Spinal Compression Fractures Demonstrated on Renal Scan

A 74-year-old white man with diabetes and hypertension was evaluated for possible renovascular disease by renal scintigraphy. The patient complained of severe thora-columbar pain, which coincidentally began 1 week before the elective outpatient renal scan was performed. The renal scan showed diminished perfusion of the right kidney suggesting renal artery stenosis or occlusion, but also unexpectedly demonstrated abnormal activity in the midline just superior to the kidneys. Abnormal activity seen during the dynamic phase images persisted on later static views. This unusual finding, associated with severe back pain, led us to suspect impending rupture of an abdominal aortic aneurysm, but a subsequent ultrasound examination of the abdomen showed a normal aorta. Bone scan performed 48 hours after the renal scan demonstrated acute compression fractures at T-12 and L-1, correlating in location with the midline activity seen on renal scan. Subsequent spine radiographs verified the compression fractures.