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Paget Disease of Bone (PDB) - Bone Scan: Radionuclide bone scintigraphy (bone scan) is the most accurate diagnostic test for PDB. Gamma emitting isotope Technetium-99m linked to a bisphosphonate is administered intravenously. Bisphophonates have a very high affinity for bone causing the isotope to accumulate in areas of high bone turnover (as shown in this scan).

Besides PDB, other conditions with high bone turnover such as fibrous dysplasia, osteomyelitis, metastases and arthritis may also have a positive bone scan. Bone scans may be negative (false neg) in inactive, sclerotic (burnt-out) lesions of PDB.

Case courtesy of Dr Alexandra Stanislavsky, Radiopaedia.org. From the case rID: 12871

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