{"title":"Diagnostic Pitfall of <sup>18</sup>F-FDG PET/CT: Unifocal Nonbacterial Osteomyelitis Mimicking Bone Metastasis.","authors":"Mürsel Daşar, Aylin Akbulut, Koray Demirel, Gökhan Koca, Meliha Korkmaz","doi":"10.2967/jnmt.126.272461","DOIUrl":null,"url":null,"abstract":"<p><p>Chronic nonbacterial osteomyelitis (CNO) is a rare inflammatory bone disorder of unclear etiology that may present with unifocal or multifocal lesions. Because it can mimic malignancy on imaging, clinicoradiologic correlation and a multidisciplinary approach are essential. We report unifocal inflammatory osteitis compatible with CNO involving the sternum in a 56-y-old woman with a history of ductal carcinoma in situ. During surveillance, bone scintigraphy showed focal <sup>99m</sup>Tc-methylene diphosphonate uptake and <sup>18</sup>F-FDG PET/CT revealed a solitary <sup>18</sup>F-FDG-avid sternal lesion. MRI findings were suggestive of osteomyelitis. Biopsy excluded malignancy, supporting a diagnosis of CNO. Follow-up MRI demonstrated regression. This case underscores that a solitary <sup>18</sup>F-FDG-avid sternal lesion does not necessarily represent metastatic disease, and histopathologic confirmation may prevent unnecessary treatment escalation.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of nuclear medicine technology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2967/jnmt.126.272461","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
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Abstract
Chronic nonbacterial osteomyelitis (CNO) is a rare inflammatory bone disorder of unclear etiology that may present with unifocal or multifocal lesions. Because it can mimic malignancy on imaging, clinicoradiologic correlation and a multidisciplinary approach are essential. We report unifocal inflammatory osteitis compatible with CNO involving the sternum in a 56-y-old woman with a history of ductal carcinoma in situ. During surveillance, bone scintigraphy showed focal 99mTc-methylene diphosphonate uptake and 18F-FDG PET/CT revealed a solitary 18F-FDG-avid sternal lesion. MRI findings were suggestive of osteomyelitis. Biopsy excluded malignancy, supporting a diagnosis of CNO. Follow-up MRI demonstrated regression. This case underscores that a solitary 18F-FDG-avid sternal lesion does not necessarily represent metastatic disease, and histopathologic confirmation may prevent unnecessary treatment escalation.
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