Technetium-99m methylene diphosphonate uptake in the brachialis muscle hematoma in a patient with prostate cancer and coagulation disorder mimicking bone metastasis evaluated by single-photon emission tomography-computed tomography/computed tomography
A 79-year-old man with prostate cancer and coagulation disorder was referred for a bone scan because of left shoulder pain. A bone scan was performed to assess for any skeletal involvement, especially in the shoulder. A total of 20 mCi (740 MBq) MDP was injected intravenously and imaging was performed 3 h later using a large field of view, dual headed gamma camera fitted with a low-energy, high-resolution collimator. Anterior whole-body images showed intense uptake in the left axilla []. SPECT CT of the chest [Figures and ] was performed to rule out whether the uptake is in the humerus, but it showed a hematoma in the left brachialis muscle, which he developed due to his coagulation disorder. A hematoma was confirmed on fine-needle aspiration and resolved spontaneously over the next 4-5 weeks. Follow-up bone scan carried out after 6 months showed resolution of uptake in the left axilla [].