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What is it?
A bone scan is a test to find areas of increased or decreased bone cell metabolism (me-TAB-o-lizm). Metabolism is the process of tissue cells dying and being replaced by new cells. This test is a type of nuclear (NU-klee-ar) medicine scan that is also called bone scintigraphy (sin-TIG-rah-fee) or musculoskeletal (mus-ku-loh-SKEL-e-tl) scan imaging.
Why do I need a bone scan?
A bone scan may be done to check the rate of bone formation. A bone scan may be done to find or help treat any of the following medical conditions:
- Avascular necrosis (a condition where parts of bone die because of lack of blood supply to them).
- Bone diseases, such as arthritis, rickets, fibrous (FEYE-brus) dysplasia (dis-PLAY-zhah), or Paget's (PAJ-ets) disease.
- Breast, prostate, or other cancer that can spread to the bones.
- Changes in the bone after radiation therapy.
- Early stress fractures that have not yet caused the bone to completely break.
- Infection of the bone, called osteomyelitis (os-tee-oh-meye-e-LEYE-tis).
- Shin splints (pain along the front of the bone of your lower leg).
- Trauma, such as broken bones from an accident.
- Unexplained bone pain.
Who should not have a bone scan?
Tell your caregiver before the test if you might be or are pregnant. Caregivers may suggest waiting to have the test until after your baby is born. Tell caregivers if you are breast feeding. They may suggest waiting to have the test until after you have finished breast feeding your baby. Wait at least four weeks after finishing breast feeding to have a bone scan.
What should I do to get ready for the bone scan?
You do not have to do anything special to prepare for the scan. You may eat, drink fluids, and take any medicines that you take regularly. Your caregiver may tell you to take a laxative before the test.
You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
How is a bone scan performed?
- Your caregiver will tell you what time to come to the Nuclear Medicine department where the scan is performed. A caregiver checks your weight, and then puts an IV (intravenous line) into a vein, probably in your hand or arm. A solution containing a substance called a radioactive tracer is put into the IV. As the tracer decays (breaks down) it gives off gamma radiation. The scan is taken with a gamma camera that showing how much of the tracer is in your bones.
- When the scan will be taken depends on the reason you are having the bone scan. The scan is usually done two to three hours after the injection. This gives the tracer enough time to get into your bones. The scan may be done immediately after the injection for some medical conditions. If the scan is going to be done later, you may be allowed to leave and return later at a specific time. Drink plenty of liquids, such as water or juice between the time of the injection and when the scan is done. Make sure you go to the bathroom (empty your bladder) as much as possible.
- When its time for the scan, remove jewelry and other metal objects, put on a hospital gown, and empty your bladder. As you lie on a table, caregivers use the gamma camera to take the pictures of your bones. You must lie very still during the scan and only move when caregivers ask you to change positions. It usually takes about 30 to 90 minutes to do the scan.
What will I feel during the scan?
You may feel discomfort when the IV is put in your vein. The scan itself is not painful, but you may be uncomfortable lying still or changing positions during the scan. Caregivers may offer you medicine which may help you to lie still.
What should I do after the scan?
The tracer leaves your body quickly through your urine. You may continue activities, eat, drink, and take your usual medicines as you did before the test. Drink plenty of water and other fluids to help flush the tracer out of your body. Flush the toilet three times after going to the bathroom. This makes sure that the small amount of tracer that leaves your body does not stay in the toilet bowl.
What are normal and abnormal results?
All the bones in a normal bone scan look the same and gray throughout. An abnormal scan can have "hot" or "cold" spots. A hot spot is an area that looks black because bone growth is more active. A cold spot is an area that looks lighter or white because bone growth is less active.
What are the risks with having a bone scan?
You may feel nauseated (sick to your stomach) or vomit (throw up). Rarely, you may develop a rash, swelling, or a serious allergic reaction to the injection. The place where your IV was could bleed, become red, inflamed (sore), or infected. If you do not have a bone scan, caregivers may not be able to decide what would be the best care for your health problems. Your problem could get worse, and you could die. Call your caregiver if you are worried or have questions about your medicine or care.
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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