PMC4891618_01
Photographs of the lower extremities demonstrate multiple ulcerated lesions with surrounding violaceous changes in the skin. [Powerpoint Slide]
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Approximately five days prior to admission the patient experienced severe lower extremity pain from long-standing skin lesions (Figure 1).
Tc-99m bone scan reveals confluent areas of moderately increased activity predominately around the medial and lateral aspects of the thighs. This radionuclide distribution corresponded to the locations of the patient's cutaneous lesions. Minimal activity is also appreciated extending up the flanks to the level of the lower thorax. Of note on the bone scan is the patient's large body habitus. There are very faint renal outlines without bladder activity related to the underlying renal failure. [Powerpoint Slide]
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The imaging findings (Figure 2) demonstrate confluent areas of minimally increased activity extending up the flanks to the level of the lower thorax.
PMC4891618_02
Tc-99m bone scan reveals confluent areas of moderately increased activity predominately around the medial and lateral aspects of the thighs. This radionuclide distribution corresponded to the locations of the patient's cutaneous lesions. Minimal activity is also appreciated extending up the flanks to the level of the lower thorax. Of note on the bone scan is the patient's large body habitus. There are very faint renal outlines without bladder activity related to the underlying renal failure. [Powerpoint Slide]
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The imaging findings (Figure 3) demonstrate more focal activity in the lower extremities when compared to Case 1, more typical and specific for calciphylaxis.