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Case Reports
. 2018 Dec 1;10(12):e1235-e1237.
doi: 10.4317/jced.55248. eCollection 2018 Dec.

Use of bone scintigraphy in the early diagnosis of bisphosphonate related osteonecrosis of the jaw. Case report and review of the literature

José-Darío Sánchez-López  1 , Paolo Cariati  1 , Jacobo Cambil-Martin  2 , Mercedes Villegas-Calvo  3 , María-Luisa Moreno-Martin  4
Affiliations
Case Reports

Use of bone scintigraphy in the early diagnosis of bisphosphonate related osteonecrosis of the jaw. Case report and review of the literature

José-Darío Sánchez-López et al. J Clin Exp Dent. .

Abstract

The main aim of the present report is to show the potential utility of bone scintigraphy for the diagnosis of jaw osteonecrosis. We report the history of a 62-year-old woman underwent breast cancer surgery in 2010. Moreover, patient received postoperative radiotherapy and chemotherapy. Intravenous bisphosphonates were also added to the treatment strategy to reduce the risk of bone metastasis. However, a hypermetabolic focus on left hemimandible was evidenced with a bone scintigraphy during follow up. After a careful study, the diagnosis of Bisphosphonate Related Ostneonecrosis of the Jaw (BRONJ) was carried out. This case highlights that bone scintigraphy may be extremely helpful for the early detection of BRONJ in high risk patient. Key words:Bone scintigraphy, mandibular osteonecrosis, bisphosphonates.

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Conflict of interest statement

Conflict of interest statement: The authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
Bone scintigraphy that shows gadolinium enhancement. Enhancement on the right shoulder corresponds to chronic arthralgia. Enhancement on the left hemimandible is related to subclinical BRONJ.
Figure 2
Figure 2
Pathological enhancement on left hemimandible (detail).
Figure 3
Figure 3
CT scan with osteosclerosis and bone sequestration areas, related to advanced stage BRONJ (red arrow).
See this image and copyright information in PMC

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