Background: Skeletal tuberculosis accounts for 1% to 5% of all tuberculosis (TB) cases. Multifocal skeletal tuberculosis is rare. Early diagnosis of multifocal skeletal TB is crucial and challenging for proper treatment and to prevent development of complications. The purpose of this case report is to highlight importance of bone scan in suspected cases of skeletal tuberculosis. Case Presentation: We describe a case of 24-year-old female, referred to Nuclear Medicine Department for bone scintigraphy. Patient had complaint of neck stiffness and generalized body aches. Patient underwent 99mTc-methylene diphosphonate scintigraphy which showed multifocal bony pathology mimicking bony metastasis. However, patient was treated with antituberculous therapy and showed excellent response on follow up bone scan. Post-therapy: patient recovered without developing any complications. Conclusion: Multifocal skeletal tuberculosis must be kept in the differential diagnosis of multifocal bony pathology seen on bone scintigraphy.

Keywords: Bone scintigraphy, multifocal bony pathology, multifocal skeletal tuberculosis, Case report.