Case Author(s): Marc Montella, MD and Tom R. Miller, MD, PhD , 6/22/00 . Rating: #D2, #Q4

Diagnosis: Diffuse Metastatic Disease from Prostate Cancer

Brief history:

78 year-old man with right arm pain


Whole Body Bone Scan

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View fourth image(xr). Left Hip Radiograph

Full history/Diagnosis is available below

Diagnosis: Diffuse Metastatic Disease from Prostate Cancer

Full history:

78 year-old male with history of prostate cancer and right arm pain.


20 mCi Tc-99m MDP, i.v.


Delayed whole-body scintigrams were obtained. There is diffusely increased activity throughout the axial and appendicular skeleton, with relatively little activity in both kidneys or urinary bladder. The increased bony uptake is in a patchy distribution in both upper extremities. There is decreased activity in the lumbosacral region.


This is a "super scan" appearance with increased bone uptake and little soft tissue activity. This pattern is relatively easily separated from the super scan due to diffuse metabolic disease, most commonly renal osteodystrophy, by the fact that the uptake is heterogeneous. The reduced pelvic activity is due to prior radiation therapy.

ACR Codes and Keywords:

References and General Discussion of Bone Scintigraphy (Anatomic field:Skeletal System, Category:Neoplasm, Neoplastic-like condition)

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Case number: bs119

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