Hepatic abscess detected on a three-phase bone scan.

Abstract

A 12-year-old boy was examined for right shoulder pain and clinical signs of infection. A three-phase radionuclide bone scan was performed with Tc99m MDP to rule out osteomyelitis. The blood-pool phase showed a photopenic defect involving the dome of the right lobe of the liver, with a peripheral area of increased activity. Delayed bone images were normal. Subsequent computed tomography (CT) revealed a liver abscess corresponding to the lesion noted on the blood-pool image. The shoulder pain was most likely referred phrenic nerve pain secondary to irritation from the hepatic abscess.