A 67-year-old patient with a history of left shoulder pain for more than one year. He was treated with more than 30 rehabilitation sessions and indicated surgery. (a) Initial image in which the circle marks the rotator cuff lesion. Nobody noticed the alterations of the humeral head. (b) X-rays were requested that had not been requested in the previous consultations in which an alteration in the metaphyseal-epiphyseal region was observed. c) Scintogram showing pathologically increased uptake in different regions of the skeleton and especially in the proximal end of the humerus. The final diagnosis was a metastasis of prostate carcinoma.