Hypermetabolism in bilateral basal ganglia in Sydenham chorea on F-18 FDG PET-CT.

This is an 11-year-old girl with newly diagnosed Sydenham chorea. The patient presented with mood change for 6 months, hearing voices for a few weeks, and dysarthria and abnormal movements for a few days before medical attention. She did not have any recent infections, pharyngitis, or strep throat. In addition, she had no significant medical history or family history, especially neurologic disease or movement disorders. On physical examination, she had continuous choreoathetosis of 4 extremities, more prominent on the right. Brain MRI was unremarkable. The PET-CT images demonstrate significantly and symmetrically increased activity in bilateral caudate and putamen, compatible with Sydenham chorea. This case illustrates the characteristic PET findings of rare Sydenham chorea.