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Tests

Overview of Radionuclide Bone Scan | Orthopaedics

What is a radionuclide bone scan?

A radionuclide bone scan is a nuclear imaging technique that uses a very small amount of radioactive material that is inserted into the patient’s bloodstream to be detected by a scanner. This test shows bone-to-bone blood flow and cell activity and can help evaluate any degenerative or arthritic changes in the joints. This test can also be used to diagnose bone diseases and tumors and to determine the cause of bone pain or inflammation. This test can rule out any infection or cracks.

A bone scan is an imaging test that helps identify problems with your bones. You safely use a very small amount of the so-called radiopharmaceutical drug. It is also known as “color”, but it does not stain the fabric.

Specifically, the bone is scanned to reveal problems with bone metabolism. Bone metabolism refers to the process by which bones break down and rebuild. New bone formation when bones are injured or broken is part of the healing process. A bone scan is a good way to see and document abnormal metabolic processes in the bones.

A radionuclide bone scan can also be used to find out if cancer has spread to another area of ​​the body, such as the prostate or breast.

During a radionuclide bone scan, radioactive material is injected into a vein that takes your bones. Then it will be monitored for many hours. A very small amount of radiation is used in the substance and is released from your body in about two to three days.

Purpose of radionuclide bone scan

Bone scans are used primarily to detect the spread of metastatic cancer. As cancer cells multiply rapidly, they appear as a hotspot on the bone scan. This is due to increased bone metabolism and bone repair in the area of ​​cancer cells. Bone scans can also be used to diagnose cancer before and after treatment to assess the effectiveness of treatment.

Your doctor may order a bone scan if he thinks you have a problem with your bones. A bone scan can also help find the cause of the unexplained bone pain you are experiencing.

Bone scans reveal bone problems associated with the following conditions:

  • Evaluation of bone lesions in situations where routine radiographs reveal no lesions
  • Identify hard-to-locate cracks
  • To determine the age of the fracture
  • To diagnose and / or diagnose bone infections (osteomyelitis)
  • To assess unexplained bone pain

Arthritis, benign bone tumors, Paget’s disease (a bone disorder that usually occurs in people over the age of 50, in which the bones become stiff and soft and have long, curved bones), and avascular necrosis (bone loss due to bone loss) blood supply to bones)

There may be other reasons for your doctor to recommend a bone scan.

What are the risks of a radionuclide bone scan?

The amount of radionuclide bone scan that is injected into the vein for this procedure is very small and no precautions against radioactive exposure are required. The injection of the marker causes some discomfort. Allergic reactions to the marker are very rare, but can occur.

Patients who are allergic or sensitive to medications, contrast dyes or latex should inform their doctor.

If you are pregnant or suspect that you are pregnant, you should inform your healthcare provider, as there is a risk of injury to the fetus from the bone scan. If you are breastfeeding or breastfeeding, you should notify your healthcare provider as there is a risk of contaminating breast milk with a marker.

There may be other risks depending on your specific medical condition. Be sure to discuss any problems with your doctor before the procedure.

How do I prepare for a radionuclide bone scan?

Remedies: If you are pregnant or think you are pregnant, consult your doctor before scheduling a test. We will discuss other options with you and your doctor.

Lactation: If you are breastfeeding, you should inform your doctor, as there is a risk of contaminating breast milk with a marker.

Clothing: You may be asked to change into a patient gown. A gown will be provided. Lockers are provided to store your personal belongings. Remove all stitches and keep all jewelry and valuables in the house.

Eating / Drinking: Generally, no prior preparation such as fasting or anesthesia is required before a bone scan.

Allergies: Tell a radiologist or technologist if you are allergic to medications, contrast dyes, or iodine. Injection of the radiotracer causes some discomfort. Allergic reactions to radiotracer are very rare but can occur.

Generally, no prior preparation, such as fasting or sedation, is required before a bone scan.

Tell a radiologist or technologist if you are allergic or sensitive to medications, contrast dyes, or iodine.

