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21 Cards in this Set
- Front
- Back
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How long is the delay for the delayed portion of a bone scan?
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3 hours
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Which components of a 3 phase bone scan are abnormal in osteomyelitis?
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Flow, pool, and delayed (bone image)
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What is the sensitivity for a 3 phase bone scan for osteo?
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95%
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What is the specificity, as long as a certain condition is met?
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also 95%
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What is that condition?
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Patient must have a normal x-ray or x-ray showing only changes suggestive of osteomyelitis in order to get this level of sensitivity.
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What does a cold defect in a region of bone suspected to be infected suggest?
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May represent gangrene. Check patient's blood flow. If vasculopath, this is a more likely possibility.
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How is joint infection differentiated from osteomyelitis on bone scan?
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Presence of uptake on both sides of joint suggests joint infection.
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What are false positives for 3 phase bone scan?
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Any causes of active bone remodeling with soft tissue inflammation.
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Such as?
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Healing fracture
Orthopedic surgery/implant Neuropathic osteoarthropathy |
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What is the next step if the patient has an abnormal radiograph in the area of increased uptake on bone scan?
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111Indium leukocyte scan
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What is the difficulty with this?
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Differentiating bone from overlying inflammed soft tissues
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What can be used if In WBC scan is inconclusive?
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MRI
HMPAO scan |
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What is the differential diagnosis for breast uptake on bone scan?
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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 |
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What is the appearance of normal breast uptake?
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Mild and bilaterally symmetric (unless patient has h/o mastectomy)
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What mets are most commonly identified in the breast on bone scan?
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Lung
Colon CA Neuroblastoma |
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How is neuroblastoma evaluated overall?
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CT/MRI to look for spread to soft tissues, distant nodes, CNS, and organ involvement.
Also, do bone marrow biopsy. |
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What is the nuclear medicine evaluation of neuroblastoma?
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Bone scan
MIBG |
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What is the cause of increased soft tissue uptake in an enlarged extremity on bone scan?
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Soft tissue neoplasm
Soft tissue injury (crush injury) Venous or lymphatic obstruction |
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What if the enlarged extremity is the upper extremity? What lesion would be most likely?
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Lymphatic obstruction due to breast CA
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What additional finding would further corroborate this diagnosis?
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increased uptake in the anterior ribs
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What other causes of this finding in an upper extremity are possible?
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Lymphedema due to LND for another tumor (melanoma)
Electrical or frostbite injuries |
