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Small FOCI IN FEMUR WITH MINIMAL UPTAKE. What it means?

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I had a bone scan in February that my doctor told me was negative. It said that there were "multiple small foci in the knee and two small foci on the right femur with MINIMAL UPTAKE". I have arthritis in my knee so that isn't surprising.  But I'm worried about the foci higher up on the femur. 

One of the foci in the right femur was about half way up the leg, the other was a little lower. I don't remember any trauma to that leg. So, I wonder what can cause foci with MINIMAL uptake. Could lobular breast cancer mets show up very minimally?  I hope not.

Then I had another bone scan in April, and it was completely negative. It didn't even show arthritis in the knee. I am afraid it is a false negative.

My real question, is my doctor said the first scan was negative. I'm hoping you can give me some ideas of what could cause those 2 foci in the femur that isn't mets. As I said, I had not had trauma to the femur (and in February I had NOT started chemo yet  Also I have very dense bones, so it cannot be osteoarthritis). Can regular arthritis come in the middle of a bone, and not in a joint?  Are there some other alternatives?

Please help!

Category: Oncologist

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Category: Hematologist
 25 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com

A decision of whether a lesion is benign or malignant depends upon many factors taken into consideration. In PET SCAN, a value mentioned for each lesion as SUV determines the nature of the lesion. Can you send me your report ?

Moreover, there can be innumerable cause which can cause minimal uptake in bone. It would be really impossible to blindly guess. Additionally, it may direct you wrongly. So please help us to guide you properly in the right direction.
Feel free to discuss further,

Kind regards.


Patient replied :

Thank you for your answer, but this was not a pet scan, it was a bone scan.
It was bone scintigraphy. My doctor said that when the radiologist says "minimal uptake" it is negative. But I was just hoping you could give me some causes for minimal uptake (although it couldn't be trauma, chemo, or bones that are not dense enough--because I know I don't have those problems).
I have given you a copy to look at. But remember it is a bone scan NOT a pet scan.
The doctor didn't even think twice about it. He wasn't worried at all. Then I had another scan in April, and it was completely negative. No foci anywhere.
Should I just stop worrying--since my doctor said it is negative?
Do bone scans sometimes just show foci for no real reason?


Hello,
I am sorry, I read somewhere in the old consult as PET scan. I apologise.
Bone scans generally show uptake where there is bone destruction / growth activity happens. Normally all bones in the body undergo this process throughout the life. Bone scan to be interpreted as positive needs to have a significant uptake. Minimal and negative uptake are indicative of normal bone . So you can stop worrying about it. I am not worried about your reports at all.
I hope I addressed your concern. Kindly revert back in case of additional queries.
Regards.


Patient replied :

Thank you so much!!!! Do you think lobular cancer can show up minimally? My worry is a false negative. What do you think?
Also, why would those 2 foci have decided to have extra growth/destruction on that day. Does that make sense? Or is this just something that typically happens with bone scans???


Lobular cancer as per available scientific reports, can show minimal uptake on PET CT scan.
I don't think there is any evidence of such reports in Technitium bone scan as their mechanisms are completely different. I guess i mentioned this even earlier, in one of our conversations.
These variations can be present in bone scans.
Hope this was helpful,
Regards.


Dr. Prasad Eswaran
Category: Hematologist
Experience: 
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
Dr. Prasad Eswaran and 4 other Medical Specialists are ready to help you

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