Translate this page into:
Tc99m-MDP bone scintigraphy in Engelmann-Camurati disease
Address for correspondence: Dr. Bhagwant Rai Mittal, Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh – 160 012, India. E-mail: brmittal@yahoo.com
This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article was originally published by Medknow Publications and was migrated to Scientific Scholar after the change of Publisher.
Abstract
Engelmann-Camurati disease (ECD) is a rare bone disorder characterized by autosomal dominant inheritance. It usually presents in early childhood and is associated with symmetrical diaphyseal sclerosis. We report a 20-year-old female with scintigraphic findings characteristic of ECD. She was treated with corticosteroids and showed marked clinical improvement.
Keywords
Bone scintigraphy
Engelmann-Camurati disease
progressive diaphyseal dysplasia
INTRODUCTION
Engelmann-Camurati disease (ECD) is an autosomal dominant bone disorder caused by mutations in the TGF1 gene[1] and is characterized by progressive bilaterally symmetrical diaphyseal sclerosis of the long bones. It presents prenatally or early during childhood with severe deformities and dwarfism and is characterized by marked thickening of the cortices limited to the diaphyseal regions of tubular bones, occurring on both periosteal and endosteal surfaces.[2] It usually presents in young children with gait disturbance and limb pain and deformity. Autosomal dominant transmission has been noted.[3] Scintigraphically, ECD presents as an increased tracer uptake in the diaphyses of the long bones with sparing of the metaphyses and epiphyses, with corresponding sclerosing dysplastic changes in X-rays.[4–6] This pattern of involvement of the diaphyses with sparing of the metaphyses and epiphyses is characteristic of ECD.[7]
CASE REPORT
We report a 20-year-old female, who presented with generalized weakness, dull aching pain in the legs and difficulty in waking. Neurologic work up was within normal limits. Bone marrow examination, performed to exclude malignancy, revealed normal bone marrow. Bone scintigraphy was diagnostic of ECD [Figure 1]. She was treated with corticosteroids and physiotherapy and showed marked improvement clinically.

Source of Support: Nil
Conflict of Interest: None declared.
REFERENCES
- The first Korean case of Camurati-Engelmann disease (progressive diaphyseal dysplasia) confirmed by TGFB1 gene mutation analysis. J Korean Med Sci. 2009;24:737-40.
- [Google Scholar]
- Progressive diaphyseal dysplasia (Engelmann's disease): Report of a sporadic case of the mild form. J Bone Joint Surg Am. 1980;62:465-72.
- [Google Scholar]
- Camurati-Engelmann disease.Genetics and clinical manifestations with a review of the literature. J Med Genet. 1972;9:73-85.
- [Google Scholar]
- Camurati-Engelmann disease on a 99mTc-HMDP bone scan. Eur J Nucl Med Mol Imaging. 2008;35:2143.
- [Google Scholar]
- Radionuclide bone scintigraphy in Engelmann-Camurati disease. Arch Dis Child. 2004;89:737.
- [Google Scholar]
- Scintigraphic evaluation of pamidronate and corticosteroid therapy in a patient with progressive diaphyseal dysplasia (Camurati-Engelmann disease) Clin Nucl Med. 2001;26:680-2.
- [Google Scholar]
