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:
- Primary malignant bone tumors (e.g., osteosarcoma)
- Bone metastasis from primary extraosseous tumors (e.g., breast cancer, prostate cancer, lung cancer)
- Inflammatory and/or degenerative disorders; (e.g., osteomyelitis, rheumatoid arthritis, psoriatic arthritis)
- Paget disease of bone
- Fractures (e.g., stress fractures, nonaccidental injury in children, fracture healing)
- Impaired vitality of bone (e.g., infarct of bone transplants, osteonecrosis)
- Bone diseases that do not show up on primary imaging studies (e.g., x-ray, CT)
- Absolute contraindication: pregnancy
- Relative contraindications
We list the most important contraindications. The selection is not exhaustive.
- Intravenous administration of a radionucleotide tracer with an affinity for bone (e.g., Technetium-99m diphosphonate, Technetium-99m oxidronate)
- Uptake of tracer in areas with high bony metabolic activity (“hot spots”)
- Detection of these “hot spots” with a gamma camera
- Renal elimination of the radiopharmaceutical agent with increased uptake in the urinary tract