Bone Scan (Nuclear Medicine)

Sometimes the question is not just whether a bone is damaged, but whether it is actively healing, inflamed or injured right now. A bone scan answers that question by showing which bones are working the hardest.

A bone scan is a nuclear medicine test. A small amount of a radioactive tracer is injected into a vein in your arm. Over the next few hours, the tracer collects in bone, especially in areas where bone is breaking down and rebuilding quickly. A special camera then takes pictures of your whole body or one area.

Often a SPECT or SPECT/CT scan is added, which makes 3D pictures and pinpoints the exact bone or joint that is active.

Areas with more tracer show up as “hot spots.” A bone scan can show:

• Whether a compression fracture is new and still healing or old and healed, which helps decide whether kyphoplasty may help
• Small fractures that do not show up on X-ray, such as stress fractures
• Inflammation or arthritis in joints such as the facet joints or sacroiliac (SI) joints
• Bone infection, such as spinal osteomyelitis
• Cancer that has spread to the bones, such as metastatic spine disease
• Whether a fusion has healed or whether there is loosening around hardware

An MRI can also show whether a fracture is new. Dr. Grunch may order a bone scan when you cannot have an MRI, or when she needs to look at the whole skeleton at once.

• Eat and take your medicines as usual.
• Tell the center if you are pregnant or breastfeeding.
• Tell them if you recently had a test with barium or another nuclear medicine scan.
• Wear comfortable clothes without metal.
• Plan for the test to take several hours, including a waiting period. Bring something to read.

A technologist injects the tracer into a vein. You then wait about two to four hours while it settles into your bones. You can usually leave and come back during this time. You will be asked to drink extra water and to empty your bladder right before the pictures. For the scan, you lie on your back while a camera moves close to your body. It does not make noise or touch you. The pictures take about 30 to 60 minutes, longer if SPECT is added.

You can return to your normal activities right away. Drink plenty of fluids and empty your bladder often for the rest of the day to help the tracer leave your body. A radiologist reads the scan, and Dr. Grunch or one of her physician assistants will go over the results with you.

The amount of radiation is small and the tracer leaves your body within a day or two. Allergic reactions are very rare. Bone scans are generally avoided during pregnancy, and breastfeeding mothers may be asked to pause for a short time.

What does a hot spot on a bone scan mean?

A hot spot is an area where bone is very active. It can mean a new fracture, inflammation, arthritis, infection or a tumor. Dr. Grunch matches it with your other imaging and symptoms to find the cause.

Can a bone scan tell if a compression fracture is new?

Yes. A new, healing fracture usually shows up as a hot spot, while an old, healed fracture usually does not. An MRI can answer the same question.

Am I radioactive after a bone scan?

You give off a very small amount of radiation for a day or so. Drinking fluids and emptying your bladder often helps it leave your body faster.

If Dr. Grunch has ordered a bone scan for you and you have questions, call 470-293-9800 or contact us. You can also ask general questions any time through our “Ask Us Anything” chat. For questions about scheduling, cost or arrival time for the test itself, call the imaging center where it is booked.

Related: All imaging and diagnostic tests · SPECT/CT scan · Compression fractures · Spinal osteomyelitis

This information is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk to your provider about your symptoms and follow the instructions from your imaging center.