[99m Tc] Tc‐MDP bone SPECT/CT diagnosing unstable slipped capital femoral epiphysis with secondary AVN in a patient with misleading knee pain

Bone scan is highly sensitive whole‐body imaging with relative low radiation in patients with non‐localized skeletal symptoms. Patient is 12‐year‐old boy with Down syndrome, suffering recent claudication and exacerbated left knee pain unable to walk even with crutches. Three‐dimensional Single photon emission computed tomography/Computed tomography (SPECT/CT) detected left slipped capital femoral epiphysis (SCFE) and secondary Avascular necrosis (AVN). [99mTc] Tc‐Methylene diphosphonate (Tc‐MDP) whole body bone scintigraphy and pelvic blood pool images diagnosed slipped left capital femoral epiphysis and secondary AVN in a 12 year old boy with Down syndrome.