Diffuse hepatic uptake of technetium-99m methylene diphosphonate in a patient receiving high dose methotrexate

A child with diffuse accumulation of [99mTc]MDP in the liver on a bone scan, at the time of study the patient had a severe, but reversible, hepatic dysfunction on the basis of methotrexate toxicity. Visualization of the liver on skeletal scintigrams can be a consequence of high-dose methotrexate therapy, as there was no other explanation for this unusual finding.