Loculated Pericardial Effusion Detected on Blood Pool Bone Imaging

The authors evaluated an 80-year-old man with congestive heart failure and Staphylococcus aureus sepsis. A three-phase bone scan was performed to identify possible osteomyelitis of the cervical spine. The blood pool images revealed a round photopenic defect within an area of diffuse pericardial uptake. This corresponded to a 5 × 7 cm pericardial mass noted on CT. A pericardial effusion also was noted. A subsequent In-111 leukocyte study showed no abnormal localization. The pericardial collection measured 6 Hounsfield units on CT and was consistent with a loculated pericardial effusion within the backdrop of a pericardial effusion.