Superscan
Summary
Diffuse intense skeletal tracer uptake bone scan pattern with low soft tissue and absent/faint renal activity due to high bone turnover.
Key imaging features
- Diffuse, very intense skeletal uptake
- Low soft tissue background
- Faint or absent kidneys and bladder
- Loss of focal lesion conspicuity
- Can appear deceptively “normal”
Differentiating imaging patterns
Metastatic
- Patchy or asymmetric
- Axial predominance (spine, pelvis)
Causes
- Prostate cancer
- Breast cancer
- Other osteoblastic metastases
Metabolic
- Symmetric
- Skull, mandible, sternum
- Costochondral junctions, distal appendicular uptake
Causes
- Renal osteodystrophy (most common benign)
- Hyperparathyroidism
- Osteomalacia / rickets
- Hyperthyroidism
- Paget disease (polyostotic)
- Myelofibrosis
- Lymphoma / leukaemia
- Mastocytosis
Mimics
- Looks like normal scan (uniform uptake)
Warning
"Beautiful" uniform scan = NOT normal. Always check kidneys. → Absent kidneys = superscan until proven otherwise.
