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IMAGE INTERPRETATION · BONE IMAGING

Diffuse Skeletal Metastases on Bone Scan

Whole-body bone scintigraphy (Tc-99m)
Whole-body bone scintigraphy (Tc-99m)

CC BY-SA 3.0 · Wikimedia Commons · source file

Question

This whole-body bone scan shows multiple foci of abnormally increased tracer uptake scattered throughout the axial skeleton — spine, ribs, pelvis, and skull. In a patient with known carcinoma, this pattern is most consistent with:

  1. AMultifocal osteomyelitis
  2. BHyperparathyroidism
  3. CDiffuse skeletal metastases
  4. DPolyostotic Paget's disease
Show the answer and explanation

C. Diffuse skeletal metastases

Multiple randomly distributed foci of increased uptake throughout the axial and appendicular skeleton in a patient with known primary cancer is the classic pattern of diffuse skeletal metastases. Prostate and breast cancer most commonly cause osteoblastic (hot) metastases on bone scan. Paget's disease shows intense uptake in expanded bone segments. Hyperparathyroidism may cause a 'superscan' with generalized increased uptake but typically lacks the focal random distribution seen here.

More bone imaging images

Tc-99m MDP bone scan, focal uptake in the hip regionFemoral Neck Stress Fracture on Bone Scan Tc-99m MDP bone scan showing focal uptake at the femoral neckFemoral Neck Insufficiency Fracture on Bone Scan Three-phase bone scan: flow, blood pool, and delayed images of the lower extremityOsteomyelitis on Three-Phase Bone Scan Whole-body Tc-99m MDP bone scan (anterior and posterior projections)How Tc-99m MDP Localizes in Bone Whole-body Tc-99m MDP bone scan — anterior and posterior projections showing skeletal metastases patternBone Metastases: Prostate and Breast Primaries Whole-body bone scintigraphy showing diffusely increased skeletal uptakeSuperscan on Bone Scintigraphy
← Normal Whole-Body Bone Scan (Tc-99m MDP)Femoral Neck Stress Fracture on Bone Scan →

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