Ladder Pattern of Increased Gallium Uptake in Diffuse Idiopathic Skeletal Hyperostosis

An 82-year-old woman received gallium scan for intermittent fever. There was a ladder pattern of increased gallium uptake along lower thoracic spine to whole lumbar spine. She denied lower back pain and there was no local inflammatory symptom of sign on physical examination. Following MRI showed flowing calcification along anterior and lateral aspects of lumbar spines, favoring diffuse idiopathic skeletal hyperostosis.