99mTc-MDP bone scan guides in the identification of mesenteric vein thrombosis

A 50-year-old man with postprandial abdominal pain, weight loss, and generalized body ache was referred to Nuclear medicine department for a whole body bone scan to look for any malignancy. Clinical examination did not reveal any specific positive findings. He underwent a Technetium-99m Methylene Diphosphonate (99mTc-MDP) bone scan which showed no obvious bone pathology. But there was abnormal increased MDP uptake in the entire transverse colon, splenic flexure, and sigmoid colon prompting further evaluation. Contrast-enhanced computed tomography (CECT) was performed and it suggested superior mesenteric vein thrombosis. Thus MDP uptake in bowel loops reflects the extra osseous tracer uptake at the cellular and tissue level due to chronic inflammation and plasma protein binding due to edema. Colonoscopy and segmental biopsy were noncontributory.