Bone scan appearance supportive of Schnitzler's syndrome: Report of two new cases

Schnitzler's syndrome is often characterized by bone pain, chronic nonpruritic urticaria, intermittent fever, and monoclonal immunoglobulin (IgM) gammopathy. In this study, we present 2 cases supportive of Schnitzler's syndrome, in which clinical features and laboratory results were suggestive of the diagnosis. Although arthralgia is one of the major symptoms, patients are rarely referred for bone scintigraphy. We present contributing bone scan findings for diagnosis of this syndrome. The scintigraphic appearance in these 2 patients demonstrated increased concentration of the radioactive tracer in the femora, tibiae, shoulder joints, elbow joints, ankle joints, and the metatarsals and correlated with the regions of symptomatic bone pain. The pattern of the bone scintigraphy in correlation with the clinical history and laboratory investigations are supportive of the final diagnosis.