Nuclear medicine
A triple phase bone scan of the neck was performed followed by whole-body study and SPECT/CT of the neck.
Dynamic flow and blood pool images show focally increased perfusion and vascularity in the right side of the mid survival spine.
Delayed SPECT/CT static images show a single focus of intense increase in tracer uptake located between the right lateral masses of the C4 and C5 vertebrae and invading the right C4-5 apophyseal joint from anteriorly. This corresponds to a definite calcified irregularity seen on the CT scan at the site.
No other significant abnormalities are seen in the neck or upon following whole-body bone scan..
Overall impression :
Appearances are suspicious of a bone tumour or osteomyelitis or (very unusually hence unlikely) still active myositis ossificans in the right C4-C5 inter lateral mass invading the right C4-5 apophyseal joint from anteriorly. This abnormality is scintigraphically too intense for osteoarthritic type apophysitis and a simple fracture or myositis ossificans/heterotopic calcification would be expected to scintigraphically heal after 3 years.