What's going on with these total body bone images? If the title didn't give it away, then you probably know that the Tc99m-MDP injection went into the arterial system rather than into the venous side. We call it the Michael Jackson sign, for the "gloved one". A student had injected in the left antecubital fossa ... did they notice that the vein was pulsating rhythmically? ... not sure.
This is typical of an arterial injection with a high amount of tracer deposition distal to the injection site. We know that the MDP had been prepared correctly since there are no choroid plexus, thyroid, salivary or gastric uptake that would result from free pertechnetate. Furthermore bone uptake is visible. Now as with an interstitial injection with such a large dose, we would normally see uptake in the lymph nodes on the side that the injection was given... but the image did not pick up any lymph nodes (trust me .. I know it's hard to see)
What other conditions may have caused this type of uptake? Soft tissue uptake in bone scans can result from:
- Increased blood flow
- Soft tissue calcification
- Neoplasm
- Inflammatory process
- Hyperparathyroidism
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