Splenic Visualization Using 99mTc-Methylene Diphosphonate in a Patient with Sickle Cell Disease

Splenic visualization with a bone-seeking agent Tc-methylene diphosphonate (Tc-MDP) with absence of splenic uptake using sulfur colloid was seen in a 15- year-old boy in sickle cell crisis. Uptake of Tc-MDP is probably due to splenic infarction and calcification. This represents a potentially sensitive method for following the functional auto-splenectomy process in sickle cell disease and may also detect the presence of splenic tissue when it is not visualized in a sulfur colloid liver/spleen scan. Splenic visualization by bone-seeking agents should not be confused with skeletal lesions or indicate the presence of an abnormal left upper quadrant mass lesion.