Rad

Lumbar Spine Bone Scan

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Lumbar Spine Bone Scan, Spine Bone Scan, Bone Scintigraphy of Spine

  • Indications (with normal L-Spine XRay)
  1. Osteomyelitis
  2. Bony neoplasm or metastases
  3. Occult Vertebral Fracture
  • Mechanism
  1. Radiographic tracer compounds taken up by new bone
    1. Technetium Tc 99m Phosphate
    2. Gallium 67 Citrate
  2. Incorporated into hydroxyapatite crystals
  3. Increased uptake indicates areas of high bone turnover
  • Advantages
  1. Sensitive for bony neoplasm
    1. Test Sensitivity in spinal metastases: 85%
  2. Sensitive for infection
  • Disadvantages
  • Non-specific
  1. False Positives in 33% older patients (Osteoarthritis)
  2. False Negatives
    1. Diffuse bony metastases
    2. Multiple Myeloma
  • Protocols
  1. Technetium Tc 99m Phosphate
  2. Gallium 67 Citrate
    1. Most accurate imaging in infectious spondylitis (95%)
  3. Single-Photon Emission Computed Tomography (SPECT)
    1. Three dimensional bone scan imaging
    2. Lesions of Vertebral pedicles suggests malignancy
  • References
  1. Humphreys (2002) Am Fam Physician 65(11):2299-306 [PubMed]