PMC4891466_01
53-year-old woman with breast cancer who presented for staging. Anterior view of total body Tc99 MDP bone scan shows focus of minimally increased focal radiotracer activity at anterior-lateral portion of left greater trochanter (arrow).
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A technetium-99m methylene diphosphonate (Tc-99m MDP) total body bone scan was interpreted as negative for metabolically active metastatic bone disease (Figure 1). Revisiting the total body bone scan there was a focus of minimally increased radiotracer activity in the region of the anterior left greater trochanter (Figure 1).
Axial image of 18F fluorodeoxyglucose positron emission tomography (18F-FDG PET) scan at level of bilateral hips shows focus of increased glucose uptake (arrow) near anterior-lateral portion of left greater trochanter, which was suspicious for metastatic disease. [Powerpoint Slide for Figures 1 & 2]
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However, a subsequent 18F fluorodeoxyglucose positron emission tomography (18F-FDG PET) scan demonstrated a focus of increased glucose activity in the region of the left greater trochanter (maximum body weight corrected standardized uptake value [SUV] 1.4, Figure 2).
53-year-old woman with breast cancer who presented for staging. Axial CT image at the level of the greater trochanter shows amorphous calcification (arrow) anterior to left greater trochanter. [Powerpoint Slide]
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Tomography (CT) showed an unremarkable left femur without any evidence of metastatic lesion or cortical bone erosion. There was a 5 mm oval amorphous calcification anterior to the left greater trochanter (Figure 3).
Calcific tendinosis: a potential mimicker of malignancy on PET. 53-year-old woman with breast cancer who presented for staging. Axial T1-weighted spin echo MR image (TR/TE= 550/8 ms) at the level of greater trochanter shows thickening at left gluteus medius tendon insertion (arrow). [Powerpoint Slide]
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The T1 weighted images showed subtle thickening of the left gluteus medius tendon anterior to the left greater trochanter (Figure 4).
Calcific tendinosis: a potential mimicker of malignancy on PET. 53-year-old woman with breast cancer who presented for staging. Axial T1-weighted fat suppressed spin echo MR image (TR/TE= 500/8 ms) following i.v. gadolinium contrast administration shows intense enhancement at left gluteus medius tendon insertion (arrow). Note central low signal focus corresponding to calcific deposit. [Powerpoint Slide]
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Post contrast fat suppressed T1-weighted images showed intense enhancement at the left gluteus medius tendon insertion surrounding a low signal focus corresponding to the calcification identified on CT, representing calcific tendinosis of the gluteus medius tendon insertion with active inflammation (Figure 5).