Nuclear medicine imaging in osteonecrosis of hip: Old and current concepts

Figure 2 A 30-year-old female treated with chemotherapy for breast cancer was referred for ^99mTc-MDP bone scan to evaluate cause of disabling hip pain. Whole body (A and B) and delayed images (C and D) demonstrate photopenic areas in bilateral femoral heads (arrows) with increased osteoblastic activity surrounding the photopenic region in the right femoral head, suggestive of bilateral avascular necrosis. Increased osteoblastic activity in bilateral distal femora is likely due to biomechanical stress reaction due to altered gait.