Joint Program in Nuclear Medicine
Diabetic with a Non-healing Ulcer
Presentation
A 65 year old male with a history of non-insulin dependent diabetes mellitus, alcohol abuse, and severe peripheral vascular disease presented with a non-healing ulcer of the left first toe.
Imaging Technique
Three Phase Bone Scan
25 millicuries of Tc-99m MDP were administered intravenously. Dynamic 2-5 second images were obtained for 60 seconds after injection (angiographic phase). A static tissue phase image was obtained. Delayed skeletal phase images were obtained at 2-4 hours after injection.
Gallium Scan
5 millicuries of Ga- 67 citrate were administered intravenously. Delayed images of the feet were obtained at 48 hours.
Images
Radiograph
Three Phase Bone Scan
Bone and Gallium Scans
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J. Anthony Parker, MD PhD, Tony_Parker@CareGroup.Harvard.edu
Three Phase Bone Scan
Bone and Gallium Scans