TITLE:
Contribution of Bone Scintigraphy in the Diagnosis of a Calcaneus Fatigue Fracture in a Case at the Nuclear Medicine Department of Idrissa Pouye General Hospital (HOGIP) in Dakar
AUTHORS:
El-Hadji Amadou Lamine Bathily, B. Ndong, O. Diop, M. S. Djigo, K. Gueye, A. Kokou, G. Thiaw, G. Mbaye, L. A. D. Diouf, M. Soumboundou, A. R. Djiboune, P. M. Sy, O. Ndoye, M. Diarra, M. Mbodj
KEYWORDS:
Fatigue Fracture, Bone Scintigraphy, Sports
JOURNAL NAME:
Open Journal of Medical Imaging,
Vol.10 No.1,
March
31,
2020
ABSTRACT: Introduction:
Fatigue fractures are secondary to excessive, unusual, repeated mechanical
stress, occurring on healthy bone. Bone scintigraphy (BS) with 99mTc-HMDP is an
excellent means of diagnosis. We report a case of stress fracture of the
calcaneus with scintigraphic diagnosis, in a marathon runner. Patient and
Methods: He is a 40-year-old athlete in overtraining with right calcaneal pain
on running, intense at first, moderate in the middle and then persistent after
exercise. The interrogation found no trauma to the right foot and the x-ray of
the foot was without abnormality. The so 3 phases were performed following an injection
of 564 MBq of 99mTc-HMDP, with a SPECT gamma camera. Results: Bone scintigraphy
found in the early phase, hyper-perfusion and hyper-fixation of the right
calcaneal region compared to its left counterpart and in the bone phase
persistence of focal hyperfixation opposite the right calcaneus. This
scintigraphic aspect of the right calcaneus in an overtrained marathon runner,
in a painful context and in front of a normal X-ray, made us evoke a fracture
of fatigue. A complementary CT scan performed two days after the BS was without
abnormality. Conclusion: Fatigue fractures are micro-fractures generally not
noticed on radiography and CT. BS due to its high sensitivity is an excellent
or the best tool for the early diagnosis of stress fractures.