A 34-year-old man with history of Hodgkin lymphoma presented 7 months after allogeneic stem cell transplantation with an unexplained severe musculoskeletal pain syndrome. A 99mTc-MDP bone SPECTCT showed multiple foci with moderate to intense bone uptake across the axial and appendicular skeleton consistent with periostitis. The patient had been on voriconazole daily for 4 months to treat an Aspergillus pneumonia, and in the absence of other causes, a drug-induced periostitis was suspected. Voriconazole was changed to posaconazole with complete resolution of the musculoskeletal symptoms within 3 weeks.
From the Departments of *Nuclear Medicine and Molecular Imaging, and
†Radiology, University Hospitals Leuven;
‡Department of Imaging and Pathology, Catholic University of Leuven;
§Department of Hematology, University Hospitals Leuven; and
∥Department of Public Health and Primary Care, Catholic University of Leuven, Leuven, Belgium.
Received for publication August 31, 2018; revision accepted October 7, 2018.
Conflicts of interest and sources of funding: none declared.
Correspondence to: Sander Jentjens, MD, Department of Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. E-mail: firstname.lastname@example.org.