case_images: PMC4290068_01
case_images: (a) X-ray of spine shows dense and sclerosis at the margins of the vertebral bodies in alternating parallel sclerotic and lucent bands (sandwich vertebrae or "rugger-jersey" spine). (b) Dual-energy X-ray absorptiometry scan shows dense sclerosis at the margins of the vertebral bodies and the T-score was high at +6.5 (b and c). On computed tomography (CT) component of single-photon emission computed tomography/CT, there is dense sclerosis at the margins of the vertebral bodies (bone-in-bone appearance) and within the pelvic bones (d and e)
case_images: IJNM-30-55-g001.jpg
case_images: PMC4290068_01_IJNM-30-55-g001.jpg
case_images: F1
case_images: Dual-energy X-ray absorptiometry (DXA) scan revealed high bone density [Figure 1b and c]. CT scan showed dense sclerosis at the margins of the vertebral bodies (bone-in-bone appearance) and within the pelvic bones [Figure 1d and e].
case_images: 99mTc-methylene diphosphonate bone scan shows increased tracer uptake at the proximal ends of humeri and tibiae along with proximal and distal ends of femora. Linear uptake at the proximal femora and several lower ribs bilaterally is suggestive of fracture at these sites
case_images: IJNM-30-55-g002.jpg
case_images: PMC4290068_01_IJNM-30-55-g002.jpg
case_images: F2
case_images: Patient underwent 99mTc-methylene diphosphonate (MDP) whole body scan supplemented with single-photon emission computed tomography (SPECT)/computed tomography (CT) of the spine. 99mTc-MDP bone scan showed increased tracer uptake at the proximal ends of humeri and tibiae, proximal and distal ends of femora [Figure 2a]. SPECT images of the spine were unremarkable [Figure 2b].