Incidental Detection of a Vertebral Body Hemangioma on Three-Phase Bone Scintigraphy

A 62-year-old man was hospitalized with back pain that occurred immediately after trauma. Radiographs showed a compression fracture of the L2 vertebra. The patient was referred for a bone scan to determine the phase of healing of the L2 vertebra fracture caused by another accident 4 years earlier. Three-phase Tc-99m MDP bone imaging with 20 mCi Tc-99m MDP revealed increased perfusion and blood pool activity in the region of L1. There was also significant uptake in L1 on delayed static images. No abnormalities were associated with L2 on the early-phase images, whereas delayed static images showed relatively increased uptake in L2. MRI revealed a vertebral hemangioma in L1, whereas L2 showed findings of an earlier compression fracture.