Bone scan
This page tells you about bone scans. There is information on
A bone scan looks for changes or abnormalities in the bones. It is also called a radionuclide scan, or a scintigram. It is usually done in the medical physics department or nuclear medicine department of the hospital. A bone scan can look at a particular joint or bone. In cancer diagnosis, it is more usual to scan the whole body. The scan involves one injection, but apart from that, it is painless.
The scan uses a large camera called a gamma camera. Gamma cameras pick up radioactivity. To have the scan, you first have a radioactive substance called a radionuclide injected into your bloodstream. You only need a very small amount of this radioactive substance - not enough to do you any harm. The radionuclide travels through the blood and collects in your bones. More of it tends to collect in areas where there is a lot of activity in the bone. 'Activity' means the bone is breaking down, or repairing itself. These areas of activity are picked out by the camera. Doctors call them 'hot spots'. Below is an example of a bone scan.
Having 'hot spots' doesn't necessarily mean that there is cancer in your bones. Bone can break down and repair for other reasons. For example, if you have arthritis this will also show up on the scan.
The scan is done in either the medical physics department, nuclear medicine departmentor X-ray department at the hospital. You will have to arrive up to 4 hours before your scan to allow for the radionuclide to travel throughout your body and collect in the bones.
When you arrive, you have the injection of radionuclide into a vein. You will then be free to leave the department for a couple of hours. The doctor will tell you exactly when you have to be back. You can walk around or sit down - what you do won't affect the scan.
The doctor will ask you to drink plenty of fluids while you are away. It doesn't really matter what you drink - you just need to flush the injection through your body. The doctor will ask you to pass urine just before you return (or when you return) to get rid of any radionuclide in your bladder. Otherwise this could interfere with the scan.
When you go back to the department, you usually go straight into the scanning room. You may have to undress and put on a hospital gown first, but this isn't always necessary.
When you are ready for the scan, you will lie down on an X-ray couch and will need to keep still. The gamma camera will then take pictures of the whole of your skeleton. The scan takes about an hour.
After the scan, you will be free to go home. It can take up to 24 hours for the radionuclide to get out of your system. It will help if you drink plenty of fluids during this time.
There are no special preparations for a bone scan. You don't have to restrict what you eat or drink.
A radioactive injection does sound dangerous, but you will only have a small amount of radioactivity given to you. It is about the same as 200 normal X-rays. This sounds a lot, but is not enough to be dangerous to you. The body gets rid of the radionuclide in the urine. This takes up to 24 hours. If you need to take any precautions in the meantime, the doctor or nurses will tell you beforehand.
These days, some doctors tell bone scan patients that they should not have close contact with pregnant women, babies and young children until the day after their scan. Breast feeding mothers are advised to express enough milk beforehand to get their baby through the first 6 hours after the scan. This isn't because there will be radiation in the milk. It is because the mother shouldn't be holding the baby that close during the time the radiation is in her body. Some doctors recommend you get someone else to feed the baby for 24 hours, although it is safe for you to express more milk for those feeds from 6 hours after your scan.
If there is a possibility you might be pregnant, you may not be able to have a bone scan. This is because the radionuclide could cross the placenta and affect the baby.
It can take time for test results to come through. How long will depend on why you are having the scan but it may be a couple of weeks. Usually, a specialist in radiology or nuclear medicine examines the scan and a report is typed up. The report is then sent to your specialist, who gives the results to you. If your GP has sent you for the test, the results will be sent directly to the surgery.
Understandably, waiting for results can make you anxious. If your doctor needed the results urgently, it would have been noted on the scan request form and the results will be ready sooner than that. Try to remember to ask your doctor how long you should expect to wait for the results when you are first asked to go for the test. If it is not an emergency, and you have not heard a couple of weeks after your test, ring your doctor's secretary to check if they are back.
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