Table 2.

Differential diagnosis table for voriconazole-induced periostitis

Differential Diagnosis	X-Ray/CT	Bone scintigraphy
Voriconazole-induced periostitis	Diffuse dense and irregular periosteal reaction	Associated increased uptake
Fluoride excess/Periostitis deformans	Indistinguishable from voriconazole-induced periostitis	Associated increased uptake
Hypertrophic Osteoarthropathy	Long bone diaphyses Symmetric, generalized; smooth, linear, single layer periostitis Underlying carcinoma/chronic disease	Associated increased uptake
Thyroid Achropachy	Metacarpals/metatarsals most common Spiculated, lacy	Associated increased uptake
Venous Stasis	Lower extremities Associated phleboliths/cellulitis	Associated increased uptake
Leukemia	Adults- axial skeleton Smooth, lamellated or sunburst; permeative bone destruction	Increased uptake but may underestimate disease
Hypervitaminosis A	Ulna, lower leg, metatarsals, clavicle May be undulating with soft tissue nodularity	Associated increased uptake