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Bone Scan

  • A bone scan is a specialized radiology procedure used to examine the various bones of the skeleton.
  • A bone Scan is done to identify areas of physical and chemical changes in bone.
  • A bone scan may also be used to follow the progress of treatment of certain conditions.
  • A bone scan is a type of nuclear radiology procedure.

Frequently Asked Questions

It is an imaging test used to examine bones that may have been affected / damaged due to cancer/any other disease. It is also known as scintigraphy.
Small amount of radioactive substance called as radiotracer is injected into a patient’s arm vein. A scanning camera moves around the patient to detect the amount of radioactive substance that collects in the bones.
It will be suggested:
  • When there is unexplained bone pain, the cause for which cannot be detected in a normal x ray.
  • For detection of cancer that has its origin in the bones or has spread to the bones.
  • For detecting bone infection as in osteomyelitis.
  • For diagnosing bone fracture which cannot be seen on a normal X ray.
  • To diagnose metabolic disorders of the bone like Osteomalacia, Osteoporosis, Paget Disease, etc.
A bone scan will show areas of metabolism: increased/ decreased or normal bone metabolism.
A bone scan can take about an hour.

The patient will be asked to remove any metal objects or jewelry that he may be wearing. A hospital gown will be given to wear.

If you have recently taken medications that contain bismuth or if you have undergone an x ray where barium meal was given, then doctor must be informed because barium and bismuth affect the test results.

A pregnant woman should not undergo this test as there is use of radiations. A lactating mother is also not recommended a bone scan.
The patient will be asked to change positions and will have to lie down still during the scan.

If the radiotracer moves evenly through the bones, there is no anomaly and the result is considered normal.
If certain areas show increased or decreased accumulation of radiotracer material as compared to the surrounding areas, then the scan findings are abnormal in respect to those areas.
Areas that absorb little amount of tracer, will appear dark and are called as cold spots. This is also indicative of lack of blood supply to the bone and this is seen in cases of cancer.
Areas that absorb more amount of tracer are seen bright and are called as hot spots. They are seen in cases of fracture/ infection/trauma.

A very small amount of radiotracer is injected and exposure to radiations is very low. Radiation exposure is almost similar to conventional x rays.
Usually there is no risk. In some cases, there may be allergic reaction to the radiotracer and the patient may develop rashes.
Your doctor may order a bone scan if you have unexplained skeletal pain, a bone infection or a bone injury that can't be seen on a standard X-ray.
A bone scan can also be an important tool for detecting cancer that has spread (metastasized) to the bone from the tumor's original location, such as the breast or prostate.
A whole body bone scan takes around 3-4 hours, which includes two separate visits. In the first visit you will be given an injection of a radioactive isotope into a vein in your arm. There are no side effects to this injection. The isotope takes 2-3 hours to circulate in the blood and get absorbed in the bone.
During a bone scan, a radioactive substance is injected into a vein that is taken up by your bones. You'll then be monitored for several hours. A very small amount of radiation is used in the substance, and nearly all of it is released from your body within two or three days.
No special preparations are needed. You may be able to remain fully clothed, depending on the area of your body being scanned. But you'll need to remove any clothes that have metal fasteners, such as zips, hooks or buckles. In some cases, you may need to wear a gown.
Unlike ordinary X-rays, DEXA scans can measure tiny reductions in bone density. This makes it possible to diagnose osteoporosis in its early stages, before you break a bone. A DEXA scan also uses a low dose of radiation, which means the risks to health are much lower than with standard X-rays.
After the bone scan
You can do normal activities after the scan. This includes driving. You should not feel any side effects from the tracer or the test itself. Your doctor may ask you to drink lots of water for the next 1 to 2 days.
Bone scintigraphy (BS) that utilizes Tc-99m phosphonate compounds has high sensitivity but low specificity for the detection of bone and joint disease. In other words, using this test, we can easily identify active arthritis in patients, although the results are not specific for RA.
If you are taking medication for osteoporosis, you must have a bone density test every 1 to 2 years.
Even if you don't have osteoporosis, your doctor may suggest that you get a bone density test every 2 years, especially for women during or after menopause.
Certain areas of the bone lack the presence of tracer, showing one or more "cold" spots. Cold spots may be caused by a certain type of cancer (such as multiple myeloma) or lack of blood supply to the bone (bone infarction).
Bone Scan is a different test than a bone density study (such as DEXA), which evaluates bone strength and your risk of osteoporosis (thinning of the bones).
And the denser your bones, the stronger they generally are and the less likely they are to break. Bone density tests differ from bone scans. Bone scans require an injection beforehand and are usually used to detect fractures, cancer, infections and other abnormalities in the bone.
Bone scans are used primarily to detect the spread of metastatic cancer. Because cancer cells multiply rapidly, they will appear as a hot spot on a bone scan. This is due to the increased bone metabolism and bone repair in the area of the cancer cells.