed by biopsy, operation, autopsy or follow-up. Considering the clinical consequences of the diagnosis of bone metastases, we suggest that a bone marrow MRI of the affected region should be performed to clarify the cause of a solitary hot spot in bone scintigrams of cancer patients, especially if X-ray studies are inconclusive.
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PMID:[Magnetic resonance tomography of the bone marrow in cancer patients with a solitary area of increased uptake in the bone scintigram]. 207 88

Recent findings suggested a possible role for pinhole collimator scintigraphy to differentiate between metastases, infection and fractures of the vertebrae. The aim of this study was to verify these findings and to ascertain whether we could identify any other specific scintigraphic patterns. The study group consisted of 58 patients. A metastatic pattern was obtained in 18 patients, while 16 showed the compression fracture pattern, 3 the tuberculosis pattern and 1 the pyogenic infection pattern. The study was considered normal in 4 patients and showed a nonspecific pattern in 4. Sensitivity was 85% for the metastatic pattern and 83% for the compression fracture pattern. Specificity was 94% for both patterns. Unique new patterns were identified in Paget's disease and in degenerative disease of the vertebrae (12 patients). Pinhole scintigraphy of the vertebrae is a valuable aid for detecting specific diseases of the vertebrae. Our findings suggest a valuable new role for skeletal scintigraphy, improving the specificity and obviating, in most cases of vertebral disease, the need for additional investigations.
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PMID:[The value of pinhole collimator imaging in the scintigraphic analysis of vertebral diseases]. 292 72

Twenty patients with known metastatic cancer or high-risk primary cancer developed new lesions on Tc 99m bone scans and had normal plain radiographs. Spinal computed tomography (CT) was performed on all new bone-scan-positive lesions in minimal examination time. Fifteen patients had extensive metastatic vertebral disease and received local radiotherapy. One patient with new metastatic vertebral disease on CT was treated only with chemotherapy and developed acute spinal cord compression. Four patients had discogenic disease or degenerative disease but no evidence of metastases. Radionuclide bone scans are more sensitive but less specific than plain radiographs in detecting early bone metastases. Early and accurate diagnosis of metastasis is particularly important in the axial spine to prevent epidural compression and fracture. Spinal CT is valuable for identifying the presence and extent of vertebral metastases, as well as the presence of benign disease in cancer patients.
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PMID:Spinal computed tomography scanning in the evaluation of metastatic disease. 623 98

Increased patellar uptake on bone scans is seen quite commonly but the possible or probable etiologies of this finding have not been previously well described. A review of 100 consecutive bone scans showed that the incidence of bilateral "hot" patellae is 15%. Identified etiologies include osteoarthritic degenerative disease (35%), fracture, possible metastatic disease, bursitis, Paget's disease, and osteomyelitis. The value of careful history, physical examination, and radiographs is stressed.
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PMID:The "hot" patella. 646 May 76

Instability of the cervical spine gives rise to vertebral and neurological symptoms which may be progressive. The principal causes of instability are: trauma, sequelae of laminectomy, malformations, vertebral infections, rheumatoid arthritis, primary tumours (benign and malignant), metastases, and chronic degenerative disease of the discs. Each of these forms of instability must be identified and, depending on the symptoms and pathogenesis, is capable of responding to the appropriate treatment.
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PMID:Diagnosis and treatment of cervical instability. 715 81

In recent years there has been spectacular progress in the approach to various disorders of the spinal column. Owing to improved methods of osteosynthesis there is no longer so much need for long periods of postoperative bed rest. Of all the scolioses, idiopathic scoliosis is most common. The vast majority of these cases are not clinically significant. What is seen in the remaining cases if left untreated is a progression in the curvature during growth. Progressive idiopathic scoliosis can be effectively treated using conservative methods. Screening at school is an important part of this process. If the curvature proves progressive and skeletal growth is not complete a brace can be prescribed. Use of this strategy and form of treatment can avoid progression of the curvature and development of serious deformities. This conservative therapy has markedly reduced the need for corrective surgery. Scheuermann's disease is characterized by a fixed dorsal thoracic kyphosis. Progressive Scheuermann's kyphosis can be effectively treated using a brace. The majority of fractures of the vertebral bodies can be treated conservatively. However, serious fractures normally require surgical intervention. In the industrialised Western world, low back pain is a major health problem and the foremost cause of disability and unfitness for work. Low back pain caused by degenerative disease of the spinal column should be treated using a multidisciplinary approach. The development of advanced operative techniques and osteosynthesis methods has made it possible to treat metastases of the spine surgically. The effects of this treatment on the quality of life are encouraging.
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PMID:[One hundred years of orthopedics in the Netherlands. IV. Spinal abnormalities]. 962 1

