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. 2017 Oct 18;8(10):747–753. doi: 10.5312/wjo.v8.i10.747

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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.

Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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A 30-year-old female treated with chemotherapy for breast cancer was referred for ^99mTc-MDP bone scan to evaluate cause of disabling hip pain. Whole body (A and B) and delayed images (C and D) demonstrate photopenic areas in bilateral femoral heads (arrows) with increased osteoblastic activity surrounding the photopenic region in the right femoral head, suggestive of bilateral avascular necrosis. Increased osteoblastic activity in bilateral distal femora is likely due to biomechanical stress reaction due to altered gait.