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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). [1]
The only definitive diagnostic test in the early acute stage is a bone scan, which will show heterotopic ossification 7 – 10 days earlier than an x-ray. The three-phase bone scan may be the most sensitive method of detecting early heterotopic bone formation.
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.
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.
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]
A scanner used to measure bone density using dual energy X-ray absorptiometry. Bone density, or bone mineral density, is the amount of bone mineral in bone tissue.The concept is of mass of mineral per volume of bone (relating to density in the physics sense), although clinically it is measured by proxy according to optical density per square centimetre of bone surface upon imaging. [1]
The "Honda sign" (H-pattern [1]) is a radiologic sign seen in case of sacral insufficiency fracture in bilateral sacral insufficiency fractures on a radioisotope bone scan. [2] It gets its name because the shape observed resembles the logo of the Honda motor company, resembling the alphabet "H".
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]