F-18 FDG Positron Emission Tomography and Benign Fractures

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Abstract
F-18 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) has been used extensively in the imaging of cancer, including metastatic skeletal disease. Although uptake into benign osseous disease has been reported, there is very limited information regarding uptake into benign fractures. This report provides additional information regarding the appearance of benign fractures on FDG-PET images. Four case reports of FDG-PET scanning are presented in patients with proved benign fractures. In three of these cases, FDG uptake was noted in fractures when images were obtained 17 days to 8 weeks after injury, with the most avid uptake observed when FDG-PET imaging was performed 17 days after fracture. In the patient in whom imaging was performed 8 weeks after fracture, no uptake of FDG was seen in a benign fracture. Fractures may accumulate FDG to varying degrees, and false-positive findings may occur when FDG-PET imaging is performed to assess for metastases, although the different pattern of uptake and clinical correlation usually allows accurate differentiation of fracture from skeletal metastases.