PMC3180725_01
Radiograph of both forearms AP view shows linear periosteal reaction
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F1
The digital skiagram of both hands AP view showed the presence of shaggy periosteal reaction in the distal radius on both sides, also involving parts of the epiphysis [Figure 1].
Radiograph of both hands AP view shows shaggy periosteal reaction in the distal radius bilaterally involving the epiphysis. Increased cortical thickness in the region of the diaphysis of the metacarpals, proximal and middle phalanges
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F2
There was increased thickening of the cortical bone in the region of diaphysis of all metacarpal bones, proximal and middle phalanges [Figure 2].
Radiograph of both legs shows periosteal reaction involving tibia and fibula on both sides, extending to involve the epiphysis
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F3
Similar periosteal reaction involving the tibia and fibula on both sides was noted [Figure 3].
Posterior view of distal forearm and hands shows increased uptake in the phalanges, distal ends of metacarpals, radius and ulna
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F4
It showed the presence of pericortical linear uptake along the distal ends of tibiae, fibulae, ulnae and radii [Figure 4].
Anterior view of feet and lower limb on a Tc-99m MDP bone scan shows pericortical uptake in the distal ends of tibia and fibula. Prominent uptake in distal ends of 1st metatarsal and phalanges of both feet is also seen
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F5
There was increased radiotracer concentration in the terminal phalanges of feet, metacarpophalyngeal, interphalyngeal joints and phalanges of both hands [Figures 5 and 6].
Posterior view of both lower limb and feet showing increased uptake at the distal ends of tibia and femur bilaterally with increased pericortical uptake at distal ends
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F6
There was increased radiotracer concentration in the terminal phalanges of feet, metacarpophalyngeal, interphalyngeal joints and phalanges of both hands [Figures 5 and 6].
Whole body bone scan with normal chest anterior and posterior view and normal axial skeleton
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F7
The axial skeleton appeared normal [Figure 7].