ACTIVE LEARNING TEMPLATE:
Diagnostic Procedure
STUDENT NAME______________________________________
Bone Scan
PROCEDURE NAME_____________________________________________________________________
REVIEW MODULE CHAPTER____________
Description of Procedure
Involves injection of radiostope (usually technetium) that is taken up by bone. Uniform uptake
of the isotope is normal. Increased uptake is seen in osteomyelitis, primary and metastatic
cancer of bone, and certin fractures. Decreased uptake is ssen in areas of avascular necrosis
Indications
Detection and follow up of metastatic disease
Differentiation between osteomyelitis and cellulitis
Determination of bone viability: infection or avascular necrosis
Evaluation of fractures difficult to assess on radiograph (stress
fractures, fractures of complex structures and possible fractures in
nonaccidental injuries of children)
Evaluation of prosthetic joints for infection or loosening
Determination of biopsy site
Evaluation of bone pain in patients with normal or equivocal
radiographs
Evaluation of the significance of an incidental skeletal finding on
radiographs
Interpretation of Findings
Test results are considered normal when the radioactive
substance is spread evenly throughout the body. This
means that you likely don’t have a major bone problem.
Results are considered abnormal when the scan shows
darker “hot spots” or lighter “cold spots” in the bones.
Hot spots describe places where an excess of radioactive
substance has collected. Cold spots, on the other hand, are
areas where it didn’t collect at all. Abnormal results can
indicate that you have a bone disorder, such as cancer or
arthritis or infection in the bone
Potential Complications
A bone scan carries no greater risk than conventional
X-rays. The tracers in the radioactive substance used
in a bone scan produce very little radiation exposure.
The risk of having an allergic reaction to the tracers is
low.
However, the test may be unsafe for pregnant or
breastfeeding women. There is a risk of injury to the
fetus and of contaminating breast milk. Make sure to
tell your doctor if you’re pregnant or breastfeeding.
ACTIVE LEARNING TEMPLATES
CONSIDERATIONS
Nursing Interventions (pre, intra, post)
Pre: Explain that radioisotope is given 2hr
before procedure. Ensure the bladder is
emptied before scan. Inform patient that
procedure requires 1hr while patient lies
supine and that no pain or harm will result
from isotopes.
Post: Increase fluids after scan.
Client Education
Prior to undergoing any medical procedure, patients should be fully
informed as to the reason for the procedure, the alternatives, the
benefits, and risks. The reason, alternatives, and benefits of a bone
scan are patient-specific and dependent upon the clinical situation.
After a bone scan, a small amount of the radiotracer remains in the
patient and emits radiation. The amount is very small, and patients
are safe to go about their routine activities after the procedure.
However, it is important to keep in mind that patients may set off
sensitive radiation detectors at border crossings for several days
after the procedure.
Nursing Interventions
Assess the client’s understanding of the procedure, providing explanation, clarification,
and emotional support as needed. Radioactive material (technetium-99m phosphate) is
injected intravenously for 2 to 3 hours so that it concentrates in the bone. Observe the
injection site for redness or swelling. If a hematoma forms, apply warm soaks to the area.
Have the client drink four to six glasses of water in the 2- to 3-hour waiting period before
the procedure to facilitate renal clearance of any circulating radioactive material. The client
is not restricted to foods or fluids prior to the exam. Have the client empty the bladder prior
to testing; a full bladder will mask the pelvic bones and make the client uncomfortable.
The scan takes about 30 to 60 minutes to complete. The client must remain still during the
scanning. The client may be active during the waiting period. A sedative should be
ordered and administered to any client who may have difficulty lying quietly.
Therapeutic Procedure
A3