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Diagnostic Test – Bone Scan (Technetium Pyrophosphate Nuclear Bone Scan)
1. What is this?
A nuclear bone scan using technetium-labeled pyrophosphate is an imaging study used to detect occult disease involving bone.
It is particularly helpful when pathology is not visible on plain radiographs.
2. How does it work?
- Technetium is taken up by osteoblasts
- It is deposited in areas of new bone matrix formation
- Regions with increased osteoblastic activity demonstrate increased radiotracer uptake (“hot spots”)
- Osteoblastic activity is required for a lesion to be detected on bone scan
3. What makes it abnormal?
A bone scan becomes abnormal when there is increased uptake due to:
- Infection
- Osteomyelitis
- Malignancy
- Primary bone tumors or metastatic disease
- Bone scans are highly sensitive but poorly specific
- They often cannot differentiate bone involvement from adjacent soft-tissue infection
4. What is the most accurate test?
- A bone biopsy is the definitive diagnostic test
- It is required to determine the exact etiology of an abnormal bone scan
- Culture for infection
- Histology for malignancy
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