Sclerotic lesions of the right iliac bone were discovered incidentally in a 52-year-old Korean woman. In this case, imaging of the right iliac bone showed intense osteoblastic activity on the bone scan and very mild F-18-fluoro-2-deoxyglucose (FDG) uptake on positron emission tomography (PET). Since Paget's disease is rare in Koreans, we aimed to rule out other bone diseases such as osteoblastic metastasis or osteomyelitis. These results allowed us to exclude chronic osteomyelitis or malignancy and clarify the diagnosis of Paget's disease of the iliac bone. This case illustrates how F-18 FDG PET/CT can be a useful tool in the differential diagnosis of various bone diseases.
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