Abstract
Three-phase Tc-99m MDP bone imaging of the feet was performed in a 69-year-old woman, a retired missionary who had worked in India and Africa. She was followed in the tropical disease clinic at our institution for a draining sinus from the dorsum of her right foot, which was cultured and found to be positive for Madurella mycetomatis. The three-phase bone scan, performed to assess disease activity and rule out underlying fractures before therapy was begun, showed marked hyperemia to the right forefoot on the anterior and plantar projections. Delayed images showed increased activity in the medial aspect of the right foot that corresponded to the destructive changes seen on the plain radiographs of the right foot. The scintigraphic appearance was more consistent with infection rather than an acute fracture.
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