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Bone Scan

(Skeletal Scintigraphy)

A bone scan is a nuclear medicine test to check your bones for issues or changes. You receive an injection of a substance called a radiotracer. The radiotracer collects in areas of irregular activity and highlights these areas on an imaging scan. It’s painless and safe for most people.

Overview

What is a bone scan?

A bone scan is a test to check the health of your bones. Healthcare providers typically order this scan to check whether cancer has spread (metastasized) to your bones. You may also have a bone scan to help determine cancer stage (how advanced it is).

A bone scan is a type of nuclear medicine imaging scan. Providers use advanced technology that may sound complicated. But the tests are painless, effective and safe for most people.

Before the test, you receive an injection of a radiotracer (a substance that contains a small, safe amount of radioactive material). The radiotracer collects in areas of your bones where there are changes or irregularities. These areas appear brightly on an imaging scan, helping your provider pinpoint disease.

What does a bone scan show?

A bone scan can show damage or changes in your bones. The test doesn’t show your provider the cause of the damage or changes.

Your provider may use a nuclear bone scan as one of several tools when diagnosing conditions like:

Avascular necrosis.

Bone cancer.

Bone fractures.

Bone infections (osteomyelitis).

Fibrous dysplasia.

Osteoarthritis.

Paget’s disease of the bone (osteitis deformans).

Unexplained bone pain.

Purpose of the Test

A bone scan may be ordered if you are experiencing unexplained bone pain or have signs and symptoms of a bone disease.

Among some of the reasons why your healthcare provider would request a bone scan:

To assess bone trauma that an X-ray cannot pick up

To pinpoint fractures that are difficult to locate

To investigate an unexplained bone fracture (pathologic fracture)

To determine the age of a fracture

To investigate persistent pain in the extremities, ribs, or spine

To assess a bone infection detected by other tests

To assess damage caused by arthritis and other bone disorders

To determine whether blood flow to a bone has been obstructed

To establish the presence of primary or secondary bone cancer

To stage bone cancer

To monitor your response to treatment for a bone disease

Usefulness for Diagnosis

By using a bone scan, a nuclear medicine technologist can quickly pinpoint areas of damage with a specialized instrument called a gamma camera. The gamma camera is designed to capture patterns of internal radiation and translate them into a two-dimensional image.

A bone scan is an extremely sensitive test that can detect even minor abnormalities in bone metabolism. It is central to the investigation of bone cancers, including secondary (metastatic) cancers.

Among the conditions a bone scan can help diagnose, monitor, or characterize:

Arthritis

Avascular necrosis, bone death due to restricted blood flow

Benign bone tumors

Bone fractures

Fibrous dysplasia, a genetic disorder affecting the normal development of bone tissue

Osteomalacia, the abnormal softening of bones

Osteomyelitis, a type of bone infection

Osteopetrosis, abnormally dense and breakable bones

Paget’s disease, a disorder affecting normal bone remodeling

Primary bone cancers, such as osteosarcoma

Secondary bone cancers that have spread from a primary tumor

A bone scan is performed routinely following certain cancer diagnoses to proactively check for bone metastasis.

Advantages and Disadvantages

A bone scan has both advantages and disadvantages.

Among them:

A bone scan will produce images that are far less detailed than a positron-emission tomography (PET) scan, but will also be far less costly.

While a bone scan is highly sensitive in spotting lesions and other bone abnormalities, the images are non-specific and may require further investigation with PET, computed tomography (CT), magnetic resonance imaging (MRI), or a bone biopsy.

Test Details

How does a bone scan work?

A bone scan works by using a radiotracer injection. The radiotracer gathers in areas where cells show signs of change or irregular activity. Changes in cells could indicate cancer or other diseases. A large scanner called a gamma camera takes images of your body. The gamma images show “hot spots” or areas where the radiotracer has collected.

How do I prepare for a bone scan?

Your care team gives you specific instructions for a bone scan. Most people don’t need to do anything special. You can typically eat and drink as usual and take your regular medications unless your provider says otherwise.

You’ll need to remove any objects containing metal from your body, like jewelry or belts with metal buckles. Tell your provider if you have a metal joint implant, dental implant or pacemaker. They can help determine whether a nuclear bone scan is safe for you.

Pre-Test

Before the actual scan can be done, the radioactive tracer must be injected. The IV is placed using sterile technique as follows:

Once you are positioned on the examining table, a nurse or technologist inserts a flexible IV catheter into a vein in your arm or hand. You may experience fleeting, minor pain as the needle is inserted.

The tracer is then injected into the IV, during which you may feel a cold sensation moving up your arm, but likely no pain. From start to finish, the infusion process takes around 10 to 15 minutes.

You're then free to move around while the tracer circulates in the bloodstream and begins to be absorbed in bone. During this waiting period, you will need to drink four to six glasses of water to flush any excess tracer not absorbed by cells. You can eat and do anything else you’d like during this time.

