Bone scintigraphy with technetium-99m (Tc)-labeled diphosphonates is one of the most frequently performed radionuclide procedures. Accumulation of Tc-labeled diphosphonate is well recognized to reflect conditions of accelerated bone turnover and metabolism. Therefore, it is a functional imaging modality for detecting metastatic bone tumors, metabolic bone disease, traumatic injury, and inflammation. This pictorial essay describes the possible patterns of distribution of abnormal uptake for differential diagnosis of metastatic bone tumor, as well as the diagnostic pitfalls of bone scintigraphy.
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