Physiologic pelvicalyceal fullness on bone scan

Case contributed by J. Ray Ballinger
Diagnosis certain

Presentation

History of breast cancer. No urinary tract-related symptoms.

Patient Data

Age: 55 years
Gender: Female
Nuclear medicine

Anterior and posterior whole body views from a bone scan using Tc-99m MDP were obtained showing no abnormal activity to suggest metastatic disease, however retention of activity in seen in the right renal pelvis and ureter.

A post void anterior image shows elimination of the increased activity in the right renal pelvis and ureter.

Case Discussion

Emptying the bladder before scanning is useful to avoid being confused with physiologic retention of activity in the collecting systems. Bladder activity may also obscure subtle abnormal areas of activity in the sacrum and pubis.

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