Skip to main content
SpringerLink
Log in

The Bone Scan in Metabolic Bone Disease

  • Chapter
Book cover Bone Scanning in Clinical Practice

Abstract

Skeletal uptake of 99mTc-labelled diphosphonate depends primarily upon osteoblastic activity and, to a lesser extent, skeletal vascularity (Fogelman 1980). A bone scan image therefore presents a functional display of total skeletal metabolism and as such has a potentially valuable role to play in the assessment of patients with metabolic bone disorders. However, the bone scan appearances in metabolic bone disease are often non-specific, and their recognition depends upon a subjective impression of increased tracer uptake throughout the whole skeleton (Fogelman and Citrin 1981). This may be particularly difficult to detect when dealing with mild disease. It is the presence of focal lesions, as in metastatic disease, that makes a bone scan appear obviously abnormal. While focal lesions are easily identified, slightly increased tracer uptake throughout the whole skeleton may be virtually impossible to detect by visual inspection alone.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alberts C, Van der Schoot JB, Busemann-Sokole E (1981) Bone scintigraphy and densitometry in symptomatic haemodialysis bone disease. Eur J Nucl Med 6: 505–509

    PubMed  CAS  Google Scholar 

  • Ali A, Tetalman MR, Fordham EW et al. (1980) Distribution of hypertrophic pulmonary osteoarthropathy. Am J Radiol 134: 771–780

    CAS  Google Scholar 

  • Briancon D, Meunier PJ (1981) Treatment of osteoporosis with fluoride, calcium and vitamin D. Orthop Clin North Am 12: 629–648

    PubMed  CAS  Google Scholar 

  • Cavalli PL, Camuzzini GF, Ghezzi P, Palanca R, Rovere A, Tortore P (1976) Total body gammagraphy in uraemic patients. Minerva Nefrol 23: 142–148

    PubMed  CAS  Google Scholar 

  • de Graaf P, Schicht IM, Pauwels EK, te Velde J, de Graeff J (1978) Bone scintigraphy in renal osteodystrophy. J Nucl Med 19: 1289–1296

    PubMed  Google Scholar 

  • de Graaf P, Schicht IM, Pauwels EKJ, Souverijn JHM, de Graeff J (1979) Bone scintigraphy in uremic pulmonary calcification. J Nucl Med 20: 201–206

    Google Scholar 

  • de Graaf P, Pauwels EKJ, Vos PH, Schicht IM, te Velde J, de Graeff J (1984) Observations on computerized quantitative bone scintigraphy in renal osteodystrophy. Eur J Nucl Med 9: 419–425

    Article  PubMed  Google Scholar 

  • Devacaanthan K, Yap AU, Chayes Z, Stein RM (1976) Pulmonary calcification in chronic renal failure; use of diphosphonate scintiscan as a diagnostic tool. Clin Nephrol 6: 488–491

    PubMed  CAS  Google Scholar 

  • Duraler F, Vulpetti AT, Guise ER, Levin NM (1977) 18F -scintigraphy in the early diagnosis of osteonecrosis of the femoral head in chronic haemodialysis and transplantation. Clin Nephrol 8: 349–353

    Google Scholar 

  • Evens RG, Ashburn W, Bartter FC (1969) Strontium 85 scanning of a “brown tumour” in a patient with parathyroid carcinoma. Br J Radiol 42: 224–225

    Article  PubMed  CAS  Google Scholar 

  • Fogelman I (1980) Skeletal uptake of diphosphonate: a review. Eur J Nucl Med 3: 473–476

    Google Scholar 

  • Fogelman I, Boyle IT (1980) Bone scanning in clinical practice. Scott Med J 25: 45–49

    PubMed  CAS  Google Scholar 

  • Fogelman I, Carr D (1980) A comparison of bone scanning and radiology in the evaluation of patients with metabolic bone disease. Clin Radiol 31: 321–326

    Article  PubMed  CAS  Google Scholar 

  • Fogelman I, Citrin DL (1981) Bone scanning in metabolic bone disease: a review. Appl Radiol 10: 158–166

    Google Scholar 

  • Fogelman I, McKillop JH, Greig WR, Boyle IT (1977a) Pseudofracture of the ribs detected by bone scanning. J Nucl Med 18: 1236–1237

    PubMed  CAS  Google Scholar 

  • Fogelman I, McKillop JH, Cowden EA, Fine A, Boyce B, Boyle ET, Greig WR (1977b) Bone scan findings in hypervitaminosis D: case report. J Nucl Med 18: 1205–1207

    PubMed  CAS  Google Scholar 

  • Fogelman I, McKillop JH, Bessent RG, Boyle IT, Turner JG, Greig WR (1978a) The role of bone scanning in osteomalacia. J Nucl Med 19: 245–248

