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Nuclear Bone Scan showed chances of degenerative disease. What does it mean?

Answered by
Dr. Manoranjan Chowhan

Radiologist, Nuclear Medicine

Practicing since :1991

Answered : 103 Questions

Posted on Thu, 27 Dec 2012 in X-ray, Lab tests and Scans
Question: 1. In Nuclear Bone Scan which was done in two parts- one before injection and second one after 2 hours of injection, total time taken for images allover body to evaluate swelling and pain in bones.
It has noted that Radiologist have just taken 4 MINUTES to read complete Nuclear Bone Scan Does this is correct procedure.
2.In the report mentioned that there is- MAY BE DEGENERATIVE DISEASE OF BOTH KNEES
Radiologist is not clear about the ailment and problem in whole of the bones.
Nuclear Bone Scan was ordered to find cause of sever swelling and pain along legs, knees ,elbows and pedal edema.
3.What can be considered with remark made by Radiologist in report that this is difficult study and further mentioned that impressions are not clear, what are the expectations for such.
4.Does for obese persons these types of impressions made by Radiologists are normal while reading such high ended Nuclear Bone Scans , in case some disease is missing .
It has been noted while different tests –remarks like difficult study and unclear pictures /impressions are a routine attitude adopted by Radiographers while reading high ended scans, does this is in safety of patients?
Answered by Dr. Manoranjan Chowhan 8 hours later
As regards the bone scan please let me clarify some points:

The bone scan is not a study that can give diagnosis of any and every problem. You have mentioned that patient had swelling in legs and pedal edema but you have not mentioned age of patient.

Generally speaking, bone scan is not done for evaluation of swelling though pain anywhere in body may be evaluated with bone scan (some times radiological evaluation eg CT/MR may be combined if needed)

You have mentioned that the bone scan done in 2 phases one before injection and one after injection:

Please note that bone scan is done only after injection though at times 2 phase and 3 phase scan is done that means scan is done twice or thrice after giving injection (the latter in situation where there is suspicion of bone infection or stress related issues eg stress fracture etc).

Now as regards the report:-

1. The Radiologist who has read the report may have found only degenerative change and nothing else.
2. Incase this is degenerative cause, nothing to worry as this is common at certain age group. However, one must know the cause of pedal edema and other swelling as you mentioned.
3. As it appears in obese patients it is not uncommon to have degenerative bone disease as mentioned in the report.
4. As bone scan does have high sensitivity it usually does not miss any pathology and most of the time bone scan is most relied upon to exclude metastatic lesion and is superior to other tests.

However if the scan is available please send the scanned copy of the same I can comment and reply, if anything is missing in the finding as without personally seeing the bone scan one cannot say much about it.

Do write back for further discussion on this.


Above answer was peer-reviewed by : Dr. Shanthi.E
Follow up: Dr. Manoranjan Chowhan 4 hours later
Thanks Dr.Chowhan,
I am enclosing tests of Ca, etc and will request doctor here for the tests which are being mentioned, Bone scan report will be sent to you.
In which city you are working. Your knowledge is great and will be help to me .
Answered by Dr. Manoranjan Chowhan 11 hours later
Thanks for your reply.

As regards the reports that you have sent me I find your TSH level is higher than normal as it is 5.87 and that implies that you are hypothyroid which causes swelling in body (that you had mentioned in your complaints).

So as there are symptoms of swelling in body and there may be underlying Thyroid problem you need to consult a Thyroid specialist who can confirm the same and will treat that will help you to solve the problem of swelling which you had mentioned.

Please also send the scanned copy of bone scan so that I can do the needful.

Well, I work in a Hospital in Kolkata, India.

I thank you for your acknowledgement.

With best wishes from Dr Chowhan

Above answer was peer-reviewed by : Dr. Shanthi.E

The User accepted the expert's answer

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