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Specialists in the Field of Skeletal Scintigraphy
Information About the Field of Skeletal Scintigraphy
Definition: What Is Skeletal Scintigraphy?
Skeletal scintigraphy is a nuclear medicine examination generally used to image bone metabolism and suspicious changes in the body. For this purpose, the patient is administered a radioactive drug (radiopharmaceutical), which accumulates primarily in metabolically active bone areas. The radioactive radiation can be measured and imaged from the outside with a special camera. The physician receives a so-called skeletal scintigram. He uses it to evaluate the general bone metabolism and the sections with possibly pathological changes.
Indications: When Do You Need a Bone Scintigram?
Bone scintigraphy is often used to detect bone tumors and characterize them in more detail. On the one hand, this involves bone cancers such as osteosarcoma (in children) and metastases from other cancerous tumors such as breast , prostate , lung , or renal cancer . On the other hand, in a bone scintigram, abnormal changes can often be detected even earlier or better than in standard diagnostic radiology . For this reason, skeletal scintigraphy is often used for cancers in which bone metastases occur more frequently. The technique is used for diagnosis, exclusion, and also follow-up.
In addition, the examination is used to diagnose inflammatory diseases such as activated osteoarthritis (inflammatory joint wear), rheumatism , or periostitis. Scintigraphy should also be performed before a radiosynoviorthesis , treating joint diseases with radioactive drugs.
Bone fractures can also be assessed in a bone scintigram, particularly the fracture age, the current state of healing, and the tissue's vitality. In addition, any complications following the implantation of a joint prosthesis, such as loosening, can be identified.
In general, unexplained bone pain may be a reason for performing skeletal scintigraphy.
Procedure: What Is Done During Skeletal Scintigraphy?
Before a nuclear medicine examination, the attending physician usually informs the patient about the benefits and possible risks. Then, a radioactively labeled drug, usually technetium-99m bisphosphonates, is injected into a vein and enters the bloodstream. This drug accumulates preferentially in areas that show increased bone metabolism. The patient lies on his back during the scintigraphy while the gamma camera takes images. Depending on the diagnostic task, the images are taken at different times. Often, the bone scintigram is taken about 2 to 5 hours after the injection (single-phase scintigram) when bone metabolism can be assessed very well. However, it is also possible to take images during the radiopharmaceutical administration, after a few minutes, and after several hours (a multiphase scintigram). In this case, especially blood flow can be assessed. During the time between the injection and the scintigraphy, the patient should consume a sufficient amount of fluids. The actual recording time is about 30-45 minutes but can vary individually.
Diagnosis: What Can Be Detected During Skeletal Scintigraphy?
In principle, a skeletal scintigram shows bone areas with increased metabolism. In these areas, the radiopharmaceutical accumulates and emits radiation that is recorded. This can be seen on the scintigram as darkening.
For example, bone fractures such as vertebral body fractures can be visualized in this way. The age of a fracture can also be estimated using the technique described. In addition, various bone tumors can be identified, including benign tumors and bone metastases of other cancers. Especially osteoblastic tumors, i.e., a mass that leads to increased bone metabolism, are often clearly visible. They occur, among others, in breast or prostate cancer. However, not all skeletal tumors are consistently well visible on a scintigram because some also lead to bone loss or only a slight increase in metabolism. They are also challenging to see because of their location. Furthermore, various types of inflammation of the skeleton can be detected with the help of a scintigraphy examination.
However, simple bone scintigraphy cannot always reliably distinguish between the described clinical pictures. All show increased storage of the radioactive drug, which is indicative of increased bone metabolism. Further examination is necessary to differentiate with certainty.
Risks: How Dangerous Is Skeletal Scintigraphy?
In principle, skeletal scintigraphy is a low-risk procedure. The radiation that affects the body during the examination is very low (about 3-4 mSv), even lower than in other radiological examinations. Moreover, the radiopharmaceutical leaves the body quickly due to the short half-life (about 6 hours). Side effects such as heat sensation, itching, or skin symptoms are very rare. The examination is not painful or uncomfortable for the patient. However, in pregnant women and nursing mothers, scintigraphy should only be performed under urgent circumstances.
Aftercare: What Should Be Considered After Bone Scintigraphy?
Usually, there are no serious restrictions for the patient after bone scintigraphy. Provided that no sedatives were used during the procedure, driving a car after the examination is not a problem either. A sufficient amount of fluids should be drunk after the scintigraphy to excrete the radiopharmaceutical quickly. Close contact with small children, pregnant women, or nursing mothers should be avoided on the examination day to protect them from the slightest radiation.
Which Doctors and Clinics Are Specialized in Bone Scintigraphy?
Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively, and a reliable doctor would never claim to be the best one, we can only rely on a doctor's experience.
We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in skeletal scintigraphy and are awaiting your inquiry or treatment request.
- Anvil Bone Scintigraphy
- Guideline for skeletal scintigraphy
- University Hospital Tübingen Skeletal Scintigraphy
- University Hospital Halle (Saale) Skeletal Scintigraphy
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