Case contributed by Stijn Bollen
Diagnosis certain

Multiple small well defined sclerotic foci (bone islands) centered about the joints and epiphyses. 


Multiple small well defined foci of low signal intensity in distal tibia epiphysis and talus.

Nuclear medicine

Lack of uptake on bone scan.

Case Discussion

Lack of uptake in bone scan is helpful if rarely sclerotic bony metastasis is considered amongst differentials. 

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