How a bone scan helps doctors diagnose neck and back pain

A bone scan is a test in which radioactive material, called a tracer, is injected into a patient’s blood stream, where it will bind to bones. Once the tracer is absorbed, a special camera known as a gamma is used to take pictures of the bones. The test shows areas of new or rapid bone growth, which can be a problem in adults.

Bone scans capture pictures of the entire skeleton, which makes them useful when a physician isn’t quite sure where the problem is located. Bone scans do not capture images of soft tissue, so they are not a method for identifying disc conditions or nerve compression. Instead, physicians use bone scans to rule out small fractures, bone cancer or infection. A bone scan may also be helpful in detecting facet disease or osteoarthritis.

What to expect during a bone scan procedure

If your doctor orders a bone scan, he or she will typically ask if you are pregnant or breastfeeding, as the radioactive material injected during the tests can be potentially harmful in this situation. You should also be asked if you have recently taken Pepto-Bismol or another substance that contains bismuth, or if you’ve recently had any kind of test involving a barium contrast (such as a barium enema). This is because these substances can create inaccurate test results.

When you arrive for your test procedure, you’ll be injected with a small amount of the radioactive tracer. Sometimes, a picture will be taken right away, but only in certain cases. Whether an initial picture is taken at the time of injection or not, you’ll need to wait two to three hours for the tracer to be fully absorbed into your bones. During this time, you’ll be asked to drink lots of water and urinate as much as possible. This helps flush any excess tracer fluid out of your body as quickly as possible. Right before the imaging begins, you’ll be asked to empty your bladder a final time.

Before the images are taken, you’ll be asked to remove jewelry, dentures and most of your clothes. You’ll be given a cloth to cover yourself during the test. Since the test requires you to lie as still as possible, you may also wish to request a pillow to make yourself comfortable. Once you are lying on the table, the camera is positioned over you, attached to an arm that moves the camera around. The camera does not emit any radiation of its own; it simply reads the radiation given off by the tracer material in your bones. The scan takes about an hour and is painless.

After the test is complete, you’ll be cleared to go home. The radioactive tracer will be eliminated from your body within two days.

What the bone scan shows

The tracer material is brought into your bones through blood flow. Therefore, areas with a high degree of blood flow absorb more of the tracer, resulting in dark “hot spots” on the scan. Areas with little or no blood flow, on the other hand, look very light on the scan due to low absorption of the tracer.

Low blood flow can indicate a blockage from a tumor or other obstruction. Areas of very high blood flow tend to be areas where lots of growth is taking place, which could mean cancer or some other disorder. However, the scan itself cannot distinguish healthy growth from abnormal growth, so other tests, such as a CT scan, dermatome maps, an X-ray, or MRI will likely be ordered if the bone scan results are abnormal.

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