Volume 7 | Issue 3 | September-December 2021 | Page: 46-49 | Nurnadiah A Denil, Siti Zarina A Hassan
Authors: Nurnadiah A Denil MMed Nucl. Med. , Siti Zarina A Hassan MMed Nucl. Med. 
 Department of Nuclear Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Address of Correspondence
Dr Nurnadiah A Denil
Department of Nuclear Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Systemic mastocytosis is a rare disorder of the mast cells with a wide spectrum of clinical manifestations depending on the organs involved.
We report a case illustrating the role of Tc-99m hydroxyl diphosphonate (HDP) to assist in diagnosing systemic mastocytosis in a 4-year-old girl who presented right thigh pain and intermittent fever. She initially presented with right thigh pain. The findings of the radiograph of the lower limbs were unremarkable. MRI of the right femur showed heterogenous intramedullary signal within the right femur, involving the diaphysis and metaphyseal region. Based on the radiographs and MRI changes, the differential diagnosis of disseminated acute osteomyelitis was made. Bone scan with Tc-99 hydroxy diphosphonate (HDP) performed showed diffuse skeletal uptake involving the appendicular and axial skeleton. Bone biopsy of the femur showed the presence of mast cell infiltration.
Diagnosing systemic mastocytosis remains challenging due to the contradictory results of available imaging modalities. When interpreting a focal or diffuse uptake on bone scintigraphy, systemic mastocytosis should be considered, particularly in the paediatric age group.
Keyword: Systemic mastocytosis, Tc-99m bone scintigraphy
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|How to Cite this Article: Denil NA, Hassan SZA | Osseous Manifestation of Systemic Mastocytosis in a Paediatric Bone Scan: A Case Report | International Journal of Paediatric Orthopaedics | September- December 2021; 7(3): 46-49.|