Abstract

This case illustrates an example of the unusual scintigraphic images that may result in patients referred for various studies at different practices by multiple practitioners.

Case Report

A 53-year-old man was referred for a bone scan to evaluate right hip pain. Delayed images revealed increased osteoblastic activity in the right sacro-iliac joint consistent with trauma or inflammation. In addition the ascending and transverse colon were well visualised. The uptake in the tomographic images throughout the ascending and transverse colon was so prominent that the haustrations were clearly visualised confirming intraluminal activity.

Fig 1: Delayed anterior whole body (A), lateral (B) and tomographic (C) images demonstrating increased osteoblastic activity in the right sacro-iliac joint and prominent uptake in the ascending and transverse colon (arrow) due to the biliary excretion of Tc-99m Sestamibi from the earlier myocardial perfusion study. The uptake throughout the ascending and transverse colon was so prominent that the haustrations are clearly visualised confirming intraluminal activity.

No obvious pathology was evident but review of the images by one of the authors

(RFU) revealed that the patient had a myocardial perfusion study using Tc-99m

Sestamibi the previous day at a different practice and referred by another medical practitioner.

Discussion

This case illustrates an example of the unusual scintigraphic images that may result in patients referred for various studies at different practices by multiple practitioners. Reporting physicians must remain vigilant to the possibility of a study being contaminated by isotopes from previous studies.