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.