Giant enostosis of spine with increased uptake on planar and SPECT views of bone scan

An enostosis or bone island is a benign bony lesion that is almost diagnosed based on clinical and radiologic defining characteristics. One of the known diagnostic procedures in the evaluation of enostosis is bone scintigraphy. Generally, we don’t expect to see increased uptake by enostosis in the bone scan. Herein we present a 52-year-old lady who was suffering from chronic low back pain that was referred for 99mTc-MDP bone scanning. A bony lesion in a thoracic vertebral body had been discovered on CT and MRI and conventional imaging characteristics were compatible with enostosis, but skeletal scintigraphy showed increased uptake both on planar and SPECT images.