[¹⁸F]Fluoride PET Indicates Reduced Bone Formation in Severe Glucocorticoid-induced Osteoporosis

Summary

A 61-year-old female patient presenting with mixed connective tissue disease (Sharp syndrome), underwent a long-term high dose glucocorticoid treatment because of multiple organ manifestations. Under steroid therapy she developed severe osteoporosis resulting in multiple fractures. A dynamic [¹⁸F]fluoride PET study in this patient revealed reduced fluoride influx in non-fractured vertebrae. This finding corresponds to pathogenetic concepts which propose an inhibition of bone formation as major cause of glucocorticoid-induced osteoporosis. In the light of the presented case it seems to be promising to evaluate the diagnostic benefit of [¹⁸F]fluoride PET in osteoporosis.

Zusammenfassung

Eine 61jährige, an einer Mischkollagenose (Sharp-Syndrom) erkrankte Patientin mußte aufgrund vielfältiger Organmanifestationen langfristig und hochdosiert mit Glukokortikoiden behandelt werden. Unter der Therapie entwickelte sich eine schwere Osteoporose mit multiplen Frakturen. In einer dynamischen [¹⁸F]Fluorid-PET-Studie wurde bei der Patientin ein erniedrigter Fluoridinflux in nicht frakturierte Wirbelkörper nachgewiesen. Dieser Befund korrespondiert zu pathogenetischen Vorstellungen, die eine verminderte Knochenneubildung als wesentliche Ursache der glukokortikoid-induzierten Osteoporose sehen. Nach dem vorliegenden Fall erscheint es aussichtsreich, den Nutzen der [¹⁸F]Fluorid-PET im Rahmen der Diagnostik der Osteoporose systematisch zu untersuchen.

Keywords

Osteoporosis - glucocorticoids - [¹⁸F]fluoride ion - positron emission tomography (PET)

Schlüsselwörter

Osteoporose - Glukokortikoide - [¹⁸F]Fluorid - Positronen-Emissions-Tomographie (PET)

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