PEDIATRICS Vol. 65 No. 2 February 1980, pp. 339-341
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Radionuclide Joint Imaging: Acute Rheumatic Fever Simulating Septic Arthritis

James A. Wolff Jr MD1, Elaine I. Tuomanen MDCM1, and I. David Greenberg MDCM FRCP(C)1

1 Montreal Children's Hospital, Montreal

Technetium (Tc-99m) diphosphonate skeletal imaging is a sensitive modality for the detection of joint disease.1 Recently, the combined use of Tc-99m diphosphonate and gallium (Ga-67) citrate has been advocated for the evaluation of inflammatory joint disease and in particular the differentiation of septic arthritis from adjacent osteomyelitis and cellulitis.2,3

The case of acute rheumatic fever (ARF) described here demonstrates diffuse radioactive gallium and phosphate uptake in an affected joint. The scan findings, not unexpectedly, simulated those of a septic arthritis. Differentiation of these two entities could only be made on the basis of the clinical and biochemical picture.

CASE REPORT