Non-osseous uptake in a bone scintigraphy of a 6-month-old female presenting with extremity ecchymoses and edema

We present a case of a 6-month-old female who exhibited unusual bone scan findings of intense, non-osseous tracer uptake in the extremities. The striking appearance of the scan immediately catches the attention of the reader and the attending physician. The final diagnosis upon discharge (discharged against medical advice) was osteomyelitis; pathologic fracture, radius and ulna, left, etiology to be determined; anemia, reactive. A number of possible disease entities were entertained which could explain the patients' findings. Extrapolating all the available data, with clear uncooperation of the parents, the most likely explanation for the unusual bone scan findings could have been trauma from child abuse.