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BMJ Case Reports 2017; doi:10.1136/bcr-2017-222258
  • Images in…

Bone and muscular viability assessment before amputation: usefulness of bone scan and 99mTc sestamibi dual-phase scintigraphy

Editor's Choice
  1. Ariane Boubaker4
  1. 1 Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
  2. 2 Pediatric Intensive Care Unit, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
  3. 3 Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
  4. 4 Department of Nuclear Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
  1. Correspondence to Dr Steve Durante, steve.durante{at}me.com
  • Accepted 9 October 2017
  • Published 19 October 2017

Description

99mTc-sestamibi has been used to evaluate metabolic muscle abnormalities since 25 years.1 Uptake and retention in myocytes correlates with mitochondrial content and has been used to evaluate muscle functionality and viability.2

A 2-year-old boy presented with extensive musculoskeletal necrosis due to streptococcal septicaemia. Level of amputation of right arm was modified during surgery, necrosis being far more extensive than predicted by a preoperative MRI. Therefore, a bone scan was done to assess perfusion and bone viability before amputation of both legs …

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