Bone scintigraphy in non-neoplastic diseases in children

Since the introduction of Tc-99m labeled polyphosphates bone scintigraphy h as become a widely accepted method for the evaluation of non-neoplastic bon e diseases in children. High quality images require the child's immobilisat ion and a correct positioning as well as an optimized technical equipment. Two or three phase scintigraphy is the routinely procedure but additional t echniques like pinhole images or SPECT can be very helpful for special indi cations and localisations. Due to the age and sex dependent differences of bone metabolism in the developing skeleton the interpretation of the bone s can in children is more difficult than in adults and requires more experien ce. Infections, trauma and aseptic necrosis are the most important non-neop lastic diseases requiring bone scintigraphy. Bone scan has a high sensitivi ty in the early detection of pathological. bone metabolism indicating bone disease; other investigations, which are describing morphological changes l ike X-ray are less sensitive especially at the beginning of the disease. Ne gative bone scan rools out significant bone disorders with a high certainty . Follow-up studies can give additional informations about the response to therapeutical regimes and about the prognosis. To improve the specificity o f a bone scan a combined interpretation of scintigraphy and X-ray is recomm ended.