On bone scintigraphy with Tc-99m MDP, the 'superscan' pattern is characterised by:

• A Focal areas of increased uptake in a few bones with normal background activity
• B Diffusely increased skeletal uptake with absent or faint renal and soft-tissue activity ✓
• C Photopenic (cold) areas in affected bones indicating avascular necrosis
• D Increased uptake limited to axial skeleton only

Explanation

A superscan shows diffusely increased and homogeneous skeletal uptake with absent or markedly diminished renal and soft-tissue background activity. The kidneys are absent or barely visible because nearly all tracer is taken up by bone. This pattern is seen in diffuse metastatic disease (prostate, breast), metabolic bone disease (hyperparathyroidism, osteomalacia), and myeloproliferative disorders. It can be mistaken for a normal scan without careful attention to renal activity.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.