Case 3
Presentation:
66-year-old female, active runner/cyclist. Presents with left knee pain. History includes traumatic knee pain 1 month ago.
Image findings:
IV injection of 700 MBq Tc-99m MDP, three-phase bone imaging along with SPECT CT of knees.
Focal hyperemia along with moderately intense early uptake within the medial femoral condyle in the distal left femur indicating an acute process
Mild uptake associate with previously characterized supracondylar enchondroma
Intense focal increased early and delayed uptake within the right first MTP joint
Scintigraphy compatible with suspected subchondral insufficiency fracture of the knee (previously known as spontaneous osteonecrosis of the knee) and appears recent
Incidental right first MTP joint uptake could be inflammatory or traumatic, radiographic correlation could be considered.
Question 1:
Question 2 (bonus):
What incidental finding is visible on the bone scan?