<p>Primary myelofibrosis (PMF) is a myeloproliferative neoplasm (MPN) resulting from clonal proliferation of hematopoietic stem cells. It often manifests as varying degrees of cytopenia, leukocytosis, extramedullary hematopoiesis, leading to progressive splenomegaly and a spectrum of constitutional symptoms, severely impacting the quality of life. Following definitive diagnosis, the median survival for this condition is approximately 5 years, with nearly 20% of patients eventually progressing to acute leukemia. Common causes of mortality include severe anemia, heart failure, bleeding, or recurrent infections. Consequently, early diagnosis plays a pivotal role in the prognosis of this disease. The ^99mTc-MDP whole-body bone scintigraphy provides a comprehensive visualization of the entire skeletal system in a single session. Not only does it facilitate the early detection of concealed lesions in structural imaging, but it also reflects the metabolic status of the entire skeletal system. Therefore, as a screening tool, it holds significant clinical relevance for prompting further diagnostic evaluation.</p>