1. Localization of Staphylococcus Lugdunensis Clavicular Osteomyelitis Using FDG- PET/CT 
Hian Liang Huang, MBChB, MRCP, Michelle Soo Rui Ting, MBChB, Dariusz Piotr Olszyna, MD, PhD, MmedSci, Swee Tian Quek, MBBS, Arvind Kumar Sinha, MBBS, Hoi Yin Loi, MD, MRCP 
The American Journal of Medicine 
Volume 129, Issue 3, Pages e9-e11 (March 2016)
DOI: /j.amjmed
Copyright © 2016 Elsevier Inc. Terms and Conditions

2. Figure 1
Magnetic resonance imaging of the right shoulder was performed, given the patient's history of right shoulder pain, as part of the initial workup for the source of bacteremia. It showed a complete supraspinatus tendon tear, glenohumeral joint/subacromial-subdeltoid bursitis, and osteoarthritis of the right acromioclavicular joint with inferior osteophytes. It was negative for any focus of infection. Note that the extent of the field of view was to the mid-clavicle.6,7
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3. Figure 2
Axial positron emission tomography/compute tomography (PET/CT) images at the level of the right clavicle showed a moderate focus of fluorodeoxyglucose (FDG) uptake. Imaging showed a standardized uptake value of 3.9.
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4. Figure 3
Axial positron emission tomography/compute tomography (PET/CT) images at the level of the right clavicle showed a subtle lytic lesion with area of surrounding sclerosis in the medial aspect of the right clavicle. Imaging by FDG-PET/CT of the rest of the body scanned from the vertex of the skull up to the feet did not show any further suspicious foci of FDG uptake to suggest malignancy or other nidus of infection. Clinical correlation and magnetic resonance imaging of the right clavicle was then advised, on the basis of PET/CT findings, to narrow down the differential diagnosis of this lesion.8
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5. Figure 4
Another right shoulder magnetic resonance imaging scan was ordered, but now the field of view was extended to include the medial heads of the clavicles. Axial T1 fat-saturated images of the right clavicle showed a decreased T1-weighted signal at the medial end of the right clavicle. Mild adjacent soft-tissue enhancement is also noted. The advantage of the fluorodeoxyglucose positron emission tomography with computed tomography is that this modality is a sensitive method of screening the whole body and directing subsequent investigations for greatest diagnostic yield.9
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