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Bone Imaging: Radionuclide Scan vs MRI

M. Moinuddin, MD; J. S. Buchignani, MD
JAMA. 1990;264(4):456. doi:10.1001/jama.1990.03450040044027.
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To the Editor.—  With reference to the article "Musculoskeletal Applications of Magnetic Resonance Imaging [MRI],"1 we offer the following comments.Page 2423 shows a metastatic lesion in the sacrum on MRI examination with a negative bone scan. However, the bone scan in the figure is an anterior view, which will not show a posterior lesion. That is why anterior and posterior views are performed routinely in bone scintigraphy. Similarly, on page 2425, a negative posterior view of the bone scan is presented, with a positive MRI scan showing a stress fracture of the right femoral neck. Bone scans show hip fractures almost exclusively on the anterior view; again, a wrong view was depicted.Although the article was published by the Council on Scientific Affairs, we were impressed by the lack of knowledge about bone scintigraphy. Indeed, MRI is an excellent imaging modality, but that does not mean the authors


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