Pain palliation with strontium-89 in children with metastatic disease

Pain in children who have life-limiting conditions

Children and adolescents who have life-limiting conditions are vulnerableto acute and chronic pain problems. Many compounding and complicatingfactors often need to be explored in this setting. Barriers to effective painmanagement include poor assessment and measurement of pain anda lack of specialist knowledge. Fears regarding the use of opioids and theirassociation with the end of life must be addressed openly and with clarity.Day-to-day management should include continual appraisal of pain issuesif quality of life is to be maximized. Pain is a complicated phenomenon. The impact of pain and the compli-cated dynamic of suffering in children and young people who have life-lim-iting conditions must not be underestimated. The clinician must be vigilantand take responsibility for all aspects of pain management in these patients.

Nuclear medicine topics in pediatric musculoskeletal disease: techniques and applications

Musculoskeletal scintigraphy has excellent sensitivity for the evaluation of benign disease in children. Using illustrative cases, a spectrum of techniques and applications of nuclear medicine studies for benign bone diseases are presented. An approach to the use and evaluation of bone density evaluation in children also is discussed.

Strontium-89 (89Sr) analgesia for rare thymic carcinoid tumor with bony metastases

The authors report the cases of two patients in whom strontium-89 (89Sr) was used to relieve diffuse metastatic bone pain. The type of cancer involved, thymic carcinoid tumor, is itself rare and the risk of its metastasizing to the bone is very low. Both patients showed a measure of response to treatment, suggesting that this analgesic method has value for some patients. The marked benefit of one patient for a total of 9 months was attributable to two 89Sr injections, whereas the other patient improved for only 5 weeks after one injection.