Interesting ImagesIntraosseous Medullary Fat Necrosis on 99mTc-MDP Bone Scan of Patient With Acute PancreatitisTupalli, Avinash DNB; Angamuthu, Meivel MD; Prashanth, Arun MD, DM; Singh, Roma MBBS; Kumar, Rakesh MD, PhDAuthor Information From the Department of Nuclear Medicine, All India Institute of Medical Science, New Delhi, India. Received for publication October 9, 2019; revision accepted February 16, 2020. Conflicts of interest and sources of funding: none declared. Ethical approval statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent: Informed consent from the patient was obtained to be included in the study. Correspondence to: Rakesh Kumar, MD, PhD, Division of Diagnostic Nuclear Medicine, Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029. E-mail: firstname.lastname@example.org. Online date: April 23, 2020 Clinical Nuclear Medicine: June 2020 - Volume 45 - Issue 6 - p e294-e295 doi: 10.1097/RLU.0000000000003022 Buy Metrics Abstract Pancreatic disease can be associated with polyarthritis and panniculitis in a small number of patients, and this triad constitutes PPP syndrome. Early diagnosis is critical as it has high morbidity and mortality. Panniculitis can occur in fat present anywhere in the body. Involvement of fat in bone marrow is relatively uncommon, and radiologic imaging shows osteolytic lesions involving long bones. Here we present a case of acute pancreatitis, referred to our department for evaluation of severe joint pain and multiple bone pain. 99mTc-MDP scan with SPECT/CT has been done, which showed medullary expansion with heterogenous tracer uptake, that is, moth-eaten appearance. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.