Bone Scan Diagnosis

According to Lancaster General Health, a regional health care provider located in Lancaster County with more than 100 years of experience in the health care field, a bone scan is defined as a special test or procedure in radiology used to examine the skeleton and bones to identify chemical and physical changes that have occurred in the bone(s). Bone scans are administered by experienced and educated nuclear radiologists. They are also administered to detect a number of different types of changes in the bone.

What Do Bone Scans Diagnose?

• Bone scans are used for different purposes. They are used to identify cancer cells that grow within bones and assess the effectiveness of cancer treatment before and after treatments are administered. In addition, bone scans can be used to assess bone trauma where normal X-rays will not work, locate fractures that are difficult to find, determine the age of fractures, and detect or evaluate infections within the bone. Additionally, bone scans can be used to detect the cause of bone pain that is otherwise unexplained and to detect certain disorders of the bone such as arthritis, tumors or Paget's disease.

Process

• The process of bone scanning begins with the injection of a substance known as radionuclide. It is injected into the body through the use of a needle into a vein, where it travels directly into the bloodstream. There is a little pain associated with this part of the procedure. Radionuclide is a radioactive substance that collects in areas of the bone affected by one of the conditions already mentioned. The substance collects in these areas--or "hot spots"--and emits gamma rays. The gamma rays are picked up by an imaging camera that slowly scans the body and allows radiologists to see parts of the bones that are not visible on a normal X-ray.

Results

• The results of a bone scan are either normal or abnormal. In a normal result, the scan will reveal an even distribution of the radioactive substance. This even distribution will appear gray in all areas of the image. In an abnormal result, there will be increased accumulation of the radioactive substance in some areas, while there will be decreased accumulation in other areas. The areas of increased accumulation are called "hot spots" and areas of decreased accumulation are called "cold spots." The "hot spots" are where the attention is focused because the substance will accumulate in areas where a problem presents itself during the process.

Risks

• The risks to having a bone scan performed are minimal. There is a small amount of pain when the substance is injected into the body. However, the radioactive material used does not submit a person to a high degree of radioactive exposure that requires treatment. There is also a slight risk that a patient may have an allergic reaction to the substance once injected. This typically happens in people who are allergic to medications, contrast dyes, shellfish and latex. If a patient is allergic to one of these, he should notify his physician and discuss the risks. Further risks exist for pregnant mothers and mothers who are breast-feeding, and they should discuss possible risks with their doctors. There may be other risks as well from other medical conditions, and patients should address concerns with their doctor before having the scan completed.

After the Procedure

• Because the procedure takes awhile to perform and patients must lay down the entire time, the patient should be careful and get up slowly. Getting up too fast, combined with the substance used in the procedure, can result in lightheadedness or dizziness. Over the next 24 to 48 hours, it is also important that the patient drink and go to the bathroom as often as possible to expel the remainder of the substance from the body. Additionally, it is important that the patient not have any more radionuclide procedures performed within 24 to 48 hours of each procedure.