A right below knee amputation is noted. On early phase imaging, there is increased blood flow to the remaining right leg compared to the left. There is hyperaemia of the stump below the knee, most marked at the distal aspect. No additional areas of hyperaemia are identified on early phase imaging. Note that the whole body blood pool acquisition was terminated early before imaging the left lower leg due to patient discomfort.
On delayed phase imaging, there is moderate to markedly increased tracer accumulation in the remnant right tibia, most focal at the distal tip. On SPECT/CT, intense tracer accumulation is present adjacent to a large cortical erosion at the cut surface of the tibia. Bone scan findings are in keeping with osteomyelitis.
There is mild to moderately increased periarticular uptake in both knees and the small joints of the left foot most in keeping with osteoarthritis.