Abstract
A 61-year-old woman with a history of lupus had a Positron emission tomography-computed tomography (PET-CT) scan as part of a malignancy workup for new cerebellar lesions. She had presented with new onset headaches. A CT scan of the thorax, abdomen, and pelvis, done 2 months earlier, had only shown an asymptomatic left hip joint effusion that was attributed to a nonerosive synovitis, possibly caused by her lupus. The PET-CT now showed extensive left acetabular and femoral head destructive bone lesions that had progressed significantly in 2 months, with associated intense 18F-fluoro-2-deoxy-glucose (FDG) uptake (maximal SUV 8.7). The left hip joint effusion also had intense FDG uptake. The hip joint was aspirated following the PET scan, and the synovial fluid grew mycobacterium tuberculosis. The PET-CT also showed an enlarged left iliopsoas bursa, which did not have FDG uptake and was therefore probably not infected.
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