With increasing energy demands, skeletal muscle relies more on glycolysis to meet those demands. Active contraction of skeletal muscle, particularly during the first half-hour following FDG injection, will be responsible for increased uptake. Laryngeal muscles normally show mild uptake. Though efforts are made to isolate the patient and avoid conversation, increased uptake is commonly seen within the laryngeal muscles, likely due to their use prior to injection and during the short conversations with the technologist. Usually the uptake is bilateral and symetric, but occasionally high assymetric uptake can be seen with recurrent laryngeal nerve palsy and vocal cord paralysis on the unaffected side.