Incidental Bladder Hernia on Bone Scintigraphy

A 74-year-old male patient with a history of prostate adenocarcinoma, progressive increase in PSA to 3.93 ng/mL, and pain in the cervical and lumbar areas was referred to our nuclear medicine service for an extension study with bone scintigraphy. The study showed a pathological deposit of diphosphonates only in the pubic region (Fig. 1a, arrow). SPECT/CT images correlated the uptake with a hernia of the bladder at the right inguinoscrotal duct (Fig. 1b, arrows). Diphosphonates, in addition to presenting uptake in regions with elevated bone mineralization, are eliminated through the urine; as a result, their presence in certain areas may lead to a false positive.

Fig. 1