Bone scintigraphy and single photon emission computed tomography (SPECT) may be performed for evaluation of lower back pain, especially when a bone abnormality is suspected. Various patterns of tracer activity based on precise identification of the anatomic location of increased uptake may be observed and used to evaluate bones and joints. Lesions centered about the disk space and vertebral body include spondylodiskitis, metastatic disease, vertebral body fracture, and degenerative disease (disk disease, spondylosis deformans). In diskitis, tracer uptake has a vertical orientation. Metastatic involvement should be suspected in solitary lesions evaluated with SPECT when the area of increased uptake extends from the vertebral body into the pedicle. Fractures are seen on planar and SPECT images as a linear, horizontally oriented area of increased uptake centered in the vertebral body. In degenerative disease, increased uptake is centered about the disk space and may be seen in and project beyond the surface of the vertebral body. Lesions of the posterior arch (comprising the pedicle, lamina, and facet joints) include spondylolysis, pedicle lesions, osteoarthritis of the facet joints, and fracture of the transverse process. Scintigraphy may help differentiate long-standing asymptomatic spondylolysis from ongoing disease. In osteoarthritis of the facet joints, SPECT may be used to select patients to be treated with therapeutic injections. Increased uptake in the transverse process most often indicates a fracture, although tumors may also occur in this location. These findings at planar bone scintigraphy and SPECT allow differentiation of common pathologic conditions and can lead to a specific diagnosis.
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PMID:Evaluation of lower back pain with bone scintigraphy and SPECT. 1046 98

A 58-year-old woman presented with non-radicular pain in the upper thorax. Due to the prolonged duration of symptoms, a bone scintigraphy was made, which showed pathological enhancement in the upper thoracic spine. An MRI demonstrated lesions of the third and fourth thoracic vertebrae. A biopsy showed a metastasis of poorly differentiated carcinoma. A whole-body 18-F-FDG PET scan failed to identify a primary tumour. The patient was given radiotherapy, chemotherapy and analgesic treatment. She died within 3 years. In the late stage, the tumour marker CA 19-9 was positive; however, an MRI of the abdomen failed to identify a pancreatic tumour. Metastasis from an unknown primary site can present as cervical spinal disease very similar to degenerative disease.
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PMID:Spinal pain due to metastasis of unknown origin. 1568 89

Procedures involving anterior surgical decompression and fusion are being performed with increasing frequency for the treatment of a variety of pathological processes of the spine including trauma, deformity, infection, degenerative disease, failed-back syndrome, discogenic pain, metastases, and primary spinal neoplasms. Because these operations involve anatomy that is often unfamiliar to many neurological and orthopedic surgeons, a significant proportion of the associated complications are not related to the actual decompressive or fusion procedure but instead to the actual exposure itself. To understand the nature of these injuries, a detailed anatomical study and dissection was undertaken in six cadaveric specimens. Critical structures at risk in the abdomen and retroperitoneum were identified, and their anatomical relationships were categorized and photographed. These structures included the psoas muscle, kidneys, ureters, diaphragm and crura, esophageal hiatus, thoracic duct, greater splanchnic nerves, phrenic nerves, sympathetic chains, medial arcuate ligament, superior and inferior hypogastric plexus, segmental and radicular vertebral vessels, aorta, vena cava, median sacral artery, common iliac vessels, iliolumbar veins, lumbosacral plexus, and presacral hypogastric plexus. Based on these dissections and an extensive review of the literature, the authors provide a detailed anatomically based discussion of the complications associated with anterior lumbar surgery.
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PMID:Complications during anterior surgery of the lumbar spine: an anatomically based study and review. 1691 8


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