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Infected aortic aneurysm is an uncommon life-threatening disease. A 68-year-old man had a history of type 2 diabetes mellitus and repeated urinary tract infections. He presented with fever, chills, low back pain, leukocytosis, and Salmonella group B bacteremia. For evaluation of suspected lumbar vertebral osteomyelitis, a 3-phase bone scan and a gallium-67 scan were performed. An abdominal aortic aneurysm was noted incidentally on the blood flow and blood pool phase images. Gallium-67 scan demonstrated increased radioactivity within the soft tissues surrounding the aneurysm, which was suggestive of an infected abdominal aortic aneurysm. The previously unsuspected infected abdominal aortic aneurysm was confirmed by computed tomography.

Ga-67 is a useful agent for imaging infection, especially in the chest, but is not so reliable in the abdomen because of physiological bowel activity. A 64-year-old man with fever of unknown origin received a Ga-67 scan for survey of any occult infection focus. Focal Ga-67 accumulation was noted in the left lower chest region on the 24-hour image, but a different pattern of radioactivity was shown on the 48-hour image after bowel cleansing. On review of the chest radiographs and history, we found bowel activity in the left lower chest secondary to diaphragmatic paralysis masqueraded as pulmonary infection. Diaphragmatic paralysis should be considered as a differential diagnosis of abnormal activity in the chest on Ga-67 scan.

Most metastatic bone disease appears in the axial skeleton. Appendicular bone metastases are usually found in cases of general spread of the disease, and frequent sites are in the femur and humerus. A solitary appendicular bone metastasis is rare. The authors report a case of lung cancer with unusual presentation of a solitary fibular metastasis. The bone scan showed a solitary fusiform hot lesion in the fibular shaft mimicking the typical appearance of a stress fracture. A metastatic fibular lesion from lung cancer was confirmed by excision biopsy.

A hydrocele is a collection of fluid within the tunica or processus vaginalis. Most pediatric hydroceles are congenital and adult hydroceles are usually secondary. The latter can present acutely from local injury, infection, radiotherapy, or increased intraabdominal pressure. A 53-year-old man with underlying liver cirrhosis was admitted for dyspnea and abdominal distention. Massive ascites with swelling of the right hemiscrotum was noted. A communicating hydrocele was detected by peritoneal scintigraphy. After surgical repair of the communicating shunt by a Bassini procedure, the problem of the right hydrocele was resolved.