Concealed in Plain Sight: Revelation of Spina Bifida Occulta on 99mTc-MDP Whole-Body Bone Scan and SPECT/CT.

Saber Tanha, Amin; Rabani, Faeze; Raeisi, Nasrin; Shafiei, Susan · Clin Nucl Med · 2025

case_report · Level V

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Abstract

We present a case of an 11-year-old boy who presented with a 2-month history of low back pain, with no preceding medical conditions or underlying diseases reported. Initial diagnostic evaluation with a 3-phase bone scan revealed a focal area of uptake posterior to the L5 vertebra, which was confirmed by subsequent SPECT/CT imaging to be a reactive change associated with a narrow defect in the spinous process of the L5 vertebra, consistent with spina bifida occulta (SBO). This case highlights the ability of bone scans to uncover missed diagnoses of reactive changes at a typically nonsymptomatic anomaly such as SBO.

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