Fig. 2

a Computed tomography (CT) scan of the thorax demonstrating sclerosis of sternum and manubrium with erosions of sternoclavicular joint. b Positron Emission Tomography - Computed Tomography (PET-CT) fusion images demonstrating multiple areas of abnormal hypermetabolism with diffuse uptake throughout the entire manubrium sternum with expansion of the manubrium and intense activity at the manubrial sternal junction. c Positron Emission Tomography (PET) demonstrating multiple abnormal regions of hypermetabolism corresponding with sclerotic and partially lytic lesions in the sternum and bilateral clavicular heads. Normal physiologic tracer uptake is present in the brain, heart, salivary and parotid glands, adenoids and palatine tonsils and vocal cords. There is also physiologic urinary clearance of the tracer into the renal collecting system