WHEN TO USE BONE-SCINTIGRAPHY - IT CAN REVEAL THINGS OTHER STUDIES CANNOT

Despite advances in nuclear medicine, bone scintigraphy remains an imp ortant imaging technique. It is sensitive in detecting stress fracture s and bone metastases and can assess suspected injury that is difficul t to see on plain films (eg, rib fracture). Scintigraphy is useful in evaluating new symptoms, response to therapy, and prognosis in patient s with known malignant tumor. In patients with low back pain, the tech nique can determine the age of fractures to help identify osteoporosis and can uncover other causes of the pain (eg, spondylolysis, arthriti s). When Pager's disease is suggested by unexplained bone pain or an e levated serum alkaline phosphatase level, bone scintigraphy is a usefu l screening test. Combined with other appropriate nuclear medicine stu dies, it helps in early identification and localization of osteomyelit is. Scintigraphic scans can provide a general indicator of malignant v ersus benign disease (according to the amount of lesion activity seen) and may produce characteristic findings in certain primary tumors (eg , osteoid osteoma) that are difficult to evaluate with other methods.