Bone scanning: A review of purpose and method

Abstract

Bone scanning has changed the management of patients and has increased the understanding of a number of diseases affecting the skeleton. Early diagnosis of benign and malignant bone disease has become possible many months before a standard Xray or enzyme measurement confirms the pathologic process. An intelligent approach to the technique, the instrumentation, and the radiopharmaceuticals is, however, essential. Whole-body bone scanning is a non-invasive, safe, and easy procedure. Correctly interpreted it has a major role to play in medical diagnosis.Key words: Bone scanning -Whole body scanners -Gamma cameras -99mTc-ethylhydroxydiphosphonate (EHDP).Early detection of skeletal disease has revolutionized the clinical approach to several conditions affecting the bone. This became possible following the appearance of good bone-retaining radiopharmaceuticals labeled with almost ideal tracers. These give images of the skeleton of excellent resolution and reproducibility. The sensitivity of this method is far superior to the classical diagnostic procedures of standard radiology and serum enzyme measurements [14,16,28, 55,67, 93, 105, 109, 116, 118,184,189,243,285,291] and has allowed the study of bone disease whenever objective evidence of it is doubtful or even missing.The basis for such progress, however, demands that bone scanning is performed with a perfect knowledge of the technique, i.e., with the choice of the Present address

Bony sclerosis and the battered child

“…An interesting sidelight in this case is the negative radionuclide bone scan despite obvious periosteal reaction on the radiographs. The increasing usage of bone scanning for the evaluation of trauma [5,6,9] would suggest a highly sensitive method of diagnosis for this syndrome. In fact Fordham states that 'the battered child will demonstrate far more abnormality on the bone scan than can be demonstrated roentgenographically ...' [6].…”