Bone imaging—Tracer uptake in non-neoplastic osseous and nonosseous disease processes

Abstract

A 60-YR-OLD black male had resection of carcinoma of sigmoid colon. A bone scan was performed which showed no evidence of skeletal disease except increased 99mTc-phosphate uptake (Fig. 1) in the abdominal scar (Fig. 2). Due to postoperative complications, the patient died. At autopsy, gross calcification was noted in the site of abdominal scar. This case represents an example of nonosseous tracer uptake on a bone scan. The following is the gamut of uptake of 99mWc phosphate in a number of non-neoplastic osseous as well as nonosseous disorders. !. Osseous Causes A. Physiologic Variants Common: Growing epiphysis Shoulder uptake corresponding to handedness Multiple sternal ossification centers Uncommon: Spine curvature resulting in changes in spine distance from the collimator B. Traumatic (Iatrogenic) Common: Recent surgery (osteotomy, amputation, bone grafting, metallic fixation devices) on bone Cutting rib during thoracotomy Recent biopsy site of the bone or bone marrow II. Extraosseous Causes A. Soft Tissue Calcification Common: Myositis ossificans Post surgical healing