Osteomalacia presents radiographically as deossification, coarsening of the trabecular pattern, and pseudofractures. Contrary to the usual bone scan manifestation of osteomalacia, consisting of a generalized increase in periarticular radionuclide accumulation and pronounced costochondral junctional uptake, this report describes an unusual bone scan presentation with negative radiographic studies showing only some deossification. Symmetric distribution of the focal lesions is considered a suggestive sign of osteomalacia.

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