Question 1508
{"accessible":true,"alternatives":[{"id":7536,"text":"polyostotic Paget disease"},{"id":7532,"text":"renal osteodystrophy"},{"id":7533,"text":"secondary hyperparathyroidism"},{"id":7535,"text":"single left humeral metastasis with left tibial plateau insufficiency fracture"},{"id":7534,"text":"widespread metastases"}],"archived":false,"correctAlternativeId":7534,"explanation":"\u003cp\u003eThis is a\u0026nbsp;metastatic \u003ca href=\"/articles/superscan\"\u003esuperscan\u003c/a\u003e. Very little tracer accumulates in the soft tissue and there is no visible radiourine within the kidneys or bladder. The pattern of increased osteoblastic activity is predominantly in the axial skeleton, and appears heterogenous and asymmetrical – which is typical for widespread metastases. The uptake in the left tibia may relate to further metastatic disease, alternatively a fracture.\u003c/p\u003e","id":1508,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/83/1-final.jpg","imageAttribution":{"kind":"own","user_id":128,"user_param":"drjermy","user_name":"Jeremy Jones"},"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2495","nextQuestionPath":"/articles/hyperparathyroidism/questions/1409","relatedArticles":[{"id":2129,"title":"Superscan","link":"/articles/superscan?lang=us"},{"id":3935,"title":"Renal osteodystrophy","link":"/articles/renal-osteodystrophy?lang=us"},{"id":1824,"title":"Paget disease (bone)","link":"/articles/paget-disease-bone?lang=us"}],"alsoUsedIn":[{"id":257,"kind":"Course","title":"Bone Scans: What the radiologist needs to know","link":"https://radiopaedia.org/courses/bone-scans-what-the-radiologist-needs-to-know"},{"id":995,"kind":"Course","title":"2021 Virtual Conference Private Use - page 995","link":"https://radiopaedia.org/courses/2021-virtual-conference-private-use/pages/995"},{"id":995,"kind":"Course","title":"Radiopaedia 2021 - isoCME - page 995","link":"https://radiopaedia.org/courses/radiopaedia-2021-isocme/pages/995"},{"id":995,"kind":"Course","title":"2022 Virtual Conference Private Use - page 995","link":"https://radiopaedia.org/courses/2022-virtual-conference-private-use/pages/995"},{"id":970,"kind":"RestrictedPage","title":"Page 970 (in no courses)","link":"https://radiopaedia.org/admin/restricted_pages/970"},{"id":955,"kind":"RestrictedPage","title":"Page 955 (in no courses)","link":"https://radiopaedia.org/admin/restricted_pages/955"},{"id":1,"kind":"LiveSchedule","title":"1","link":"https://radiopaedia.org/admin/live_schedules/1"},{"id":69,"kind":"LiveSchedule","title":"69","link":"https://radiopaedia.org/admin/live_schedules/69"},{"id":606,"kind":"Course","title":"Lectures by Sally Ayesa - page 606","link":"https://radiopaedia.org/courses/lectures-by-sally-ayesa/pages/606"},{"id":606,"kind":"Course","title":"Radiopaedia 2020 - Lectures Only - page 606","link":"https://radiopaedia.org/courses/radiopaedia-2020-exclusive/pages/606"},{"id":606,"kind":"Course","title":"2020 Virtual Conference Private Use - page 606","link":"https://radiopaedia.org/courses/2020-virtual-conference-private-use/pages/606"},{"id":864,"kind":"Course","title":"Radiopaedia 2021 - isoCME - page 864","link":"https://radiopaedia.org/courses/radiopaedia-2021-isocme/pages/864"},{"id":864,"kind":"Course","title":"2021 Virtual Conference Private Use - page 864","link":"https://radiopaedia.org/courses/2021-virtual-conference-private-use/pages/864"},{"id":864,"kind":"Course","title":"Nuclear Medicine Lectures - page 864","link":"https://radiopaedia.org/courses/nuclear-medicine-lectures/pages/864"},{"id":905,"kind":"RestrictedPage","title":"Page 905 (in no courses)","link":"https://radiopaedia.org/admin/restricted_pages/905"}],"stem":"\u003cp\u003eA 65 year old man undergoes a bone scan for investigation of left shoulder pain. What is the most likely diagnosis?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1508"}],"attemptsPercentages":[{"alternativeId":"7535","percentage":14},{"alternativeId":"7532","percentage":7},{"alternativeId":"7534","percentage":58},{"alternativeId":"7536","percentage":13},{"alternativeId":"7533","percentage":7}],"promptToLogin":false,"questionManager":false,"articleId":"hyperparathyroidism"}