If you are pregnant or suspect that you are pregnant, you should notify your healthcare provider.

Depending on your medical condition, your doctor may order other specific preparations.

How is a radionuclide bone scan done?

The process begins with the injection of radioactive material into a vein. This substance is allowed to work for the next two to four hours through your body. Depending on the cause of the bone scan, your doctor may start taking images right away.

As the substance spreads throughout the body, bone cells are naturally drawn to areas that need repair. Radioactive tracers in the material follow these cells and pick them up at the site of bone damage. It is taken in areas with high blood flow.

After enough time has passed, your doctor will use a special camera to scan the bones. Damaged areas, where the material has settled, appear as dark spots on the film.

Your doctor may repeat the injection and imaging procedure if the first round is not definitive. They can also order single photon emission computed tomography (SPECT). This is similar to a bone scan, except that the imaging process creates three-dimensional images of your bones. Your doctor needs SPECT to see your bones more deeply. They can also use it if the original images are not clear in some areas.

What happens during a radionuclide bone scan?

A radionuclide bone scan may be done on a patient basis or as part of your hospital stay. Procedures may vary depending on your condition and your doctor’s practices.

Generally, a bone scan follows this procedure:

You may be asked to remove clothing, jewelry, or other items that may interfere with the procedure.

If you are asked to remove your clothing, you will be given a gown to wear.

The intravenous (IV) line is opened by hand or by hand to inject the tracer.

The marker is injected into a vein. The marker is allowed to focus on the bone tissue for one to three hours. During this time, you may be allowed to walk or leave the facility. It will not be dangerous to other people, as the marker emits less radiation than a standard X-ray.

During the waiting period, you should drink several glasses (four to six glasses) of water to remove any tracer not concentrated in the bone tissue.

If your bone is scanned for a bone infection, a series of scans may be done immediately after the marker is injected. Another set of scans is done after allowing the marker to focus on the bone tissue.

When the marker allows you to focus on the bone tissue for a reasonable period of time, you will be asked to empty your bladder before the scan begins. A full bladder can distort the pelvic bones and make it uncomfortable during the scan, which can take up to an hour to complete.

Since any movement affects the quality of the scan, you will be asked to lie down on the scan table.

The scanner slowly moves over you several times as it detects the gamma rays emitted by the marker in the bone tissue.

You may be ossified again during the scan to obtain specific views of the bones.

When the scan is complete, the IV is removed.

While a radionuclide bone scan may not cause any pain, staying still throughout the procedure may cause some discomfort or pain, especially in the case of an aggressive procedure, such as a recent injury or surgery. The technician will use all possible comfort measures and complete the procedure as soon as possible to minimize any discomfort or pain.

What happens after the radionuclide bone scan?

You should move slowly when getting up from the scanner table to avoid dizziness or a mild headache without lying down during the procedure.

It is recommended that you drink plenty of fluids and empty your bladder frequently for 24 to 48 hours after the procedure to help remove the remaining marker from your body.

The IV site is checked for any signs of redness or swelling. If you notice any pain, redness, and / or swelling at the IV site after returning home from your procedure, you should inform your doctor, as this may indicate an infection or other type of reaction.

You should not have any other radionuclide bone scan procedures for 24 to 48 hours after your bone scan.

You can resume your normal diet and activities unless your doctor tells you otherwise.

Your doctor may give you additional or alternative instructions after the procedure, depending on your specific situation.

Results

A doctor (radiologist) who specializes in reading images will look for evidence of abnormal bone metabolism on scans. These areas appear as dark “hot spots” and lighter “cold spots” where markers are present or have not accumulated.

The test results are considered normal when the radioactive substance is distributed evenly throughout the body. This means that you may not have a major bone problem.

Results are considered abnormal when the scan shows dark “hot spots” or light “cold spots” on the bones. Critical points describe areas where radioactive material is highly concentrated. Cold spots, on the other hand, are areas where you don’t collect at all. Abnormal results may indicate that you have a bone disorder such as cancer or arthritis or an infection in the bone.

