Involvement of the hands in Paget's disease (osteitis deformans) is infrequent. The radiographic findings have been detailed elsewhere, but the findings using Tc-99m MDP bone scanning have not been well described. A Tc-99m MDP bone scan was performed on a 77-year-old woman with known Paget's disease of the skull and vertebrae. Images obtained of the hands and forearms demonstrated diffuse, homogeneous, increased radionuclide uptake in the entire left first metacarpal. Roentgenograms were obtained for correlation. No other hand bones were affected.