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21 Cards in this Set

  • Front
  • Back
How long is the delay for the delayed portion of a bone scan?
3 hours
Which components of a 3 phase bone scan are abnormal in osteomyelitis?
Flow, pool, and delayed (bone image)
What is the sensitivity for a 3 phase bone scan for osteo?
What is the specificity, as long as a certain condition is met?
also 95%
What is that condition?
Patient must have a normal x-ray or x-ray showing only changes suggestive of osteomyelitis in order to get this level of sensitivity.
What does a cold defect in a region of bone suspected to be infected suggest?
May represent gangrene. Check patient's blood flow. If vasculopath, this is a more likely possibility.
How is joint infection differentiated from osteomyelitis on bone scan?
Presence of uptake on both sides of joint suggests joint infection.
What are false positives for 3 phase bone scan?
Any causes of active bone remodeling with soft tissue inflammation.
Such as?
Healing fracture

Orthopedic surgery/implant

Neuropathic osteoarthropathy
What is the next step if the patient has an abnormal radiograph in the area of increased uptake on bone scan?
111Indium leukocyte scan
What is the difficulty with this?
Differentiating bone from overlying inflammed soft tissues
What can be used if In WBC scan is inconclusive?

HMPAO scan
What is the differential diagnosis for breast uptake on bone scan?
1) Breast CA (incl mets; breast dysplasia (i.e. DCIS)

2) Mastitis

3) Fibroadenoma

4) Radiation therapy

5) Vascular or lymphatic obstruction

6) Normal finding
What is the appearance of normal breast uptake?
Mild and bilaterally symmetric (unless patient has h/o mastectomy)
What mets are most commonly identified in the breast on bone scan?

Colon CA

How is neuroblastoma evaluated overall?
CT/MRI to look for spread to soft tissues, distant nodes, CNS, and organ involvement.

Also, do bone marrow biopsy.
What is the nuclear medicine evaluation of neuroblastoma?
Bone scan

What is the cause of increased soft tissue uptake in an enlarged extremity on bone scan?
Soft tissue neoplasm

Soft tissue injury (crush injury)

Venous or lymphatic obstruction
What if the enlarged extremity is the upper extremity? What lesion would be most likely?
Lymphatic obstruction due to breast CA
What additional finding would further corroborate this diagnosis?
increased uptake in the anterior ribs
What other causes of this finding in an upper extremity are possible?
Lymphedema due to LND for another tumor (melanoma)

Electrical or frostbite injuries