Osteopetrosis - A potential mimic of osteomyelitis on three-phase bone scintigraphy

Osteopetrosis is an inherited defect in bone resorption leading to cortical sclerosis, marrow space compression, and skeletal deformity. Biochemically and genetically heterogeneous, the disease has three clinical presentations: precocious onset osteopetrosis, osteopetrosis tarda (Albers-Scholenberg disease), and osteopetrosis with renal tubular acidosis. A 3-year-old boy diagnosed with osteopetrosis tarda at 18 months of age was examined for fever and left lower leg pain. Radiographs of the long bones showed only cortical sclerosis and metaphyseal deformity typical of osteopetrosis. To exclude osteomyelitis, three-phase bone scintigraphy was requested.