PET Clin 2018 Oct 17;13(4):587-607. Epub 2018 Aug 17.
Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA 90033-5313, USA.
A wide range of musculoskeletal processes can demonstrate increased uptake on PET-computed tomography (CT) with fluorodeoxyglucose (FDG) F 18, including reactive, benign neoplastic, inflammatory, traumatic, posttreatment, and arthritic conditions that may mimic malignancy. In addition, physiologic causes of increased FDG uptake such as asymmetric muscle use and presence of brown fat can lead to increased FDG uptake and potential false-positive results. This article presents various case examples of non-malignant musculoskeletal hypermetabolism on 18F-FDG PET-CT and describes useful tools to avoid the potential pitfall of misinterpreting these as malignancy.