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Diagnosing the cause of back pain

Radiological testing: Bone scan (bone radionuclide imaging)

What it is:

The bone scan consists of injecting into the blood a radioactive substance which attaches itself to the bone. A device able to detect radioactive activity -called "gamma camera"-, permits measuring the amount of radioactivity each bone emits, which reflects the amount of radioactive substance attached to the bone. For instance, there is more activity and blood flow in infected bones or in some types of tumors, and therefore a greater amount of radioactive substance is attached to the bones, emitting more radioactivity.

What it allows:

Radionuclide imaging permits viewing the degree of bone activity and may be useful in detecting infections or bone tumors. It also shows bone fractures earlier than radiographs.

Risks:

Radionuclide imaging exposes patients to a considerable amount of radioactivity, therefore it is only indicated when necessary. It cannot be performed during pregnancy.

Indications:

The existing recommendations based on scientific evidence indicate radionuclide imaging:

  1. In those cases in which there is suspicion of fracture and it cannot yet be detected by plain X-rays, for example, in elderly persons in whom osteoporosis is suspected and who have suffered a recent trauma.
  2. In those cases where the patient's medical history or the characteristics of the pain suggest a tumor or infection.
  3. In those cases where blood tests suggest the presence of a tumor or infection and radiological testing is normal.


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