Although a bone scan is very sensitive to abnormalities in bone metabolism, it is less helpful in identifying the exact cause of the abnormality. If you have a bone scan that shows hot spots, more tests are needed to determine the cause.

Categories
Tests

Why would a doctor order a bone scan? | Orthopaedics

What is a bone scan?

A bone scan is an imaging test used to help diagnose problems with your bones. Safely use a very small amount of a radioactive drug called a radiopharmaceutical. It has also been referred to as “dye,” but it does not stain tissues.

Specifically, a bone scan is performed to screen for problems with bone metabolism. Bone metabolism refers to the process in which bone breaks down and rebuilds itself. New bone is part of the healing process when the bone is injured or broken. A bone scan is a good way to view and document abnormal metabolic activity in the bones.

A bone scan may also be used to determine whether cancer has spread to the bones from another area of the body, such as the prostate or breast. During a bone scan, a radioactive substance is injected into a vein that your bone takes. You will then be monitored for several hours. A very small amount of radiation is used in the material, and almost all of it is released from your body within two or three days.

Why a bone scan is done?

If you have unexplained bone pain, a bone scan may help determine the cause. The test is very sensitive to any difference in bone metabolism. The ability to scan the entire skeleton makes the bone scan very helpful in diagnosing a wide range of bone disorders, including:

  • Fractures
  • Arthritis
  • Paget’s disease of bone
  • Cancer that originates in the bones
  • Cancer that has spread to the bone from a different site
  • Arthritis or joint or bone replacement (osteomyelitis).
  • Impaired blood flow to the bone or death of bone tissue (avascular necrosis)

Risks of bone scan

Although the test relies on radiotracers to produce images, these reagents produce very little radiation exposure – less than a CT scan.

Getting ready for a bone scan

When you schedule an orthopaedic scan, the hospital or imaging centre staff will tell you how to prepare. Usually, you don’t need a lot of special preparations before a bone scan, but it is important to confirm this from the location where the test will be performed. If there is anything unclear in the instructions, speak with your health care team. Here are some things to expect:

  • What are you going to eat?: You can usually eat and drink normally before your appointment.
  • Your usual medications: Tell your health care team about all the medicines you take, including over-the-counter (OTC) medicines and supplements. Medicines containing barium or bismuth can affect test results. Your doctor may ask you not to take it before the test.
  • Personal medical history: Inform the staff if you have any allergies to any medication or medical condition. Women should tell their health care team if they are breastfeeding or may be pregnant.
  • What to wear: Before the test, you will need to remove metallic objects, such as jewellery. You may also need to wear a hospital gown.
  • Insurance, costs, and approval: If you are concerned about bone scan costs, contact your insurance provider before the scan. Ask if the test is covered and what, if any, you will pay. The hospital or centre staff will ask you to sign a consent form upon your arrival for the examination. This form demonstrates that you understand the risks and benefits of the test. The form also states that you agree to take the test. If you have concerns, talk to your doctor before signing up.

What happens during a bone scan?

The bone scan can be done on an outpatient basis or as part of your hospital stay. Procedures may vary depending on your condition and your doctor’s practices.

Generally, a bone scan follows this process:

  • You may be asked to remove any clothing, jewellery, or other items that may interfere with the procedure.
  • If you are asked to undress, you will be given a dress to wear.
  • An intravenous (IV) line will be started in the hand or arm to inject the reagent.
  • The reagent will be injected into a vein. The tracer will be allowed to focus on the bone tissue for one to three hours. You may be permitted to walk around or even leave the facility during this time. You will not be dangerous to other people, as the tracking device emits less radiation than a standard x-ray.
  • During the waiting period, you will need to drink several cups of water (four to six cups) to help flush out any tracer that is not concentrated in the bone tissue.
  • If a bone scan is performed to detect bone infection, a set of scans can be performed immediately after the injection of the tracer. Another set of scans will be done after the tracer is allowed to focus on the bone tissue.
  • When the tracer is allowed to concentrate in the bone tissue for an appropriate period of time, you will be asked to empty your bladder before the scan begins. A full bladder can deform the bones of the pelvis and may become uncomfortable during the examination, which may take up to an hour to complete.
  • You will be asked to lie flat on the scanning table, as any movement may affect the quality of the scan.
  • The scanner will slowly move over you several times as it detects the gamma rays emitted by the tracking device in the bone tissue.
  • Your position may be changed during the scan to obtain specific views of the bones.
  • When the scan is complete, the fourth streak will be removed.

