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.


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.