    PubMed  CAS  Google Scholar 

  • Fogelman I, Bessent RG, Turner JG, Citrin DL, Boyle IT, Greig WR (1978b) The use of whole-body retention of Tc-99m diphosphonate in the diagnosis of metabolic bone disease. J Nucl Med 19: 270–275

    PubMed  CAS  Google Scholar 

  • Fogelman I, Citrin DL, Turner JG, Hay ID, Bessent RG, Boyle IT (1979) Semi-quantitative interpretation of the bone scan in metabolic bone disease. Eur J Nucl Med 4: 287–289

    Article  PubMed  CAS  Google Scholar 

  • Fogelman I, Bessent RG, Beastall G, Boyle IT (1980a) Estimation of skeletal involvement in primary hyperparathyroidism. Ann Intern Med 92: 65–67

    PubMed  CAS  Google Scholar 

  • Fogelman I, Hay ED, Turner JG, Citrin DL, Greig WR (1980b) Semi-quantitative analysis of the bone scan in acromegaly: correlation with human growth hormone values. Br J Radiol 53: 874–877

    Article  PubMed  CAS  Google Scholar 

  • Fogelman I, McKillop JH, Gray HW (1983) The ‘hot’ patella sign—is it of any clinical significance? J Nucl Med 24: 312–315

    PubMed  CAS  Google Scholar 

  • Francis MD, Horn PA, Tofe AJ (1981) Controversial mechanism of technetium-99m deposition on bone. J Nucl Med 22: 72 (abstract)

    Google Scholar 

  • Front D, Hardaoff R, Levy J, Benderly A (1978) Bone scintigraphy in scurvy. J Nucl Med 19: 916–917

    PubMed  CAS  Google Scholar 

  • Frost HM (1963) Bone remodelling dynamics. Thomas, Springfield, Ill

    Google Scholar 

  • Hall FM, Goldberg RP, Davies JAK, Fainsinger MH (1980) Scintigraphic assessment of bone islands. Radiology 135: 737–742

    PubMed  CAS  Google Scholar 

  • Heaney RP (1963) Evaluation and interpretation of calciumkinetic data in man. Clin Orthop 31: 153–183

    PubMed  CAS  Google Scholar 

  • Kipper MS, Alazraki NP, Feiglin DH (1982) The “hot” patella. Clin Nucl Med 7: 28–32

    Article  PubMed  CAS  Google Scholar 

  • Kukar N, Sy WM (1981) Selected endocrine disorders. In: Sy WM (ed) Gamma images in benign and metabolic bone diseases, vol H. CRC Press, Boca Raton, Fla, pp 1–21

    Google Scholar 

  • Leicht E, Berberich R, Lauffenburger T, Haas HG (1979) Tumoral calcinosis: accumulation of bone-seeking tracers in the calcium deposits. Eur J Nucl Med 4: 419–421

    Article  PubMed  CAS  Google Scholar 

  • Levine SB, Haines JE, Larson SM, Andrews TM (1977) Reduced skeletal localization of 99m-Tc-diphosphonate in two cases of severe osteoporosis. Clin Nucl Med 2: 318–321

    Article  Google Scholar 

  • Lien JW, Wiegmann T, Rosenthall L, Kaye M (1976) Abnormal 99mtechnetium-tin-pyrophosphate bone scans in chronic renal failure. Clin Nephrol 6: 509–512

    PubMed  CAS  Google Scholar 

  • Matin P (1979) The appearance of bone scans following fractures, including immediate and long-term studies. J Nucl Med 20: 1227–1231

    PubMed  CAS  Google Scholar 

  • Nordin BEC, Horsman A, Aaron J (1976) Diagnostic procedures. In: Nordin BEC (ed) Calcium, phosphate and magnesium metabolism. Churchill Livingstone, Edinburgh, pp 469–524

    Google Scholar 

  • O’Duffy JD, Wahner HW, O’Fallon WM, Johnson KA, Muhs J, Riggs BL (1986). Mechanism of acute lower extremity pain syndrome in fluoride-treated osteoporotic patients. Am J Med 80: 561–566

    Article  PubMed  Google Scholar 

  • Olgaard K, Heerfordt J, Madsen S (1976) Scintigraphic skeletal changes in uraemic patients on regular haemodialysis. Nephron 17: 325–334

    Article  PubMed  CAS  Google Scholar 

  • Olgaard K, Madsen S, Heerfordt J, Hammer M, Jensen H (1979) Scintigraphic skeletal changes in non-dialyzed patients with advanced renal failure. Clin Nephrol 12: 273–278

    PubMed  CAS  Google Scholar 

  • Park H-M, Lambertus J (1977) Skeletal and reticuloendothelial imaging in osteopetrosis: case report. J Nucl Med 18: 1091–1095

    PubMed  CAS  Google Scholar 

  • Parkinson IS, Ward MK, Kerr DNS (1981) Dialysis encephalopathy, bone disease and anaemia: the aluminium intoxication syndrome during regular haemodialysis. J Clin Pathol 34: 1285–1294

