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Age / Sex : 64 / M
Chief complaint : left knee pain
What is your diagnosis?
Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer)
Courtesy : 최윤선 (Yun Sun Choi), 노원 을지대학교병원 (Nowon Eulji Medical Center, Eulji University)
Diagnosis: Erdheim-Chester disease
Discussion
Findings
Radiograph
Radiographs show bilateral and symmetric osteosclerosis in long bones, particularly in the diaphyseal and metaphyseal regions of the lower extremities, with epiphyseal sparing. Additionally, there is cortical thickening and loss of corticomedullary differentiation.
2. CT
CE CT images show patchy osteosclerotic lesions in the axial skeleton and the right proximal femur. Additionally, there is soft tissue infiltration involving the bilateral perirenal area and renal pelvis.
3. 99mTc scintigraphy
Bone scintigraphy shows increased uptake in bilateral femurs and tibias, bilateral humeri, bilateral clavicles, T and L-spines, and the skull.
References
1. Kumar P, Singh A, Gamanagatti S, Kumar S, Chandrashekhara SH. Imaging findings in Erdheim-Chester disease: what every radiologist needs to know. Pol J Radiol. 2018;83:e54-e62
2. Mamlouk MD, Aboian MS, Glastonbury CM. Case 245: Erdheim-Chester disease. Radiology. 2017;284(3):910-917
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