The multiscan appearance of eosinophilic granuloma

A case of multifocal eosinophilic granuloma is presented in which a 99mTc-methylene diphosphonate bone scan revealed areas of increased, normal, and decreased uptake of the radionuclide. A radiographic bone survey demonstrated some but not all of the lesions seen on the bone scan; additionally, certain lesions were demonstrated only by the radiographs. A radionuclide bone scan is therefore unreliable as the sole diagnostic procedure for evaluating the distribution of eosinophilic granuloma and should always be complemented with a radiographic bone survey.