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Bone scintigraphy was performed on an 11 year old boy with known sickle cell disease who presented with severe right hip pain. Images showed features of avascular necrosis of the right femoral head. In addition, there was increased accumulation of the 99mTc MDP in the ends of the long bones at the knees, and diffuse activity was observed in the enlarged spleen and the kidneys.
The diffuse soft tissue uptake in the enlarged spleen has been attributed to microscopic splenic calcification and/or iron deposits, both of which may occur as a result of repetitive infarcts.1 Diffuse accumulation in the kidneys does not reflect clinically altered function but is related to microcalcification due to repeated vaso-occlusive episodes.2