bone imaging demonstration of osseous lesions and hepatic uptake: amyloid and renal dialysis effect

a 64-year-old woman, with amyloid related kidney failure (on renal dialysis) had a bone scan because of pain in the right upper femur. the 99m tc-mdp images revealed marked hepatic uptake. in addition, there was right proximal femoral concentration of radiotracer, which corresponded to a fracture site. as an added finding, the same femor demonstrated circumferential uptake at the lower pole. this region fractured on next day. a biopsy of the fracture site revealed amyloid staining. the plasma aluminum level was elevated, consistent with long-term dialysis. hepatic uptake of bone imaging agent might be related to amyloid deposition or the elevated aluminum concentration.