Diffusely increased radioactivity in the left abdomen on bone scan of patient with acute colonic diverticulitis: Correlation with CT

Two days after the onset of acute colonic diverticulitis, a 66-year-old man underwent a Tc-99m hydroxylmethylene diphosphonate (HMDP) bone scan that showed diffusely and extensively increased radioactivity in the left abdomen. This area of increased activity corresponded to the colonic wall thickness and pericolonic inflammation from the descending to sigmoid colon, as seen on accompanying abdominal CT. Seven days after treatment with antibiotics, fluids, and bowel rest, the patient's fever, leukocytosis, and abdominal pain subsided. The increased radioactivity in the left abdomen seen on bone scan was attributed to inflammation of the bowel wall and pericolonic soft tissue. Tc-99m HMDP may offer an alternative, noninvasive method for the assessment of extent and activity of inflamed bowel.