Flare response seen in therapy for osteomalacia

Shiro Akaki, Kentaro Ida, Susumu Kanazawa, Yoshihiro Takeda, Yoshio Hiraki, Toru Endo

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


We report an interesting case of osteomalacia in which flare response was seen during therapy. The first 99mTc-methylene diphosphonate bone scan showed increased bilateral and symmetric uptake in the ribs, clavicles and iliac bones. Thoracic CT showed symmetric radiolucent seams (Looser's zones) in both ribs, which were pathognomonic of osteomalacia. A fter initiation of therapy with vitamin D, the patient's subjective symptoms gradually were relieved. On a second bone scan 4 mo after initiation of therapy, the hot spots in the ribs remained unchanged. Uptake in the bilateral clavicles had become more intense, and new hot spots were recognized in the right lower ribs and left tibia. A third bone scan after 10 mo demonstrated an obvious decrease in the number and intensity of the hot spots. Increased uptakes in the second scan were thought to be a flare response caused by therapy.

Original languageEnglish
Pages (from-to)2095-2097
Number of pages3
JournalJournal of Nuclear Medicine
Issue number12
Publication statusPublished - Dec 1 1998
Externally publishedYes


  • Flare response
  • Osteomalacia
  • Technetium-99m-methylene disphosphonate bone scan

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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