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Large circular black spot on sciatic bone in bone scan, history of lower back problems and procedures. Meaning?

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my wife has a large perfect circular black spot on sciatic bone on her bone scan. what can this mean? she is 32 years old, 4' 11", 120 lbs, with a 4 year history of lower back problems and procedures ie: injections, etc...
Posted Wed, 11 Apr 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Rakhi Tayal 21 minutes later
Hello
Thanks for writing to us.

A black spot on sciatic bone on bone scan with chronic lower back pain needs a detailed investigation to find out the cause.

Areas that absorb little or no amount of tracer on bone scan appear as dark or "cold" spots.

This could show a lack of blood supply to the bone or rarely certain types of cancer.

This could be indicative a localized necrosed area due to injury or chronic inflammation and may even suggest a secondary lesion arising from a malignant growth anywhere in the body.

A follow up CT- scan and MRI are advisable to know the nature of the lesion.

A biopsy may also be needed to further evaluate abnormal bone scan results.

Consult your orthopedician under whose guidance you may plan the above tests.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Large circular black spot on sciatic bone in bone scan, history of lower back problems and procedures. Meaning? 1 hour later
How common is this issue we've discussed found to be cancer. how does cancer typically appear in these scans?
 
 
Answered by Dr. Rakhi Tayal 2 hours later
Hello.
Thanks for writing again.

Cancer is not very common and if it is there then mostly it is a secondary metastasis.

Metastatic areas are usually well defined and may have some irregular margins.

In your description it is written that the lesion is smooth margined so it seems to be benign bone necrosis.

Further investigations are necessary for diagnosis.

Wishing you an early recovery.
Regards.

Above answer was peer-reviewed by
 
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