Abstract. The 99mTc-phosphate bone scan has become a sensitive, reliable, and safe method for evaluating the patient with suspected inflammatory disease of bone. The scan may become positive as early as the first 24 hr after the symptoms and 10-14 days before roentgenographic changes occur.
Bone Scan is a study used to detect any inflammatory process in the body. When the source of pain is not clear the bone scan is able to direct the attention of your physician to the area inflammation. The inflammation may be caused by fracture, infection, tumor, or high bone turn over.
A bone density test does not show arthritis but reveals the health of the bones rather than the joints. Doctors use it to diagnose the presence and severity of osteoporosis. People with rheumatoid arthritis have a higher likelihood of bone loss due to several factors.
The areas where the radionuclide collects are called "hot spots," and may indicate the presence of conditions such as arthritis , malignant (cancerous) bone tumors , metastatic bone cancer (cancer which has spread from another site, such as the lungs), bone infections , bone trauma not seen on ordinary X-rays, and ...
Areas that absorb little or no amount of tracer appear as dark or "cold" spots. This could show a lack of blood supply to the bone or certain types of cancer. Areas of fast bone growth or repair absorb more tracer and show up as bright or "hot" spots in the pictures.
Diagnosis and Tests
Blood tests: A complete blood count (CBC) checks for signs of inflammation and infection. A blood culture looks for bacteria in your bloodstream. Imaging tests: X-rays, MRIs, CT scans and ultrasounds provide images of your bones, muscles and tissues.
Bone scintigraphy (BS) that utilizes Tc-99m phosphonate compounds has high sensitivity but low specificity for the detection of bone and joint disease. In other words, using this test, we can easily identify active arthritis in patients, although the results are not specific for RA.
Using a bone scan when cancer is suspected can be particularly helpful because the scan can find both primary cancer—or, cancer that started in your bones—and bone metastases, which is cancer that has spread to the bones from another part of your body.
An abnormal scan will show "hot spots" and/or "cold spots" as compared to surrounding bone. Hot spots are areas where there is an increased collection of the radioactive material. Cold spots are areas that have taken up less of the radioactive material.
The radioactive material (contrast) may be needed sometimes and not always with an MRI. An MRI creates 3D images of the bone, whereas a bone scan creates two-dimensional (2D) images. The MRI provides a detailed view of the bone and its surrounding structures such as the ligaments, tendons and soft tissue.
The increased bone-making activity that the dark spots represent is the skeleton's response to the problem. For example, if there is a bone fracture, bone cells will very quickly begin to make new bone to try to repair it. That activity will appear as a dark spot on a bone scan.
A gallium scan is a type of nuclear scan that can find cancer, infection or inflammation. The test is done over two to three appointments at the hospital. A gallium scan uses a small amount of radioactive substance, but it's painless and safe.
A gallium scan is a test to look for swelling (inflammation), infection, or cancer in the body. It uses a radioactive material called gallium and is a type of nuclear medicine exam. A related test is gallium scan of the lung.
Bone pain usually feels deeper, sharper, and more intense than muscle pain. Muscle pain also feels more generalized throughout the body and tends to ease within a day or two, while bone pain is more focused and lasts longer. Bone pain is also less common than joint or muscle pain, and should always be taken seriously.
RA is symmetrical, where a patient feels symptoms in the same spot on both sides of the body, often in the joints in the feet and hands. Osteoarthritis, in contrast, begins in an isolated joint, often in the knee, fingers, hands, spine and hips. While both sides may hurt, one side is more painful.
People with rheumatoid arthritis often have an elevated erythrocyte sedimentation rate (ESR, also known as sed rate) or C-reactive protein (CRP) level, which may indicate the presence of an inflammatory process in the body.
This type of stimulation–response activity generates some of the most dramatic aspects of inflammation, with large amounts of cytokine production, the activation of many cell types, and in fact the four cardinal signs of inflammation: heat, pain, redness, and swelling (1).
Chronic inflammation in the joints can damage cartilage, bones, tendons (which attach muscle to bones), or ligaments (which hold joints together); irritate nerves; and produce a long list of symptoms, including pain, swelling, and stiffness.
When choosing between a bone scan versus MRI for cancer detection, providers typically prefer an MRI. Because MRIs can reveal abnormal appearance or physical abscess in bones, they are more effective at detecting bone cancer than traditional bone scans.
They're often used to help diagnose bone-related health problems, such as osteoporosis, or to assess the risk of getting them. Total body bone density scans can also be used to measure the amount of bone, fat and muscle in the body.
The results of a bone scan are usually available within 2 days. Normal: The radioactive tracer is evenly spread among the bones. No areas of too much or too little tracer are seen.