While the bone scan itself does not cause any pain, having to lie still for the duration of the procedure may cause some discomfort or pain, especially in the case of a recent injury or a surgical procedure such as surgery. The technician will use all possible comfort measures and complete the procedure as quickly as possible to reduce any discomfort or pain.

What should I expect after a bone scan?

Bone scans generally do not cause any after-effects. Through the natural radioactive decay process, a small amount of the radioactive chemical in your body will lose its radioactivity over time. It is also excreted from your body in the urine for about 24 hours. You may be asked to take special precautions after urinating, to flush the toilet twice, and wash your hands well.

It is advised that you drink plenty of water for the day after the scan to help flush radionuclides from your system. If you have been in contact with children or pregnant women, you should let your doctor know. Although the radiation levels used in the scan are small, special precautions may be advised. Your hospital should give you more advice about this.

Categories
Disease

Overview of the Nasopharynx In Children | ENT Specialist

What is nasopharynx in children?

Nasopharynx in children, nasopharyngeal cancer is the formation of malignant (cancer) cells in the tissues of the nasal cavity and throat. Nasopharyngeal cancer is a disease in which malignant (cancer) cells form in the nasopharynx. The nasopharynx is made up of the nasal cavity (inside the nose) and the upper part of the throat.

The nasopharynx is more common in adolescents than in children under 10 years of age. Epstein-Barr virus infection increases the risk of the nasopharynx. Any risk factor that increases the chance of getting a disease is called. Having a risk factor does not mean you have cancer; The lack of risk factors does not mean that you will not have cancer. Talk to your pediatrician if you think your baby is at risk.

Symptoms of the nasopharynx

Nasopharynx signs and symptoms; headache and a stuffy or runny nose. These and other signs and symptoms can be caused by nasopharynx or other conditions. Check with your pediatrician if your child has any of the following:

  • Headache
  • The nose is stuffy or swollen
  • Nosebleeds
  • Deafness
  • Ear infection
  • Hearing loss
  • Problems moving the jaw
  • Trouble speaking
  • Looking at the eyelid or looking at the drooping
  • Lumps in the neck can be painful

Diagnosis of nasopharynx

Tests that examine the nasopharynx can help diagnose nasopharyngeal cancer. The following tests and procedures can be used:

  • Physical exam and health history: An exam of the body to detect general signs of health, including the appearance of lumps or any abnormalities. The health habits of the patient and the history of previous diseases and treatments are also taken into account.
  • MRI (magnetic resonance imaging): The process of using magnets, radio waves, and a computer to create a series of detailed images of parts of the body such as the head and neck. This procedure is also known as nuclear magnetic resonance (NMR).
  • Nasal endoscopy: A procedure that examines organs and tissues inside the body to examine abnormal areas. A flexible or fixed endoscope is inserted through the nose. The endoscope is a thin tube-shaped device that is lightweight with a lens for viewing. It may have a tool to remove tissue samples, which a pathologist examines under a microscope for signs of disease.
  • Epstein-Barr virus (EBV) testing: A blood test to detect antibodies to the Epstein-Barr virus and Epstein-Barr virus DNA markers. They are found in the blood of EBV patients.

Stages of nasopharynx

After the nasopharynx is diagnosed, tests are done to see if cancer cells have spread to the nasal cavity and throat or other parts of the body. To plan treatment, it is important to know if cancer cells have spread to the nasal cavity or other parts of the body. The process used to find out if cancer has spread is called staging. Most children with nasopharynx are in an advanced stage at the time of diagnosis. nasopharynx most often spreads to the bones, lungs, and liver.

