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Image Challenge
41 (
1
); 142-142
doi:
10.25259/IJNM_38_2026

Silent Scans, Persistent Pain: Unmasking a Hidden Culprit

Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.

*Corresponding author: Dr. Harish Goyal, Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Superspecialty Block, Dhanvantri Nagar, Puducherry, 605006, India. harishgoyal.aiims@gmail.com

Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Kumar SA, Goyal H, Halanaik D. Silent Scans, Persistent Pain: Unmasking a Hidden Culprit. Indian J Nucl Med. 2026;142. doi: 10.25259/IJNM_38_2026

CLINICAL HISTORY

A 29-year-old male presented with complaints of progressive and diffuse musculoskeletal pain for the past 6 months and proximal muscle weakness for the past 3 months. He had a minimal response to oral cholecalciferol given empirically for presumed vitamin D deficiency. Radiographs of the pelvis and long bones were unremarkable, and bone mineral density assessment was normal. Laboratory investigations revealed: serum calcium 10 mg/dL (8.6–10.2), serum phosphorus 1.9 mg/dL (2.5–4.5), alkaline phosphatase 110 U/L, 25-hydroxy vitamin D 15 ng/mL, intact PTH 42 pg/mL, and serum creatinine 0.9 mg/dL. He underwent 68GaDOTATATE PET/CT for disease evaluation [Fig 1].

(A) Maximum intensity projection image of 68Ga-DOTATATE PET/CT. (B,C,D) Fused PET/CT and (E,F,G) corresponding CT images
Fig 1: (A) Maximum intensity projection image of 68Ga-DOTATATE PET/CT. (B,C,D) Fused PET/CT and (E,F,G) corresponding CT images

Ethical approval:

Institutional Review Board approval is not required.

Declaration of patient consent:

Patient's consent not required as patients identity is not disclosed or compromised.

Conflicts of interest:

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation:

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship: Nil.


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