Hepatic uptake on an MDP bone scan is a non-specific finding. When present, the etiology needs to be determined. The differential diagnosis depends on the pattern of uptake. Metastatic breast and colon cancer are frequent causes of focal faint uptake. Diffuse uptake is rare, but can be seen with hepatitis, amyloid, and IV gadolinium administration. In addition, aluminum breakthrough from the molybdenum generator can cause colloid formation and subsequent diffuse hepatic uptake. We present a case of diffuse uptake in a patient with acute hepatic failure. The etiology of the failure was extensive thrombosis of the inferior vena cava (IVC).