The following tests and procedures can be used to find out if cancer has spread:

  • Neurological exam: A series of questions and tests to check the function of the brain, spinal cord, and nerves. The test examines a person’s mood, coordination, and ability to walk normally and how well muscles, senses, and reflexes work. This is also known as a neurological test or neurological test.
  • Chest X-ray: An X-ray of the organs and bones inside the chest. X-rays are a type of energy beam that can pass through the body and into the film, creating an image of areas inside the body.
  • PET-CT scan: The process of combining images from a PET scan and a CT scan. PET and CT scans are performed simultaneously on the same machine. Combine images from both scans to create a more detailed image than the actual test produces.
  • Computed tomography (CT) scan: The process of creating a series of detailed images taken from different angles, such as the chest or abdomen within the body. The pictures are created by a computer linked to an x-ray machine. A dye may be injected into a vein or to help organs or tissues become more visible. This procedure is also known as a CT scan.
  • Bone scan: A procedure to check for the presence of rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected intravenously and travels through the bloodstream. The radioactive material collects in cancerous bone and is detected by a scanner. The drawing shows a child sliding under a scanner, a technician operating the scanner, and a computer monitor displaying images taken during the scan. A small amount of radioactive material is injected into a child’s vein and travels through the blood. Radioactive material accumulates in the bones. When the child lies on a slippery table under the scanner, the radioactive material is detected and images are created on the computer screen.

There are three ways that cancer can spread throughout the body.

Cancer spreads through tissues, the lymphatic system, and the blood:

  • Tissue: Cancer spreads from where it started growing to nearby areas.
  • Lymphatic system: It spreads from the cancer site to the lymphatic system. Cancer travels through lymphatic vessels to other parts of the body.
  • Blood: Cancer spreads from where it started by entering the bloodstream. Cancer travels through blood vessels to other parts of the body.

The cancer started in other parts of the body:

  • When cancer spreads to another part of the body, it is called metastasis. Cancer cells divide from where they started (the primary tumor) and travel through the lymphatic system or blood.
  • Lymphatic system. Cancer enters the lymphatic system, travels through the lymphatic vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • Blood. Cancer enters the bloodstream, travels through blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • A metastatic tumor is a cancer of the same type as a primary tumor. For example, if nasopharyngeal cancer has spread to the lungs, the cancer cells in the lungs are actually nasopharyngeal cancer cells. The disease is metastatic nasopharyngeal cancer, not lung cancer.

Treatment for nasopharynx

There are a variety of treatments for children with the nasopharynx. Some treatments are standard (treatment currently in use), while others are being tested in clinical trials. Treatment A clinical trial is a research study that can help improve current treatments or obtain information about new treatments for patients with cancer.

When clinical trials show that the new treatment is better than the standard treatment, the new treatment may become the standard treatment. Since cancer is very rare in children, participation in clinical trials should be considered. Some clinical trials are open only to patients who have not started treatment.

Children with nasopharynx should have their treatment planned by a team of doctors who specialize in treating childhood cancer. Treatment is overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other pediatric health professionals who specialize in treating children with cancer and who specialize in certain areas of medicine. This may include the following experts and others:

  • Pediatrician
  • Pediatric surgeon
  • Radiation Oncologist
  • Pediatric ear, nose, and throat specialist
  • Pathologist
  • Pediatric Nurse Specialist
  • Social worker
  • Rehabilitation specialist
  • Psychologist
  • Expert in child life

Four types of standard therapy are used:

Chemotherapy: Chemotherapy is the treatment of cancer using drugs to stop the growth of cancer cells by killing them or preventing them from multiplying. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and reach cancer cells throughout the body (systemic chemotherapy).

Radiotherapy: Radiation therapy is a cancer treatment that uses high-energy x-rays or other forms of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation to the area of ​​the body where the cancer is.

Surgery: Surgery to remove the tumor is done if the tumor does not spread through the nasal cavity and throat at the time of diagnosis.