الفهرس 
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Abstract
Prostate cancer is the most common non-cutaneous malignancy for men. Bone metastases cause severe complications, such as pathological fractures, spinal cord compression and bone pain, resulting in an overall compromised quality of life. Bone scintigraphy is commonly used for the detection and monitoring of metastatic spread of the cancer to the skeleton. The present study aimed to evaluate the pattern of distribution of bone metastases in prostate cancer patients by Tc-99m methylene diphosphonate (Tc-99m MDP) bone scintigraphy an series of 150 consecutive patients with prostate cancer. In the present study, the studied patients had a mean age of 61.2 ± 10.2 years. Among the studied patients, 67 patients (44.7 %) had irritative symptoms while 25 patients (16.7 %) had obstructive symptoms and 95 patients (63.3 %) had bone pain. Regarding PSA levels, we found that among the studied patients, 84 (56.0 %) had a PSA of less than 10 and 66 patients (44.0 %) had PSA ≥ 10. In respect to Gleason score, 40 (26.7 %) had a Gleason score of less than 6, 33 patients (22.0 %) had a score from 6-7 and 77 patients (51.3 %) had a score more than 7. In the current study, 100 patients (66.7 %) out of screened 150 had metastatic bone disease.
In the present study, it was noted that spine was the most commonly affected site (60.0 %) followed by ribs (52.0 %) and femur (30.0 %). As regards the grade of bone metastases in the studied patients, we found that the studied patients include 61 patients with few bone metastases, 29 patients with moderate metastases and 10 patients with extensive bone metastases. In the current study, we found that patients with bone metastases had significantly higher frequency of bone pain when compared with patients without Also, patients with extensive bone metastasis had significantly higher frequency of skull, spine, scapula, humerous, sternum, ribs, iliac bone, ischium, and femur metastases when compared with patients with moderate metastases.
Prostate cancer frequently develops into bone metastasis. This study indicates that metastatic bony lesions of prostate cancer frequently distribute in the spine followed by ribs and femur.
Predilection sites of bone metastasis mainly include iliac bones, femurs, humeri and skull.
This study shows that patients with bone metastases had significantly higher frequency of bone pain when compared with patients without.
Our results show no significant differences between the studied groups regarding PSA levels and patients’ age.
Patients with extensive bone metastasis had significantly higher frequency of skull, spine, scapula, humerous, sternum, ribs, iliac bone, ischium, pubis and femur metastases when compared with patients with moderate and few metastases.