Background Information:

What are the other Names for the Procedure?

• Skeletal Scintigraphy

What is Bone Scan radiology procedure? (General Explanation)

• A Bone Scan is an advanced imaging technique in which a small amount of radioactive material (or radiotracer) is used to diagnose bone diseases
• The radiotracer is taken up by the injured or healing bones differently, which helps in identifying areas that may not appear on other imaging techniques such as CT or X-rays

What part of the Body does the Procedure involve?

A Bone Scan radiology procedure involves the skeletal system.

Why is the Bone Scan radiology procedure performed?

A bone scan is used to identify or diagnose the following conditions:

• Cancer in the bones
• Unexplained and persistent bone pain
• Identify bone fractures not seen on CT or X-ray studies
• Infection of the bone

What are the Alternative Choices for the Procedure?

While X-ray or CT scan procedure can be used to view the skeletal system, the information generated by a Bone Scan is unique and there are no true alternatives.

What is the Equipment used? (Description of Equipment)

The following equipment may be used in Bone Scan:

• Gamma camera: It is a specialized camera designed to capture the energy produced by the radiotracer
• Single-photon emission-computed tomography (SPECT): A SPECT involves the rotation of the gamma camera around the individual to produce cross-sectional images. It is similar to a CT scan procedure
• Radiotracer: A small amount of radioactive material that targets the bones is administered through an intravenous (IV) line

What are the Recent Advances in the Procedure?

There are no recent advances to a Bone Scan radiology procedure.

What is the Cost of performing the Bone Scan radiology procedure?

The cost of a Bone Scan procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding a Bone Scan procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Brenner AI, e. (2017). The bone scan. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 8 February 2017, from https://www.ncbi.nlm.nih.gov/pubmed/22117809

Prior to Bone Scan radiology procedure:

How does the Bone Scan radiology procedure work?

• The radiotracer given intravenously travels through the bloodstream and accumulates in the bones
• The radiotracer gives-off energy that is recorded by the specialized gamma camera
• With the help of a computer, the data is reconstructed into images and interpreted by a radiologist

How is the Bone Scan radiology procedure Performed?

The Bone Scan procedure is performed in the following manner:

• A few images are taken prior to administration of the radiotracer for comparison
• An intravenous (IV) line is placed in a vein of the arm or hand and the radiotracer is injected through the IV line
• Before images are taken, the radiotracer needs 2-4 hours to be fully-absorbed by the bones. During this time, the individual is asked to drink lots of water to wash out any radiotracer not absorbed by the bones
• Prior to images being taken, the individual is asked to use the restroom, to remove any radiotracer that may have accumulated in the urinary bladder
• Following this period, the individual is positioned on the examination table near the gamma camera
• The camera will begin capturing images; it may rotate around the individual, while images are being taken

Where is the Procedure Performed?

A Bone Scan radiology procedure is usually preformed as an outpatient procedure at a hospital.

Who performs the Procedure?

A Bone Scan radiology procedure is performed by a radiology technologist under the supervision of a radiologist.

How long will the Procedure take?

The duration of the procedure may vary, but typically, from the time of injection to images being recorded, the entire procedure may take around 5 hours.

Who interprets the Result?

The results of the Bone Scan radiology procedure are interpreted by a radiologist, who will discuss the same with the attending physician. Generally, the healthcare provider conveys the results to the patient.

What Preparations are needed, prior to the Procedure?

The following preparations are needed prior to a Bone Scan radiology procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are currently being taken
• Patients should inform their physician, if they are allergic to any medications, especially to the radioactive material used in the procedure
• The radiology technologist should be informed, if a bismuth-containing medication has been recently consumed, as it may interfere with the test results
• Women should inform their physicians if they are breast-feeding, pregnant, or if there is a chance that they might be pregnant
• The patient may be asked to avoid eating or drinking several hours before the test

What is the Consent Process before the Procedure?

A physician will request your consent for a Bone Scan procedure using an Informed Consent Form.

Consent for the procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the procedure:

• A Bone Scan provides functional information a CT scan or X-ray cannot
• The procedure has a high sensitivity for identifying many diseases of the bone
• It imparts less radiation dose than a CT scan

Following are the risks of the procedure:

• There is only a minimal risk to an individual with normal health
• Rarely, allergic reactions to the radiotracer is known to occur

What are the Limitations of the Bone Scan radiology procedure?

Limitations of the Bone Scan radiology procedure may include:

• Some cancers of the bone cannot be seen on a Bone Scan
• The quality of images may not be adequate to distinguish an abnormal bone from a normal bone, and hence, additional images or biopsy techniques may be required

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is a Bone Scan procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Bone Scan radiology procedure:

What is expected during the Bone Scan radiology procedure?

• There may be some pain or discomfort associated with the insertion of the IV line
• When the radiotracer is being injected, one may feel a cold sensation in the arm

What kind of Anesthesia is given, during the Procedure?

No anesthesia is administered during a Bone Scan radiology procedure.

What are the possible Risks and Complications during the Bone Scan radiology procedure?

Generally, there is no risk involved, or the risk is minimal.

• As with any examination that uses radiation, there is a risk of developing cancer with repeated and excessive exposure. However, the dose of radiation used in a Bone Scan is low
• Rarely, the individual may develop an allergic reaction to the radiotracer

What Post-Operative Care is needed at the Healthcare Facility after the Bone Scan radiology procedure?

No post-operative care is needed following a Bone Scan radiology procedure.

After the Bone Scan radiology procedure:

What is to be expected after the Bone Scan radiology procedure?

• The radiotracer is slowly eliminated from the body over the course of the next few days; it poses no harm to oneself or to others
• One should be able to resume normal activities immediately following the procedure

When do you need to call your Physician?

A Bone Scan radiology procedure is usually an uncomplicated procedure.

• Allergic reactions are rare, and if any such reactions develop, it will typically occur within 30 minutes of exposure to the radiotracer
• If any signs and symptoms of an allergic reaction develop, then it must be immediately informed to the attending physician

What Post-Operative Care is needed at Home after the Bone scan radiology procedure?

No post-operative care is needed following a Bone Scan radiology procedure.

How long does it normally take to fully recover, from the Procedure?

No recovery time is involved; one should be able to resume normal activities immediately after the procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The Bone scan radiology procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the Bone Scan radiology procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Bone Scan radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Bone Scan procedure is performed.