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Bone scan
Scintigraphy - bone
A bone scan is an imaging test used to diagnose bone diseases and find out how severe they are.
How the Test is Performed
A bone scan involves injecting a very small amount of radioactive material (radiotracer) into a vein. The substance travels through your blood to the bones and organs. As it wears off, it gives off a little bit of radiation. This radiation is detected by a camera that slowly scans your body. The camera takes pictures of how much radiotracer collects in the bones.
If a bone scan is done to see if you have a bone infection, images may be taken shortly after the radioactive material is injected and again 3 to 4 hours later, when it has collected in the bones. This process is called a 3-phase bone scan.
To evaluate metastatic bone disease, images are taken only after the 3- to 4-hour delay.
Metastatic
Metastasis is the movement or spreading of cancer cells from one organ or tissue to another. Cancer cells usually spread through the blood or the ly...
The scanning part of the test will last about 1 hour. The scanner's camera may move above and around you. You may need to change positions.
You will probably be asked to drink extra water after you receive the radiotracer to keep the material from collecting in your bladder.
How to Prepare for the Test
You must remove jewelry and other metal objects. You may be asked to wear a hospital gown.
Tell your doctor if you are or may be pregnant.
DO NOT take any medicine with bismuth in it, such as Pepto-Bismol, for 4 days before the test.
Follow any other instructions you are given.
How the Test will Feel
There is a small amount of pain when the needle is inserted. During the scan there is no pain. You must remain still during the scan. You will be instructed when to change positions by the technologist.
You may experience some discomfort due to lying still for a long period.
Why the Test is Performed
A bone scan is used to:
- Diagnose a bone tumor or cancer
- Determine if a cancer that began elsewhere in your body has spread to the bones. Common cancers that spread to the bones include breast, lung, prostate, thyroid, and kidney.
- Diagnose a fracture, when it cannot be seen on a regular x-ray (most commonly hip fractures, stress fractures in the feet or legs, or spine fractures)
-
Diagnose a
bone infection (osteomyelitis)
Bone infection (osteomyelitis)
Osteomyelitis is a bone infection. It is mainly caused by bacteria or other germs.
ImageRead Article Now Book Mark Article - Diagnose or determine the cause of bone pain, when no other cause has been identified
-
Evaluate metabolic disorders, such as
osteomalacia
,
primary hyperparathyroidism
,
osteoporosis
,
complex regional pain syndrome
, and
Paget disease
Osteomalacia
Osteomalacia is softening of the bones. It most often occurs because of a problem with vitamin D, which helps your body absorb calcium. Your body n...
ImageRead Article Now Book Mark ArticlePrimary hyperparathyroidism
Hyperparathyroidism is a disorder in which the parathyroid glands in your neck produce too much parathyroid hormone (PTH).
ImageRead Article Now Book Mark ArticleOsteoporosis
Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).
ImageRead Article Now Book Mark ArticleComplex regional pain syndrome
Complex regional pain syndrome (CRPS) is a chronic pain condition that can affect any area of the body, but often affects an arm or a leg.
Read Article Now Book Mark ArticlePaget disease
Paget disease is a disorder that involves abnormal bone destruction and regrowth. This results in deformity of the affected bones.
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Normal Results
Test results are considered normal if the radiotracer is present evenly throughout all the bones.
What Abnormal Results Mean
An abnormal scan will show "hot spots" and/or "cold spots" as compared to surrounding bone. Hot spots are areas where there is an increased collection of the radioactive material. Cold spots are areas that have taken up less of the radioactive material.
Bone scan findings must be compared with other imaging studies, in addition to clinical information. Your provider will discuss any abnormal findings with you.
Risks
If you are pregnant or nursing, the test may be postponed to prevent exposing the baby to radiation. If you must have the test while breastfeeding, you should pump and throw away the breast milk for the next 2 days.
The amount of radiation injected into your vein is very small. All radiation is gone from the body within 2 to 3 days. The radiotracer that is used exposes you to a very small amount of radiation. The risk is probably no greater than with routine or conventional x-rays.
Risks related to the bone radiotracer are rare, but may include:
-
Anaphylaxis
(severe allergic response)
Anaphylaxis
Anaphylaxis is a life-threatening type of allergic reaction.
ImageRead Article Now Book Mark Article -
Rash
Rash
Rashes involve changes in the color, feeling or texture of your skin.
ImageRead Article Now Book Mark Article -
Swelling
Swelling
Swelling is the enlargement of organs, skin, or other body parts. It is caused by a buildup of fluid in the tissues. The extra fluid can lead to a ...
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There is a slight risk of infection or bleeding when the needle is inserted into a vein.
References
Bearcroft PWP, Hopper MA. Imaging techniques and fundamental observations for the musculoskeletal system. In: Adam A, Dixon AK, Gillard JH Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging . 6th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015:chap 45.
Ribbens C, Namur G. Bone scintigraphy and positron emission tomography. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology . 6th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap 43.
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Nuclear scan - illustration
A radiotracer is injected into a peripheral vein. As the radiotracer decays, gamma radiation is emitted and is detected by a Gamma camera. When the tracer has collected in the target organ the area is scanned. Radionuclide scans can detect abnormalities such as fractures, bone infections, arthritis, rickets, and tumors that have spread, among other diseases.
Nuclear scan
illustration
-
Nuclear scan - illustration
A radiotracer is injected into a peripheral vein. As the radiotracer decays, gamma radiation is emitted and is detected by a Gamma camera. When the tracer has collected in the target organ the area is scanned. Radionuclide scans can detect abnormalities such as fractures, bone infections, arthritis, rickets, and tumors that have spread, among other diseases.
Nuclear scan
illustration
Review Date: 12/10/2015
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
