Bone scan
From Radipedia
Three Phase Bone Scan
- Tc99m MDP 20mCi
- Image dynamic (flow), immediate (blood pool) and delay (3 hours)
- Increased on all three phases for Osteomyelitis, trauma, tumor (osteoblastic remodeling or tumor itself), and Reflex sympathetic dystrophy
- Increased on immediate images but not on delays with cellulitis
- Cold lesions - myeloma, thyroid and renal metastasis, Avascular necrosis
- Flare phenomenon - increased uptake or number of lesions due to treatment, does not persist beyond 6-9 months
- Fractures - cold within 24hrs, but can remain abnormal for years
- Shin Splints - linear uptake in tibia
- Prosthesis - THR after 1 year is abnormal (infection or loosening), TKA can be hot indefinately
Fluorine 18 PET - investigaional, not FDG (a glucose analog, with the positron-emitting radioactive isotope fluorine-18)
Whole Body Bone Scan - typically screen for metastasis
Diffuse Uptake Differential (Superscan)
- Renal osterodystrophy
- Hyperparathyroidism
- Diffuse metastasis
- Myelofibrosis
- Hypertrophic osteoarthopathy
- Vit A toxicity
- Thyroid acropachy
- Melorheostosis
