Delayed Epiphyseal Closure Seen on Tc-99m Methylene Disphosphonate Bone Scan in Association With Hypopituitarism

Evaluation of scintigraphic uptake at growth plates is a well-established method to assess the osteoblastic activity of skeletally immature patients for possible growth arrest secondary to vascular insult. Underlying endocrine abnormalities are known to be contributory in delayed epiphyseal closure. This is a report of an adult male patient with hypopituitarism whose Tc-99m methylene disphosphonate bone scan demonstrates uniform symmetric activity in all long bone physes. The mechanism of hormonal regulation on bone age maturation shows that the lack of circulating estrogen from hypopituitarism causes an arrest in epiphyseal closure with delayed fusion of the epiphyses.