“Cold bone scans” as a sign of hemorrhagic infarcts of the spine in Gaucher's disease

Abstract

The most common form of Gaucher's disease, type 1 (chronic non-neuronopathic), results in accumulation of glucocerebroside in reticuloendothelial cells of the spleen, liver and bone marrow, with frequent occurrence of bone pain due to vaso-occlusive crisis. We report the finding of a “cold” vertebral body on bone scan in two patients with Gaucher's disease and bone crisis. Photopenia was so striking as to give the appearance of a “missing” vertebra. Concurrent plain films appeared normal. In one patient Gaucher's disease had not previously been diagnosed.