Bone scintigraphy is often utilized to detect the osseous etiology of lower back pain. Here we report a 70-year-old man with lower back pain who was referred a Tc-MDP bone scan to identify possible vertebral compression fracture. The images did not detect any osseous lesion. However, the images revealed photopenic regions in the both kidneys, which were confirmed as renal cysts on the CT images. The patient received laparoscopic unroofing of renal cysts, and his symptoms improved. Our case illustrated that back pain is not always due to osseous etiology, it might be caused by urinary disorder.
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