Bone Scan With SPECT/CT Demonstrated C1 to C2 Involvement in Rheumatic Arthritis. (22nd July 2022)

• Record Type: Journal Article
• Authors: Chuang, Tzyy-Ling; Chou, Shih-Chin; Chen, Yu-Ruei; Wang, Yuh-Feng
• Is Part Of: Clinical nuclear medicine. Volume 47:Number 7(2022)
• Page Start: 661
• Page End: 663
• Publication Date: 2022-07-22
• Subjects: bone scan -- bony erosion -- C1/C2 subluxation -- rheumatoid arthritis -- SPECT/CT; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000004160
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract: An 80-year-old man was treated with rituximab for active rheumatoid arthritis until 2019, now controlled with Salazopyrin, prednisolone, methotrexate, and folic acid. However, laboratory data showed elevated C-reactive protein and erythrocyte sedimentation rate. Whole-body bone scan showed bony and joint destruction to the upper cervical vertebra (C spine), bilateral shoulders, wrists, finger joints, ankles, and left knee. SPECT/CT localized the upper C spine uptake to the C1/C2 joint and adjacent C1 and C2 with C1/C2 subluxation. C spine CT showed vertical atlantoaxial subluxation and bony erosions.