Multimodality molecular imaging in arthropathy associated with multiple myeloma

• Published in: Indian journal of nuclear medicine Vol. 37; no. 3; pp. 290 - 292
• Main Authors: Almeida, Ludmila, de Souza, Stephan, de Souza, Fernando, Reis, Fabiano, Ramos, Celso
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-07-2022; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow
• Subjects: Arthritis; Bioaccumulation; Bone marrow; Case reports; Computed tomography; Fluorine isotopes; Interesting Image; Joints (anatomy); Medical imaging; Multiple myeloma; Photon emission; Positron emission; light-chain amyloidosis; 18F-fluorodeoxyglucose; 99mTc-methylene diphosphonate; multiple myeloma; arthropathy; 99mTc-sestamibi
• ISSN: 0972-3919; 0974-0244
• DOI: 10.4103/ijnm.ijnm_205_21

We report a patient with multiple myeloma (MM) and polyarthritis of large joints. During the staging of the disease, bone marrow diffusely involved by MM was clearly demonstrated by 99mTc-2-methoxy-isobutyl-isonitrile (MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) but not by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/CT images. On the other hand, a very intense uptake of 18F-FDG was detected in periarticular tissues of multiple joints, with nonabnormal 99mTc-MIBI accumulation. Rheumatology tests were negative. A subsequent bone scintigraphy demonstrated radiolabeled bisphosphonate accumulation in periarticular tissues, suggesting amyloid arthropathy.