Normal Hypermetabolic Enthesopathy

An enthesopathy is a general term used to describe any disorder involving the attachment of a tendon or ligament to bone.   

On a PET/CT scan, an enthesopahty in nearly always an incidental finding and is rarely of clinical significance. As such, it is generally not mentioned in the report.

Nevertheless, as this is a common and often impressive PET/CT finding, it is important to be familiar with the most common sites of FDG-avid enthesopathy: 

• Abutting the lateral margin of the greater trochanter
• Abutting the inferior margin of the ischia

Uptake in these regions may be unilateral or bilateral, mild or even intense.

Although FDG-uptake in these locations is almost always normal, careful analysis of the CT bone windows is always required to exclude a subtle associated osseous lesion.