Osseous scintigraphy and fracture: two traps for the diagnosis

It is generally accepted that on a bone scintigraphy with di-phosphonates -99mTc time of visualization of a fractured bone is approximately 48 hours. The purpose of this presentation is to show two pitfalls of interpretation: firstly the time of onset of fracture is sometimes much longer, on the other hand, for the same patient the display may not be the same for all fractures. Conclusions: This case shows that we can not definitively rule out the diagnosis of fracture when the bone scan was negative 48 hours after trauma. The literature also reports a 5% false negatives when the delay is less than 72 hours. In addition, early visualization of fractures should not let us believe that all injuries must be viewed. When the bone scan does not capture all the clinical appeal signs, we can not eliminate the possibility of another fracture. Therefore in case of clinical doubt, it is recommended to repeat the subsequent scan. (N.C.)