Radionuclide bone scan imaging using the radiopharmaceutical 99Technetium-methylene diphosphonate (MDP) has a useful role in both clinical practice and research to investigate metabolic bone diseases and response to treatment. In clinical practice, bone scans are reported solely on a qualitative visual interpretation of images allowing for the detection of discrete changes in the skeleton in areas of focal tracer uptake. An increased 99mTc-MDP skeletal uptake with teriparatide is seen in patients with osteoporosis indicating an increased bone formation which was supported by BTM increases. Recently, quantitative bone scintigraphy with MDP is described as a more sensitive tool to study the bone-remodeling process even in CN. The potential utility of quantitative bone scanning for the diagnosis and more importantly for CN activity is suggested. However, translating visual assessments into quantitative data with F18 PET/ SPECT CT to study the regions of interest (ROI) and assess the response to teriparatide will be more specific.