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. 2017 Oct-Dec;32(4):367-368.
doi: 10.4103/ijnm.IJNM_53_17.

Bone Scan in Evaluation of Bone Viability in Severe Frostbite of the Hand

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Bone Scan in Evaluation of Bone Viability in Severe Frostbite of the Hand

Ishan Garg et al. Indian J Nucl Med. 2017 Oct-Dec.

Abstract

A 39-year-old male presented to the emergency department (ED) with frostbite to the fingers of both hands. In the ED, he received warm baths, acetylsalicylic acid, clopidogrel, and heparin. A three-phase bone scintigraphy with technetium-99m-methylene diphosphonate revealed absent radiotracer uptake in distal phalanges of both hands. The patient received acetylsalicylic acid, clopidogrel and wound care for the next 5 days and made an excellent recovery with satisfactory wound healing in both hands. Early rapid rewarming and reperfusion can improve the prognosis significantly and therefore bone scan done within first 1-2 days may give spurious results.

Keywords: Bone scan; cold thermal injury; frostbite; hand.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Day 0 (a-f) swollen fingers with skin erythema, blue-gray discoloration of distal phalanges and large blisters (a and b - left hand, c and d - right hand). Technetium-99m-methylene diphosphonate three-phase bone scan revealed absent radiotracer uptake in the second to fifth distal phalanges of the right hand on blood pool (e) and delayed phase planar images (f). Day 14 (g - right hand) showing wound healing with re-epithelization of dorsal aspect of fingers

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