RSNA2018病例（7）：男，60余岁，全身疼痛、疲乏、肌力弱及步态异常数年，有多发骨折、前列腺癌史，右大腿疼痛不适2-3年

Clinical History

Chronic pain, fatigue

muscle weakness

abnormal gait

OSTEOMALACIA 

FRACTURES

• Vitamin D deficiency/liver dz

• X-linked hypophosphatemia

• Drug toxicity

• Tumor-induced

MRI

• Heterogeneous 

• Primarily 

–T1 hyperintense 

–STIR isointense 

• *Foci of low signal 

• *Markedly enhancing

Imaging

– Size 

– Location 

– Density 

– Enhancement 

– *Tumor matrix 

•Amorphous 

•Punctate 

2018 RSNA

Image Interpretation Session

MSK

History

• Male in his 60’s

• Several years of generalized pain, fatigue, and muscle weakness with abnormal gait

• History of pubic ramus fractures and rib fractures

• Recent diagnosis of prostate cancer

– Watchful waiting

• 2-3 year history of pain and discomfort in right thigh

Additional Data

• Bone density evaluation → osteopenia

Clinical History

Chronic pain, fatigue

muscle weakness

abnormal gait

OSTEOMALACIA 

FRACTURES

• Vitamin D deficiency/liver dz

• X-linked hypophosphatemia

• Drug toxicity

• Tumor-induced

Laboratory

MRI

• Heterogeneous 

• Primarily 

–T1 hyperintense 

–STIR isointense 

• *Foci of low signal 

• *Markedly enhancing

Imaging

– Size 

– Location 

– Density 

– Enhancement 

– *Tumor matrix 

•Amorphous 

•Punctate 

Octreoscan

(Octreotide, 111In-pentetreotide)

• Tumors - high expression somatostatin receptors

–Neuroendocrine tumors

–Adrenal medullary tumors

–Merkel cell tumor of skin

–Pituitary adenoma

–Small-cell lung carcinoma

–Phosphaturic mesenchymal tumors

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FROM：http://archive.rsna.org/2018/Final%20Unknown%20Cases%2011.12.18.pdf