Clinical Presentation
A patient with left hand pain and swelling.
(A) Three-phase bone scintigraphy of the distal upper extremities was acquired. Angiographic phase demonstrates an asymmetric increase in blood flow to the left upper extremity (arrow). (B) Blood pool (extracellular) phase demonstrates increased uptake throughout the left hand and wrist (arrow). (C) Delayed phase demonstrates increased left-sided osseous uptake, most pronounced at the wrist and all periarticular sites of the left hand (circle).
Differential Diagnosis
• Reflex sympathetic dystrophy (RSD): Increased blood flow, blood pool, and delayed periarticular uptake diffusely is the classic appearance of this entity.
• Inflammatory arthritis: This can also show increased blood flow, blood pool, and delayed activity but will not involve all joints uniformly.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