If you plan to leave, let the nurse or technologist know. He or she will be able to tell you when you need to return. Check in with reception when you do.

What can I expect during a bone scan?

On the day of your scan, you should plan to be in the hospital or imaging center for several hours.

During the test:

The technologist injects the radiotracer into one of your arm veins.

You wait one to four hours while the radiotracer circulates throughout your body and reaches your bones. You won’t feel the radiotracer moving through your bloodstream.

You may need to drink several glasses of water and urinate frequently to help flush excess amounts of the radiotracer that your bones don’t absorb.

The technologist takes you into the testing room, and you lie on your back on an exam table.

A large camera moves over your body and takes images.

You may need to hold your breath for a few seconds to prevent blurry images. The technologist may also ask you to change positions so they can take pictures from multiple angles.

How long does a bone scan take?

The test itself usually takes around 30 to 60 minutes. But you spend several additional hours in the hospital or imaging center while the radiotracer circulates in your bloodstream.

What can I expect after a bone scan?

You should be careful when rising from the scanning table since you will have been lying on your back for a long time. It is best to prop yourself on your elbows, wait a moment, push yourself into a seated position, and wait another moment before hopping off the table. This is especially true if you have low blood pressure or existing back, leg, or hip pain. The technetium-99m injection can also sometimes cause a drop in blood pressure, which can leave you lightheaded.

Once your scan is complete, you may be asked to wait until the technologist conducts a final review of the images. If more images are needed, you may be asked to return. Don’t let this worry you. More often than not, it is simply because the image resolution wasn’t sharp enough or the positioning of the camera needed adjustment. It doesn’t mean that the technologist found something worrisome.

After the technologist tells you that the scanned images are acceptable, you can change back into your regular clothes and leave. Double check to ensure you have all of your belongings.

Once home, call your healthcare provider if you experience any unusual symptoms or side effects, including irregular heartbeat, chest pains, fever, chills, or vomiting.

Despite having been injected with a radioactive substance, you will not be harmful to anyone who touches, kisses, or stands close to you. Sexual intercourse is also safe.

What are the risks and side effects?

This is a safe test for most people. The radiotracer dose is so small that you don’t usually need to take special measures to avoid exposing others to radiation. You may need to stay an arm’s length away from higher-risk people for about 24 hours. This may include babies, children and pregnant women.

Tell your healthcare provider if you’re nursing, pregnant or think you could be. A bone scan isn’t safe for you if you're pregnant or breastfeeding.

Most people have no side effects of a bone scan. The test isn’t painful, except for a minor sting or prick when the technologist injects the radiotracer. You may have some mild bruising or swelling in your arm where you received the radiotracer injection. This usually goes away within a few days.

Results and Follow-Up

What do the results of a bone scan mean?

A bone scan shows “hot spots” or areas of irregularity in your bones. The results can show areas of concern, but they won’t necessarily tell you the underlying cause. You’ll likely need more tests if your bone scan shows irregularities in your bones.

When should I know the results of the scan?

You don’t get the results of a bone scan immediately. It usually takes one to two weeks for your healthcare provider to share the results with you. You can ask your care team for a specific timeline after your test.

If the results of my scan are atypical, what are the next steps?

Normal:	The radioactive tracer is evenly spread among the bones. No areas of too much or too little tracer are seen.
Abnormal:	The tracer collects in certain areas of the bone, showing one or more "hot" spots. Hot spots may be caused by a fracture that is healing, bone cancer, a bone infection (osteomyelitis), arthritis, or a disease of abnormal bone metabolism (such as Paget's disease).
Abnormal:	Certain areas of the bone lack the presence of tracer, showing one or more "cold" spots. Cold spots may be caused by a certain type of cancer (such as multiple myeloma) or lack of blood supply to the bone (bone infarction).

If your bone scan shows areas of concern, you may need more tests to find the culprit.

You may have a:

Biopsy.

CT (computed tomography) scan.

MRI (magnetic resonance imaging).

Positron emission tomography (PET) scan.

Additional Details

Is a bone scan the same as a bone scan?

Some providers use the terms “bone scan” and “bone scan” interchangeably. Sometimes, they use the term “bone scan” when using the test to look at only one specific joint or bone rather than your whole body.

People may also use the term “bone scan” when referring to DEXA scans. A DEXA scan is a type of X-ray that measures your bone density. It’s not the same as a nuclear medicine bone scan.

Is a bone scan the same as an MRI?

No, a bone scan isn’t the same as an MRI. An MRI uses magnets and radio waves to create three-dimensional images of your body. A bone scan uses radiotracers and a special gamma camera to get two-dimensional images of your body.

One Final Note..

It might feel a bit unnerving to hear that you need a bone scan. But the procedure itself is quick and straightforward — and it’s one of the best ways to check bone health throughout your body. Talk to your provider to learn more about this advanced imaging test.

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Most recent revision June 30, 2025 08:08:43 PM

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