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Gaucher disease, a rare inherited disorder of fat storage caused by an enzyme deficiency, results in enlargement of the spleen, an infiltration of Gaucher cells into bone marrow, and various skeletal problems which most often involve bone pain. Severe bone pain may be due to bone crisis (pain associated with local swelling and tenderness and often fever) or to pus-forming osteomyelitis (inflammation caused by an infectious organism). In order to differentiate between these two possible diagnoses, bone scanning may be employed, but its effectiveness is controversial. A study of 34 episodes of bone pain occurring in young people with Gaucher disease was undertaken to evaluate the role of bone-scanning in making this differential diagnosis. Patient age ranged from 6 to 20 years. Twenty-five patients were ultimately diagnosed with bone crisis. Delayed-image scanning was utilized; this scanning correctly diagnosed bone crisis in 23 of the 25 patients, a sensitivity of 0.92. Bone scanning and angiography (imaging of the blood vessels) were able to identify and localize most of the sites of the crisis. It is concluded that bone scanning is a simple and sensitive method of identifying the early stage of bone crisis in patients with Gaucher disease. (Consumer Summary produced by Reliance Medical Information, Inc.)