What is a bone scan?
A bone scan is a radiology procedure used to look at the skeleton. It is 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 assist in the examination of
the bones. The radioactive substance, called a radionuclide, or radioactive tracer,
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. This processes the information into 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 might I 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 in order 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 do not show the problem
- To find fractures that are hard to locate
- To determine the age of fractures
- To detect and/or assess bone infection (called osteomyelitis)
- To look for the cause of unexplained bone pain
- To detect and evaluate conditions such as:
- Benign (noncancerous) bone tumors
- Paget disease (a bone disorder, usually happening in people over age 50, in which
there is chronic inflammation of the bones, leading to thickening and softening of
the bones, and curving of the long bones)
- Avascular necrosis (death of bone tissue not due to infection)
There may be other reasons for your healthcare provider to recommend a bone scan.
What are the risks of a bone scan?
The amount of the radionuclide injected into your 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.
If you are allergic to or sensitive to medicines, contrast dyes, or latex, be sure
to tell your healthcare provider.
If you are pregnant or think you might be, tell your healthcare provider before the
If you are breastfeeding, tell your healthcare provider before the procedure.
There may be other risks depending on your specific medical condition. Be certain
your healthcare provider knows about all of your medical conditions before the procedure.
How do I get ready for a bone scan?
- Your healthcare provider will explain the procedure to you and you can ask questions.
Make a list of questions and any concerns to discuss with your healthcare provider
before the procedure. Consider bringing a family member or trusted friend to the medical
appointment to help you remember your questions and concerns and to take notes.
- 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 prior preparation, such as not eating or not taking medicine, is needed
before a bone scan.
- Be sure to tell your healthcare provider, the radiologist, or the technologist if
you are allergic to or sensitive to medicines, contrast dyes, and/or iodine.
- Tell your healthcare provider if you are pregnant or think you may be.
- Tell your healthcare provider if you are breastfeeding.
- Make sure your healthcare provider has a list of all medicines (prescribed and over-the-counter)
and all herbs, vitamins, and supplements that you are taking.
- Based on your medical condition, your healthcare provider may give you other instructions
on what to do before the bone scan.
What happens during a bone scan?
A bone scan may be done on an outpatient basis or as part of your stay in a hospital.
Procedures may vary depending on your condition and your healthcare provider's practices.
Generally, a bone scan follows this process:
- You will be asked to remove any clothing, jewelry, or other objects that may get in
the way of the scan. A bracelet with your name and an identification number may be
put on your wrist. You may get a second bracelet if you have allergies.
- If you are asked to remove your clothing, you will be given a gown to wear.
- An intravenous (IV) line will be started in your hand or arm for injection of the
- The tracer will be injected into your vein. The tracer will be allowed to collect
in the bone tissue for a period of 1 to 3 hours. You may be allowed to walk around
or even leave the facility during this time. You will not be hazardous to other people,
as the tracer gives off less radiation than a standard X-ray.
- During the waiting period, you will need to drink several glasses of water (4 to 6
glasses) to help flush out any tracer that does not collect in the bone tissue.
- If your 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.
- When the tracer has been allowed to collect in the bone tissue for the right amount
of time, you 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. This
may take up to an hour to complete.
- You will be asked to lie still on a padded scanning table. Any movement may affect
the quality of the scan.
- The scanner will move slowly over and around you several times as it detects the gamma
rays given off by the tracer in the bone tissue.
- You may be repositioned during the scan in order to get certain views of the bones.
- When the scan has been completed, the IV line will be removed.
While the bone scan itself causes no pain, having to lie still for the length of the
procedure might be uncomfortable, particularly if you have 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 happens after a bone scan?
Move slowly when getting up from the scanner table to avoid any dizziness or lightheadedness.
You will be instructed to drink plenty of fluids and empty your bladder often for
24 to 48 hours after the scan. This will help flush the remaining tracer from your
The IV site will be checked for any signs of redness or swelling. If you notice any
pain, redness, and/or swelling at the IV site after you go home, you should tell your
healthcare provider. This may be a sign of infection or other type of reaction.
You should not have any other radionuclide procedures for the next 24 to 48 hours
after your bone scan.
You may go back to your usual diet and activities, unless your healthcare provider
tells you differently.
Your healthcare provider may give you other instructions after the procedure, depending
on your particular situation.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
- Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure
Online Medical Reviewers:
- Grossman, Neil, MD
- Moloney, Amanda Jane (Johns), PA-C, MPAS, BBA