Bone Scan: Purpose, Preparation & Procedure of Bone Scan Radiology

The development and spread of numerous techniques that help in the diagnosis and treatment of diseases have significantly changed the world of medicine. This extraordinary change has revolutionised healthcare procedures, improving patient outcomes and encouraging medical innovation. Bone scanning has made extensive advances in a number of areas as the modern environment started providing medical professionals with a wide range of tools and strategies. This allows them to offer personalised and highly effective care to people seeking a bone scan test.

The bone scan is one of the methods, which are most effective at monitoring bone health and detecting abnormalities. Find out about the complexities of bone scan here, looking at its method, uses, interpretation, and important precautions for safety.

What is a Bone Scan?

Doctors frequently switch to bone scans when traditional X-rays are unable to offer significant insights into bone abnormalities or disorders. A bone scan serves as a nuclear imaging test that facilitates the visualisation of bone structure and function. By employing a radiotracer, a minute quantity of radioactive material emitting gamma rays, this procedure sheds light on the irregularities within the bones.

Purpose of Bone Scan

A bone scan can assist in identifying the underlying reason for unexplained bone pain. This test is effective in detecting variations in bone metabolism. Conducting a comprehensive scan of the entire skeleton aids in the diagnosis of various bone disorders, such as:

1. Detecting bone abnormalities and diseases: Bone scans excel in the detection of various bone abnormalities, including infections, tumours, and stress fractures. These scans reveal the presence, location, and extent of these conditions, laying the groundwork for tailored treatment plans.
2. Evaluating fractures: In cases marked by suspected fractures or traumatic injuries, bone scans inspect the severity and extent of the inflicted damage. This vital information empowers healthcare professionals to ascertain the most fitting course of treatment, be it surgery, immobilisation, or other interventions.
3. Assessing bone cancer: When identifying bone cancer, bone scans play an indispensable role in staging and determining the spread of malignant cells. They can be effectively used to identify metastatic lesions, providing guidance for treatment decisions, encompassing surgery, chemotherapy, or radiation therapy.
4. Monitoring treatment response: Bone scans prove to be instrumental in monitoring the efficacy of treatment regimens designed for various bone diseases, including osteomyelitis or Paget’s disease. By comparing scans obtained prior to and following treatment, medical professionals accurately gauge the response to therapy, enabling necessary adjustments to the treatment plan.

Preparation for the Bone Scan

When undergoing a bone scan test, imposing dietary restrictions or limiting physical activities beforehand is usually unnecessary. However, it is important to inform your healthcare provider if you have recently consumed a medication containing bismuth or undergone an X-ray examination using barium. The presence of bismuth and barium in your system can potentially interfere with the accuracy of the bone scan results.

To ensure optimal conditions for the procedure, it is advisable to wear loose clothing and refrain from wearing any jewellery. In some cases, you may be required to wear a gown during skeletal scintigraphy.

Pregnant women or nursing mothers are typically not subjected to bone scans due to concerns regarding potential radiation exposure to the developing baby. If you suspect you may be pregnant or are currently nursing, it is crucial to inform your healthcare provider beforehand.

Bone Scan Procedure

A radiographer will provide a detailed explanation of the upcoming procedure. They will request your signature on a consent form, signifying your comprehension and agreement to proceed. This moment presents an ideal opportunity for you to raise any queries or concerns you may have regarding the process. Feel free to ask any questions to gain clarity. The step involved in the procedure for the bone scan are as follows:

