Even though the name itself suggests, that it is a nuclear scanning test of bones, in order to understand what “bone scan” really is, it will be better to see what it does, rather than plainly defining it in technical terms. Bone scan serves various purposes. Let’s see what they are…
- Identification of certain abnormalities, which might be the cause that are creating obstacles in the bone’s growth or healing
- Evaluation of the damage done to the bones, like fracture, which sometimes cannot be seen clearly in the X-ray
- Finding cancer that has spread to the bones
- Monitoring conditions (like Infection & Trauma) that can affect bones, like Paget’s disease
- Diagnosing the cause of location of unexplained bone pain, like ongoing lumber backache
The process of bone scan starts with injecting into an intravenous line a small amount of radioactive material, such as 600 MBq of technetium-99m-MDP. Three to four hours time is given for the radioactive material to spread all through the concerned body part. Then the patient is scanned under Gamma Camera, which is sensitive to radiation emitted by the injected material. The radioactive material (also called “Radioactive Marker”) gets concentrated in a region where there is a high bone turnover, and this is captured by the Gamma Camera.
The outcome or the result of bone scan is shown in the form of “Hot Spots” and “Cold Spots”. Hot Spots appear darker and represent an area where there is high concentration of the radioactive marker, which indicates an abnormality. The Cold Spots, on the contrary, appear light and indicate the areas where there is low concentration of the marker, which indicates the normal condition of the region.
The bone scan, however, cannot identify the exact nature of the lesion. For instance, it cannot differentiate, whether the lesion is a tumor, an infection, or a fracture. Therefore, this scanning process is many times followed by a CT Scan or MRI Scan to better characterize the nature of the lesion.
Even though there is no specific preparatory requirement before the scan, it is better if the following things are taken into consideration and are brought to the doctor’s attention.
- Inform your doctor if you have had “Barium contrast material” (like Barium enema) or a medicine that contains Bismuth (like Pepto-Bismol) as part of X-Ray test, within last four days, because Barium and Bismuth interfere with the test results.
- Inform the doctor if you are (or might be) pregnant, and/or currently breast-feeding, because the radioactive marker can have influence over the fetus and the breast milk.
Bone scan is absolutely painless, except for the initial sting of injection, which is used to deliver radioactive marker. However, during the scanning process you may find it difficult to stay motionless, which is required for scanning. Moreover, if you have joint, back, or any bone pain, the process may prove to be little uncomfortable. Therefore, ask for a pillow or a blanket to make sure you feel as much at ease as possible.
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