Childhood pelvic osteomyelitis presenting as a "cold" lesion on bone scan: case report

A case of occult pelvic osteomyelitis is presented. The involved portions of the left pubis and left ischium presented as "cold" areas on the original bone scan with 99mTc-diphosphonate. The presumed mechanism for this unusual finding in osteomyelitis is compression of the microcirculation to bone by subperiosteal and intraosseous pus.