Bone Scan

Indications

• Bone scans are considerably more sensitive than skeletal x-rays for detecting the presence and extent of bone disease
• Primary and metastatic bone neoplasms
• Osteomyelitis, stress fracture, aseptic necrosis, bone infarction, and joint disorders
• Paget's disease
• Differentiation of bone islands versus osteoblastic metastases or other focal osteosclerotic lesions
• Bone lesion, i.e. osteoid osteoma
• Hyperparathyroidism
• Hypertrophic pulmonary osteoarthropathy
• Evaluation of progression or response to therapy
• Trauma
• Musculoskeletal inflammation/infection
• Prosthetic joint loosening/infection
• Pain of suspected musculoskeletal etiology
• Reflex Sympathetic dystrophy
• Evaluation of abnormal radiographic findings or abnormal laboratory findings
• Distribution of osteoblastic activity prior to therapy with strontium-89 or similar therapeutic radiopharmaceuticals

Radiopharmaceutical

25 mCi 99m Tc MDP or HDP intravenously

Patient Preparation

• Patient's abdomen should be free of barium; however, studies may be performed on patients who have also undergone x-ray examinations using barium if the area of interest will not be obscured by the barium. A KUB x-ray may be indicated prior to dosing the patient
• After injection of the radiopharmaceutical the patient should be encouraged to drink 32 ounces or more of liquids and to void frequently
• After injection there is a 3 hour wait
• Patient should empty urinary bladder prior to scan
• Remove all metal objects prior to scanning

Procedure

• Inject 99m Tc MDP or HDP IV and wait at least 3 hours before starting scan. Certain suspected pathologies will require a dynamic flow study to be obtained at the time of injection
• Routine views obtained are: Whole Body
• Other projections may need to be obtained to adequately demonstrate suspected pathology
• SPECT imaging if indicated, back pain, rib pain – no increased areas of uptake on whole body scan. Per physician/radiologist written order