Bone Scan

A bone scan is an imaging test used to look at the skeleton. It's done to find areas of physical and chemical changes in bone. A bone scan may also be used to see if treatment of certain conditions is working.

A bone scan is a type of nuclear radiology procedure. This means that a tiny amount of a radioactive substance is used during the scan to help in examining the bones. The radioactive substance is called a radionuclide or radioactive tracer. It may either be increased or decreased in abnormal areas of bone.

The radionuclide gives off a type of radiation, called gamma radiation. The gamma radiation is detected by a scanner. The scanner uses the information to make a picture of the bones.

The areas where the radionuclide collects are called "hot spots." They may be a sign of conditions, such as cancerous bone tumors and metastatic bone cancer. This is cancer that has spread from another site, such as the lungs, to the bones. Other conditions include those related to the bone. These include bone infection and bone injury not seen on regular X-rays.

Why Your Child Might Need a Bone Scan

Bone scans are most commonly used to look for the spread of cancer. The bone surrounding the cancer will appear as a hot spot on a bone scan. This is due to increased bone activity in the area of the cancer cells. Bone scans may also be used to see how much cancer there is before and after treatment to see if the treatment is working.

Other reasons for doing a bone scan may include:

• To assess for bone injury or damage when regular X-rays don't show the problem
• To find fractures that are hard to locate
• To determine the age of fractures
• To detect or assess bone infection (osteomyelitis)
• To look for the cause of unexplained bone pain
• To detect and assess conditions, such as arthritis and bone tumors

There may be other reasons for your child's doctor to recommend a bone scan.

Risks of a Bone Scan

The amount of the radionuclide injected into your child's vein for the procedure is small enough that there is no need for precautions against radioactive exposure. The injection of the tracer may cause some slight discomfort. Allergic reactions to the tracer are rare but may happen.

There may be other risks depending on your child's specific health condition. Be certain your child's doctor knows about all your child's health conditions before the procedure.

Getting Ready for a Bone Scan

• Your child's doctor will explain the procedure to you and your child, and you can ask questions. Make a list of questions and any concerns to discuss before the procedure. 
• You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if anything is not clear.
• Generally, no preparation is needed, such as not eating or not taking medicine, before a bone scan.
• Tell your child's doctor, the radiologist, or the technologist if your child is allergic to or sensitive to medicines, contrast dyes, or iodine.
• Make sure your child's doctor has a list of all prescribed and over-the-counter medicines, and all herbs, vitamins, and supplements that your child is taking.
• Based on your child's health condition, your doctor may give you other instructions on what to do before the bone scan.

What to Expect During a Bone Scan

A bone scan may be done on an outpatient basis or as part of your child's stay in the hospital. Procedures may vary depending on your child's condition and their doctor's practices.

Generally, a bone scan follows this process:

1. Your child will be asked to remove any clothing, jewelry, or other objects that may get in the way of the scan. Your child may have bracelet with their name and an identification number put on their wrist. They may get a second bracelet if they have allergies.
2. Your child will be given a gown to wear if they are asked to remove their clothing.
3. An I.V. (intravenous) line will be started in your child's hand or arm for injection of the radioactive tracer.
4. The tracer will be injected into your child's vein. The tracer will be allowed to collect in the bone tissue for a period of 1 to 3 hours. Your child may be allowed to walk around or even leave the facility during this time. Your child will not be hazardous to other people, as the tracer gives off less radiation than a standard X-ray.
5. During the waiting period, your child will need to drink 4 to 6 glasses of water to help flush out any tracer that does not collect in the bone tissue.
6. If your child's bone scan is being done to look for bone infection, a set of scans may be done right after the injection of the tracer. Another set of scans will be done after the tracer has been allowed to collect in the bone tissue.
7. When the tracer has been allowed to collect in the bone tissue for the right amount of time, your child will be asked to empty your bladder. This is because a full bladder can distort the bones of the pelvis and may become uncomfortable during the scan.
8. Your child will be asked to lie still on a padded scanning table. Any movement may affect the quality of the scan.
9. The scanner will move slowly over and around your child several times as it detects the gamma rays given off by the tracer in the bone tissue.
10. Your child may be repositioned during the scan to get certain views of the bones.
11. When the scan has been completed, the I.V. line will be removed. It takes about 1 hour to do a full body scan.
12. While the bone scan itself causes no pain, having to lie still for the length of the procedure might be uncomfortable, particularly if your child has recently had surgery or an injury. The technologist will use all possible comfort measures and complete the procedure as quickly as possible to reduce any discomfort or pain.

What to Expect After a Bone Scan

• Your child should move slowly when getting up from the scanner table to prevent any dizziness or lightheadedness.
• Your child will be instructed to drink plenty of fluids and empty their bladder often for 24 to 48 hours after the scan. This will help flush the remaining tracer from their body.
• The I.V. site will be checked for any signs of redness or swelling. If your child notices any pain, redness, or swelling at the I.V. site after they go home, you should tell their doctor. It may be a sign of infection or other type of reaction.
• Your child should not have any other radionuclide procedures for the next 24 to 48 hours after their bone scan.
• Your child may go back to their usual diet and activities, unless their doctor tells them differently.
• Your child's doctor may give your and your child other instructions after the procedure, depending on their particular situation.