General Question

mirifique's avatar

How safe is a bone scan?

Asked by mirifique (1540points) March 5th, 2010

I’ve been given the option of getting a bone scan to confirm tibial stress fractures, but I’ve read a bone scan emits 1000x more radiation than a X-ray; it also costs around $600. I’ve been having shin pain issues for about 5 months now, have waited the requisite 12 weeks without any running or impact, and they have returned after about 3 weeks of running (24 miles/week). The reason I’m asking Fluther is because the doctor has said “it’s basically [my] call” as to whether I want to proceed with a bone scan, or just “sort of monitor [my] symptoms and adjust accordingly.” This is frustrating to hear because I have no idea how to proceed, whether I will ever be able to solve this issue, and what exactly is causing this. Am I overreacting to the amount of radiation I’d be getting from this, and should just get the diagnosis?

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19 Answers

erichw1504's avatar

Did you ask the doctor?

mirifique's avatar

@erichw1504 Yes—he said it does emit a good deal of radiation, that I shouldn’t be too traumatized by it, but that it is ultimately my call. I suppose I just don’t have the expertise/experience to safely and properly contextualize the amount of radiation emitted from a bone scan.

erichw1504's avatar

Well if he says it won’t physically hurt you, then it should be safe. And since it is an operation that doctors have performed before without and ill effects, you should be OK.

Dr_Dredd's avatar

What about an MRI? That doesn’t involve any radiation, and it should confirm a stress fracture if one is present after such a long time. It’s pretty expensive, though.

ModernEpicurian's avatar

Hmm, I dearly want to say that all of this isn’t necessary, it could be picked up by basic acoustic analysis, but I’m afraid that the tech for that is still a couple of years away and wouldn’t confirm anymore than the existence of a fracture

davidbetterman's avatar

An MRI will cost a lot more than a bone scan, will it not?

marinelife's avatar

From the Mayo Clinic:

“A bone scan’s sensitivity to variation in bone metabolism and its ability to scan the entire skeleton make it very helpful in diagnosing a wide range of bone disorders. The test poses no greater risk than do conventional X-ray procedures. The tracers used in a bone scan produce very little radiation exposure.”

Rarebear's avatar

Very safe.

Dr_Dredd's avatar

@davidbetterman Yes, it will cost more, but it is also more accurate. A bone scan will “light up” where there is bone turnover (e.g. bone remodeling itself). That can mean anything from a healing fracture to infection to cancer. If you want to see an actual picture of what’s wrong in a specific area (as opposed to the whole body), an MRI is a better bet.

FireMadeFlesh's avatar

When looking at radiation dose, I find it useful to compare the procedure’s dose to the average background dose. A bone scan will give you an effective dose of around 3mSv, which is equivalent to 1.25 years of background radiation. This might sound like a lot, but a CT scan of the head (a region of similar radiographic density, maybe a little more dense) is around 2mSv. It is quite a substantial dose, but as your doctor said it is your choice. Personally I would have the bone scan though, because a problem must be identified before it is treated.

@Dr_Dredd and @davidbetterman An MRI is not really an option here, because MRI cannot show bone well. If it hasn’t shown up on a plain x-ray, it won’t show up on an MRI.

davidbetterman's avatar

@FireMadeFlesh I believe that is an inaccuracy.

FireMadeFlesh's avatar

@davidbetterman What exactly is an inaccuracy?

ModernEpicurian's avatar

Good answer @FireMadeFlesh. I believe that to be the exact answer needed here :-)

babaji's avatar

Obviously you have fracture that you apparently won’t let heal.
The XRay will confirm what you already know, will give you a massive dose of radiation that is not going to do you any good, and lighten your wallet accordingly.
When i ripped a tendon loose, did it all to tell me what i knew, and they wouldn’t put on a cast, they wouldn’t even give me a cane.
But you sound like you need a cast to disable you so that it will heal?
good luck

davidbetterman's avatar

Sorry, I mistook MRI for catscan. A catscan is what @mirifique requires.

thriftymaid's avatar

It’s an x-ray.

Rarebear's avatar

Actually, an MRI is an excellent test for a stress fracture.

FireMadeFlesh's avatar

@davidbetterman Not a problem. You are right, a CT scan would be a good test because of its far superior resolution and ability to demonstrate soft tissue. A bone scan does show stress fractures very well because the radiopharmaceuticals will be attracted to the healing region, but if it is only an investigation then a CT scan will show more detail and other possible causes as well.

@Rarebear Turns out you’re right on that one, thanks for the correction. Seems my lecturers forgot to mention it.

Rarebear's avatar

@FireMadeFlesh No problem. A bone scan is a good test too—it’s just not as specific. But in specific answer to the question that was asked, the radiation dose is totally safe.

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