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Journal of Computer Assisted Tomography:
Thoracic Imaging

Solitary Hot Spots in the Ribs on Bone Scan: Value of Thin-Section Reformatted Computed Tomography To Exclude Radiography-Negative Fractures

Niitsu, Mamoru; Takeda, Tohoru

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Purpose: The purpose of this study was to classify solitary, scintigraphy-positive and radiography-negative rib lesions and to clarify the features of rib fractures by using thin-section reformatted helical computed tomography (CT).

Methods: Forty-seven patients whose whole-body bone scans showed a solitary hot spot in a rib as their first abnormal scintigraphic finding and whose plain radiograph showed negative or indeterminate results were examined by thin-section reformatted CT. Final diagnosis was based on follow-up over a 20-month period.

Results: The final diagnosis included 17 cases of fractures where CT findings were fracture line, focal sclerosis, and callus formation. Fourteen ribs demonstrated intramedullary, focal osteosclerosis, and 8 ribs did not demonstrate any abnormalities. Four metastatic lesions appeared as intramedullary mixture of osteolysis and osteosclerosis, or bone destruction. Four intramedullary lesions with cystic appearance remained unchanged.

Conclusions: Thin-section reformatted helical CT delineated minute, radiographically occult fractures of the rib. Excluding fractures, helical CT can avoid further unnecessary examinations.

© 2003 Lippincott Williams & Wilkins, Inc.



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