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Bone scan

Last updated: September 14, 2019

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A bone scan (skeletal scintigraphy) is an imaging modality in which an intravenously administered radioactive tracer with an affinity for bone (e.g., Tc99m-methylene biphosphonate) is used to visualize areas of increased metabolic activity within bone with the aid of a gamma camera. Bone scans are used to evaluate bone injuries, musculoskeletal pain, joint conditions, primary bone neoplasms, and malignancies with potential for bone metastases.

A bone scan is used for the detection, evaluation, and/or follow-up of the following conditions:

References:[1]

References:[2]

We list the most important contraindications. The selection is not exhaustive.

  1. Intravenous administration of a radionucleotide tracer with an affinity for bone (e.g., Technetium-99m diphosphonate, Technetium-99m oxidronate)
  2. Uptake of tracer in areas with high bony metabolic activity (“hot spots”)
    • Uptake of the radiotracer by a particular region of the bone is dependent on:
  3. Detection of these “hot spots” with a gamma camera
  4. Renal elimination of the radiopharmaceutical agent with increased uptake in the urinary tract

References:[2][3]

  • Very high sensitivity for the detection of areas of bone with increased metabolism
  • Low specificity

  1. ACR-SPR practice parameter for the performance of skeletal scintigraphy (bone scan). https://www.acr.org/-/media/ACR/Files/Practice-Parameters/Skeletal-Scint.pdf. Updated: January 1, 2017. Accessed: November 11, 2018.
  2. Clinical guideline for bone scintigraphy. https://www.bnms.org.uk/images/stories/Procedures_and_Guidelines/BNMS_Bone_Scintigraphy_Guideline_v1.pdf. Updated: October 1, 2018. Accessed: November 11, 2018.
  3. Love C, Din AS, Tomas MB, Kalapparambath TP, Palestro CJ. Radionuclide bone imaging: an illustrative review. Radiographics. 2003; 23 (2): p.341-358. doi: 10.1148/rg.232025103 . | Open in Read by QxMD