    Article  PubMed  CAS  Google Scholar 

  • Riggs BL, Seeman E, Hodgson SF, Taves DR, O’Fallon WM (1982) Effect of the fluoride/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis. New Engl J Med 306: 446–450

    Article  PubMed  CAS  Google Scholar 

  • Rosenbaum RC, Frieri M, Metcalfe DD (1984) Patterns of skeletal scintigraphy and their relationship to plasma and urinary histamine levels in systemic mastocytosis. J Nucl Med 25: 859–864

    PubMed  CAS  Google Scholar 

  • Rosenthall L, Kaye M (1976) Observations on the mechanisms of 99mTc-labelled phosphate complex uptake in metabolic bone disease. Semin Nucl Med 6: 59–67

    Article  PubMed  CAS  Google Scholar 

  • Schulz EE, Libanati CR, Farley SM, Kirk GA, Baylink DJ (1984) Skeletal scintigraphic changes in osteoporosis treated with sodium fluoride: concise communication. J Nucl Med 25: 651–655

    PubMed  CAS  Google Scholar 

  • Singh BN, Kesala BA, Mehta SP, Quinn JL (1977) Osteomalacia on bone scan simulating skeletal metastases. Clin Nucl Med 2: 181–183

    Article  Google Scholar 

  • Suzuki Y, Hisada K, Takeda M (1974) Demonstration of myositis ossificans by 99mTc pyrophosphate bone scanning. Radiology 111: 663–664

    PubMed  CAS  Google Scholar 

  • Sy WM (1974) Bone scan in primary hyperparathyroidism. J Nucl Med 15: 1089–1091

    PubMed  CAS  Google Scholar 

  • Sy WM (ed) (1981) Osteoporosis. In: Gamma images in benign and metabolic bone diseases. CRC Press, Boca Raton, Fla, pp 223–239

    Google Scholar 

  • Sy WM, Mittal AK (1975) Bone scan in chronic dialysis patients with evidence of secondary hyperparathyroidism and renal osteodystrophy. Br J Radiol 48: 878–884

    Article  PubMed  CAS  Google Scholar 

  • Sy WM, Smith AJ (1981) Chronic renal dialysis. In: Sy WM (ed) Gamma images in benign and metabolic bone diseases. CRC Press, Boca Raton, Fla, pp 151–186

    Google Scholar 

  • Sy WM, Bonventure MV, Camera A (1976) Bone scan in mastocytosis: case report. J Nucl Med 17: 699–701

    PubMed  CAS  Google Scholar 

  • Sy WM, Mottola O, Lao RS, Smith A, Freund HR (1977) Unusual bone images in hyperparathyroidism. Br J Radiol 50: 740–744

    Article  PubMed  CAS  Google Scholar 

  • Tyler JL, Derbekyan V, Lisbona R (1984) Early diagnosis of myositis ossificans with Tc-99m diphosphonate imaging. Clin Nucl Med 9: 256–258

    Article  PubMed  CAS  Google Scholar 

  • Vanherweghem JL, Schoutens A, Bergmann P, Stolear J-C, Abramowicz D, Dhaene M, Smeyers J, Verbeelen D, Fuss M, Kinneart P (1984) Usefulness of 99mTc-pyrophosphate bone scintigraphy in aluminium bone disease. Trace Elements in Medicine 1: 80–83

    Google Scholar 

  • Whyte MP, Murphy WA, Siegel BA (1978) 99mTc-pyrophosphate bone imaging in osteopoikilosis, osteopathia striata and melorheostosis. Radiology 127: 439–443

    PubMed  CAS  Google Scholar 

  • Wiegmann T, Rosenthall L, Kaye M (1977) Technetium 99m- pyrophosphate bone scans in hyperparathyroidism. J Nucl Med 18: 231–235

    PubMed  CAS  Google Scholar 

  • Wilkins WE, Chalmers A, Sanerkin NG, Rowe MJ (1983) Osteomalacia in the elderly: the value of radio-isotope bone scanning in patients with equivocal biochemistry. Age Ageing 12: 195–200

    Article  PubMed  CAS  Google Scholar 

  • Wilson MA (1981) The effect of age on the quality of bone scans using technetium-99m pyrophosphate. Radiology 139: 703–705

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. I. Fogelman
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Nuclear Medicine, Guy’s Hospital, St. Thomas Street, London, SE1 9RT, UK

    Ignac Fogelman BSc, MD, MRCP (Consultant Physician) (Consultant Physician)

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Fogelman, I. (1987). The Bone Scan in Metabolic Bone Disease. In: Fogelman, I. (eds) Bone Scanning in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-4471-1407-9_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-1407-9_7

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1409-3

  • Online ISBN: 978-1-4471-1407-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation