Bone Scan With SPECT/CT Demonstrated C1 to C2 Involvement in Rheumatic Arthritis

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...

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Published inClinical nuclear medicine Vol. 47; no. 7; p. 661
Main Authors Chuang, Tzyy-Ling, Chou, Shih-Chin, Chen, Yu-Ruei, Wang, Yuh-Feng
Format Journal Article
LanguageEnglish
Published United States 01.07.2022
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Summary: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.
ISSN:1536-0229
DOI:10.1097/RLU.0000000000004160