Bone Scintigraphy

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The bone scan is a nuclear medical examination evaluating  abnormalities involving bones and joints. A skeletal scintigraphy produces images of the changes in the bone metabolism than can occur for example in a degenerative joint disease (arthritis), inflammation, or tumors.

 

 

Other names: Skeletan scintigraphy, Multiphase skeletal scintigraphy, Bone Scan

Used contrast agent: Methylendiphosphonat (MDP) and Hydroxymethylendiphosphonat (HMPD)

 What is a bone scintigraphy (bone scan)?

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With the bone scan, changes in local or overall bone metabolism of the human body can be made visible, especially if a disease has progressed.

When is this examination is needed (indication)?

In the case of undefined pain in the bone or joint, this assessment provides information about a pathologically altered bone metabolism.

In our practice, we use a bone scan especially for the preliminary examination for synovectomy (RSO), in the clarification of inflammatory joint disease (osteoarthritis activated), or rheumatic changes joints (arthritis). This examination also serves the assessment of inflammatory changes of the bone (osteomyelitis), the detection of tumors and tumor metastases (bone metastases), fractured bones, as well as the examination of loose joint prostheses (e.g. hip or knee replacements).

How is the examination performed?

At the beginning of a bone scintigraphy, a low dose radioactive substance is injected into a vein in the arm (injection). Subsequently, the distribution is measured from the outside at different timings by a so-called gamma camera. The degree of accumulation of the radioactive substances depends on the regional blood flow to the surrounding soft tissue and the metabolic activity of the bone. The total duration of the examination is between 3 and 5 hours, whereby there is a long break in between the single phases.

 

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The examination is usually performed in 3 phases (Multiple Phase Scintigraphy):

1. Perfusion: With the beginning of the injection, production of the regional recordings of the bones and joints over 1 minute (provides the arterial blood flow to the affected area skeletal).


Szintigraphie-Daumensattelgelenk

 

 

2. Soft phase: 5-10 min after the injection production of additional regional recordings of bones and joints over a period of about 10-20 minutes (provides the venous circulation to the affected areas skeleton resist).

3. Bone scan phase of: 2-3 hours after injection production of regional recordings and recordings of the entire skeletal system over a period of about 30-60 minutes, in some cases even a little longer (provides the bone metabolism of the skeleton). In addition, the so-called SPECT technique will create tomographic images by rotating the camera heads around the body. 

Are special preparations required?

No. Special preparation for the tests are usually not required, but you should bring 1 bottle of mineral water or similar (about 1 liter), because you should take an increased amount of fluid during the break between the individual phases. You do not have to fast before the procedure and you can take your medications as usual. Please bring all available medical records, especially X-rays and MRI (magnetic resonance) - / CT (computed tomography) images.

Are there any side effects?

Side effects or allergies occur very rarely or not at all.

 

When should the investigation not be conducted (contraindications)?

The only contraindication is pregnancy or breastfeeding.

 

How high is the radiation exposure?

The radiation exposure is low and corresponds approximately to a normal X-ray.

 

Who pays for the examination?

Bone scintigraphy is a standard benefit of all statutory and private health insurance.