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A bone scan or bone scintigraphy / s ɪ n ˈ t ɪ ɡ r ə f i / is a nuclear medicine imaging technique used to help diagnose and assess different bone diseases. These include cancer of the bone or metastasis, location of bone inflammation and fractures (that may not be visible in traditional X-ray images), and bone infection (osteomyelitis).
Generally a triple phase technetium 99 based scan will show increased uptake on all three phases. Gallium scans are 100% sensitive for osteomyelitis but not specific, and may be helpful in patients with metallic prostheses. Combined WBC imaging with marrow studies has 90% accuracy in diagnosing osteomyelitis.
DXA is only able to provide the areal bone mineral density. High-resolution peripheral quantitative computed tomography (HR-pQCT) is better than DXA at detecting bone microarchitecture, modeling whole-bone geometry using 3-dimensional information from scans. This method allows estimation of bone strength and other mechanical properties. [20]
Effective doses can range from 6 μSv (0.006 mSv) for a 3 MBq chromium-51 EDTA measurement of glomerular filtration rate to 11.2 mSv (11,200 μSv) for an 80 MBq thallium-201 myocardial imaging procedure. The common bone scan with 600 MBq of technetium-99m MDP has an effective dose of approximately 2.9 mSv (2,900 μSv). [24]
A CT scan, MRI, or 3-phase bone scan may be more effective for early diagnosis. [7] MRI appears to be the most accurate diagnostic test. [8] Tuning forks have been advocated as an inexpensive alternative for identifying the presence of stress fractures. The clinician places a vibrating tuning fork along the shaft of the suspected bone.
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CT angiography is a contrast CT taken at the location and corresponding phase of the blood vessels of interest, in order to detect vascular diseases. For example, an abdominal aortic angiography is taken in the arterial phase in the abdominal level, and is useful to detect for example aortic dissection .
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