1. Injection of the radiotracer: A small quantity of radioactive substances, known as tracers, is introduced into a vein located in the hand or arm. The duration between the injection and scan may differ based on the purpose of the scan. While a few images could be captured promptly following the injection, the primary images are typically acquired 2 to 4 hours later. This time frame allows the tracer to circulate and become absorbed by the bones. As you wait, it is possible that you will be instructed to consume multiple glasses of water. This helps eliminate any unabsorbed tracer from your body. At certain intervals, it is also likely that you will be asked to empty your bladder before subsequent scan.
2. Imaging process: Following the injection, a waiting period ensues, allowing the radiotracer to disperse evenly throughout the skeletal system. Once this waiting period concludes, the patient assumes a suitable position on an imaging table while a gamma camera captures intricate images of the bones. Through the detection of gamma rays emitted by the radiotracer, the gamma camera captures images that highlight areas of heightened or diminished bone activity.
3. Duration: The duration of a bone scan varies. It majorly depends on the unique requirements of each case. Generally, the waiting period post radiotracer injection lasts for approximately 2 to 4 hours. The imaging process itself consumes around 30 to 60 minutes. Patients are advised to maintain stillness during the imaging phase to ensure precise and unambiguous results.

After the Bone Scan

A bone scan test does not have any side effects, and there is usually no requirement for subsequent care. However, you may be advised to consume a substantial amount of water over the next one to two days to facilitate the elimination of the tracer from your body. Generally, the radioactivity resulting from the tracers is completely expelled within two days following the scan.

Interpreting the Results

The test results are normal once the radioactive material has uniformly permeated the entire body. These results suggest that there is most likely no significant need to be concerned about your skeletal system.

When the scan reveals opposing phenomena, such as heightened ‘hot spots’ or lowered ‘cold spots’ inside the skeletal framework, differences from normality become apparent. Hot spots refer to specific locations where radioactive material has accumulated excessively, whereas cold spots refer to places where no such accumulation is found. A bone-related illness, including cancer, arthritis, or a bone infection, may be present if abnormal results are detected.

Advantages and Limitations

Bone scan radiology offers numerous advantages in the diagnosis and evaluation of bone-related conditions. These advantages comprise:

1. High sensitivity in detecting bone abnormalities
2. Non-invasive procedure with minimal discomfort, instilling reassurance
3. Ability to detect bone abnormalities earlier than conventional X-rays, helping with early intervention.

The limitations include:

1. 1. Limited specificity necessitates further diagnostic tests for the precise identification of certain conditions, forging the path to clarity.
   2. Exposure to a small amount of radiation is generally safe but warrants minimisation when feasible, treading cautiously.

Safety Considerations and Risks

A bone scan or skeletal scintigraphy involves the introduction of a radioactive tracer, usually technetium-99m, into your bloodstream through an injection. The radiation level emitted during this procedure is extremely low, much lower than that of a CT scan. The radioactive tracer has a relatively short half-life, around 6 hours, so it will naturally leave your system within one to two days. The gamma scanner itself doesn’t emit any radiation. The only possible side effects associated with this procedure, besides the discomfort of staying still for a while, are related to the radioactive tracer.

If you have a heart condition or take heart medications; it’s important to inform your healthcare provider about these medicines. This doesn’t necessarily mean you can’t undergo the test, but it ensures that your condition can be closely monitored during the procedure.

As a general precaution, pregnant individuals usually avoid nuclear medicine procedures like bone scans. Additionally, if you have a higher body weight, your healthcare provider might explore alternative diagnostic options.

For breastfeeding women, it’s recommended to nurse your baby just before the test and then temporarily pause breastfeeding for 24 hours, pumping and discarding the breast milk during that time. It might be helpful to have a reserve supply of breast milk for the 24 hours following the test.

Takeaway

A bone scan test is a diagnostic tool of immense value, possessing the notable attributes of cost-effectiveness and sensitivity. Although the test may take a while, it allows you to resume your normal activities without being restricted by any residual side effects. It is crucial to avoid making fast judgements and negative inferences if your bone scan reveals intriguing hot areas. One must bear in mind that while a bone scan unveils irregularities, it remains incapable of furnishing specific details regarding their nature.

Conversely, if your scan images are clear but your symptoms continue, it is important to discuss this situation with your healthcare physician and look into other possible lines of inquiry. To ensure a comprehensive evaluation, it may prove advantageous to request the prior sharing of your medical records with the specialist prior to your appointment.

Furthermore, you possess a personal copy of the bone scan report, usually accessible in digital format. This affords you the opportunity to peruse the findings and contributes to your active engagement in your own healthcare journey.