Case 207

Medical history

Female patient, 15 years old, complains of severe pain on the left shoulder associated with a tumor, edema and reduced local mobility. Was diagnosed with an osteosarcoma in the distal right femur 2 years ago, underwent neoadjuvant chemotherapy followed by surgical resection of the lesion and placement of an endoprosthesis. Developed chronic pain at the site of the primary lesion and the need for orthosis for locomotion. The attending physician ordered a bone scan.

Based on the medical history and on the principles of bone scintigraphy, which of the following alterations is not perceived in the exam in question?

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