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Synovial Visualization During Tc-99m MDP Bone Scanning in Septic Arthritis of the Knee

During Tc-99m medronate (MDP) bone scintigraphy, visualization of the synovium during blood flow and blood pool phases was present in a patient with septic arthritis of the left knee. Inflammation with hyperemia of the synovium was the cause for radionuclide localization, which was enhanced by the large photondeficient effusion distending the suprapatellar bursa. The synovium was not seen on delayed images after redistribution of the radionuclide from blood pool to bone phase.