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IMAGE INTERPRETATION · BONE IMAGING

Paget’s Disease of Bone on Bone Scan

Whole-body bone scan showing intense uptake in expanded bony segments
Whole-body bone scan showing intense uptake in expanded bony segments

Public domain · Wikimedia Commons · source file

Question

A bone scan shows markedly intense, expanded-appearing uptake in the right hemipelvis and proximal femur, with bony enlargement visible on the delayed images. Alkaline phosphatase is markedly elevated. This pattern is most consistent with:

  1. AFibrous dysplasia
  2. BOsteoblastic metastases
  3. CAvascular necrosis
  4. DPaget's disease of bone
Show the answer and explanation

D. Paget's disease of bone

Paget's disease (osteitis deformans) produces dramatically intense radiotracer uptake in affected bones due to markedly increased bone turnover. The classic features on bone scan are: (1) expanded, enlarged bone contour; (2) intense homogeneous uptake (often described as 'hot as a light bulb'); (3) involvement extends to the articular surface; (4) markedly elevated alkaline phosphatase. The pelvis, skull, tibia, and vertebrae are the most common sites. Bone scan is more sensitive than radiographs for detecting Paget's disease and estimating extent of involvement.

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← Superscan on Bone ScintigraphyPhotopenic Bone Lesions: Multiple Myeloma →

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