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Scintigraphy is an advanced imaging technique used to evaluate certain skeletal abnormalities. It uses radioactive tracers to identify changes in bone metabolism before they become visible on x-rays – for example, to detect fractures in bone structures.
The procedure can identify problems in any part of the skeleton, but is especially useful in areas where clinical examination, including diagnostic analgesia, is often difficult, such as the pelvis and back.
What is a bone scan
Skeletal scintigraphy is a special type of imaging that uses a small amount of radioactive material to assess the severity of various bone diseases and conditions, including fractures, infections, and cancer.
The diagnostic procedure is non-invasive and, with the exception of intravenous injections, is usually painless. The device uses radioactive materials that are combined with bone (tropes) called radiopharmaceuticals or radioisotopes. Due to them, visualization of bones is carried out, based on their introduction into the patient’s body and subsequent monitoring of their distribution and interaction with the environment. The skeleton becomes visible on a special device by capturing the gamma radiation of the isotopes included in the preparation.
The radioactive energy is detected by a special camera or imaging device that creates a picture of the bones called scintigrams. The bone anomaly is displayed as a shadow on the image.
Since the procedure is able to depict the functions of the body at the molecular level, it makes it possible to identify the disease at the earliest stages, therefore, to select the most effective treatment.
In fact, a skeletal scintigraphy or bone scan can often detect bone abnormalities much earlier than a conventional x-ray.
Indications and contraindications for the procedure
Bone scans cannot identify some types of cancer. Sometimes additional tests, such as CT scans, MRI scans, blood tests, or biopsies, may be needed to visualize pathology on a bone scan to help distinguish between normal and abnormal bone. Diagnostic procedures can take a long time – up to several hours. Among the contraindications for bone scintigraphy, it is worth noting: the period of breastfeeding, pregnancy, diseases of the cardiovascular system, pathological changes in the central nervous system, and a tendency to allergies.
Doctors prescribe bone scintigraphy if necessary:
- confirm or refute the presence of cancers in bone tissues;
- Diagnose the cause or location of unexplained bone pain, such as persistent low back pain
- determine the location of the damaged bone in complex bone structures, such as the foot or spine;
- diagnose broken bones, such as a hip fracture
- look for bone damage caused by infection or other conditions such as Paget’s disease.
Preparation for bone scintigraphy
The patient does not need special preparation before this diagnostic procedure. A month before the diagnosis, you must completely abandon contact with iodine-containing products. For a month, you need to give up medicines, which include bromine (some cough medicines and sedative drugs). Blockers should be discontinued in patients with cardiac arrhythmias.
Procedure Algorithm
In conventional x-rays, an image is made by passing x-rays through the patient’s body. A bone scan uses a radioactive material called a radiopharmaceutical (RP) or radioactive isotope that is injected into the blood, swallowed, or inhaled as a gas.
This radioactive material accumulates in the organ or area of the body being examined, where it releases a small amount of energy in the form of gamma rays. Special cameras detect this energy and then use a computer to create images detailing pathological changes.
The doctor injects radiopharmaceuticals into the patient’s body and lets him go home for at least three hours. During the waiting period, you should try to drink at least one and a half liters of water in order to significantly increase the rate of cleansing the body of radionuclides. Before the procedure itself, it is imperative to empty the bladder.
The patient is placed in a sitting or lying position on a couch. It is important not to move or talk during the diagnostic process. There is no one in the study room, except for the patient, all medical workers are in the adjacent room, from where the process of observation and diagnosis is carried out.
A gamma camera that captures changes in bone tissue is a large crystal that simultaneously scans the entire body. The data from the camera is transferred to a computer and interpreted into a graphic image. It is recommended to choose the best modern medical centers for the procedure, which actively use scintigraphy as a bone diagnostic.
The results can be collected from the radiologist, usually within a day. The images will fully display the human skeleton, which allows you to assess the general condition of the patient’s skeleton, as well as the number and location of metastases. Diagnosis helps not only to determine the focus of the disease, but also to suggest its type: benign or malignant.
Diagnostic safety
After the procedure, each patient is recommended to take a slightly warm shower with gel or soap, while washing the hair thoroughly with shampoo, and sending the clothes to the laundry. All consumables: bandages, cotton pads or balls are sent to the scrap, they are by no means carried home. In order to quickly remove radiopharmaceuticals from the body, it is recommended to drink plenty of water. It is worth noting that on the first day after diagnosis, the patient is advised to limit communication with children, with women in position and those who breastfeed children.