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Bone Scintigraphic Findings of Hypophosphatemic Osteomalacia Associated With Adefovir Therapy: Involvement of Lower Extremity Skeletons

Kim, Do-Hoon MD*; Lee, Sang-Woo MD, PhD*; Kweon, Young Oh MD, PhD; Lee, Jaetae MD, PhD*; Ahn, Byeong-Cheol MD, PhD*

doi: 10.1097/RLU.0b013e3182868a7f
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Occurrence of hypophosphatemic osteomalacia (HO) induced by administration of low-dose adefovir therapy is rare, and bone scintigraphy of the disease has rarely been reported. We report on bone scintigraphic findings in patients with HO. Multiple uptakes in ribs, spines, and lower extremities, suggesting multiple fractures, were observed on bone scintigraphy. Patients were diagnosed as HO associated with adefovir therapy. Owing to the same predilection sites, multiple uptakes on the axial skeleton can cause confusion with malignant metastatic disease; however, involvement of lower extremity skeletons can provide a scintigraphic clue for use in differentiation of HO from malignant osseous metastasis.

From the *Departments of Nuclear Medicine and †Internal Medicine, Kyungpook National University School of Medicine and Hospital, Daegu, Republic of Korea.

Received for publication July 19, 2012; and revision accepted December 29, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Byeong-Cheol Ahn, MD, PhD, Department of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, 50, Samduk 2-ga, Jung gu, Daegu 700-721, South Korea. E-mail:

© 2013 by Lippincott Williams & Wilkins