Replies

The March 5, 1991 bone scan radiologist's report. The bold characters are actually part of the report's own emphasis. a Copy of this document is part of the parent's recent lawsuit introduced in federal court, dated August 30, 2003 (see Reply 105, above).

Radiologist's report; "Exhibit 'A'" of that lawsuit:

BONE SCAN
Indication: Evaluate for trauma
Procedure and findings: Multple gamma camera images of the
axial and proximal appendicular skeleton in the anterior and
posterior projections were obtained, following 21.1
millicuries of Technetium 99m HDP. There are extensive
number of focal abnormal areas of nuclide accumulation of
intense type. These include multiple bilateral ribs, the
costovertebral aspects of several of the thoracic vertebral
bodies, the L1 vertebral body, both sacroiliac joints, the
distal right femoral diaphysis, both knees, and both ankles,
right greater than left. Correlative radiographs are
obtained of the lumbar spine and of the right femur which
reveal compression fracture, minor, superior end plate of L1
and shaggy irregular periosteal ossification along the
distal femoral diaphysis and metaphysis primarily
ventrally. The patient has a history of trauma, most
likely the femoral periosteal reaction reflects a response
to a subperiosteal hemorrage and the activity in L1
correlates perfectly with the compression fracture which is
presumably traumatic. The presumption is that the other
multiple areas of abnormal activity also relate to previous
trauma. Additional possibility would be neoplastic bone
disease, widespread disseminated infectious bone disease or
multiple bone infarcts from abnormal hemoglobin.
CONCLUSION
Multiple areas of abnormal scintigraphic accumulation some
of which are radiographic for differential as discussed
above.
W. Campbell Walker. M.D./mjt
Dictated 3/5/91
Transcribed 3/5/91