Preparing for bone scan

Overview

A bone scan is a special imaging test that looks at your bones. It uses a small amount of a safe radioactive substance (called a tracer) to find areas of bone that may be damaged, infected, or growing abnormally. The tracer is injected into a vein and then travels through your blood to your bones. A camera takes pictures to show where the tracer collects, which can help doctors spot problems like fractures, arthritis, infection, or cancer that has spread to bones.

Yes, bone scans are a common imaging test used to check for a variety of bone conditions. Millions are done each year worldwide.

Anyone can need a bone scan, but it is most often used for people with unexplained bone pain, suspected fractures, cancer that may have spread to bones, or infection in the bones.

Symptoms

Common symptoms

• Unexplained bone pain that does not go away
• Pain from a possible fracture (broken bone) that does not show on an X-ray
• Swelling or tenderness in a bone area
• Suspected infection in a bone (osteomyelitis)
• Cancer that might have spread to the bones (for example, breast, lung, or prostate cancer)

Symptoms in children

• Limping or refusing to use an arm or leg
• Unexplained fever with bone pain
• Pain that wakes a child at night
• Swelling or redness over a bone

Symptoms in older adults

• New or worsening back pain that may be from a compression fracture
• Pain in the hips, knees, or shoulders that limits movement
• Sudden pain after a minor fall, even if X-rays look normal

Causes

Main causes

• Fractures (broken bones) – especially stress fractures or those that are hard to see on X-ray
• Bone infections (osteomyelitis) – often from bacteria entering through a wound or after surgery
• Arthritis – especially osteoarthritis or inflammatory types like rheumatoid arthritis
• Cancer that has spread to the bones from another part of the body (bone metastases)
• Paget's disease of bone – a condition where bones grow too fast and become weak

Risk factors

• Older age – bones become more brittle and healing slows
• Osteoporosis – weak bones that break easily
• Cancer – especially breast, lung, prostate, or kidney cancer
• Long-term use of steroid medications
• Smoking and heavy alcohol use
• Having had a previous bone infection

When to see a doctor

See a doctor urgently if:

• See a doctor right away if you have sudden severe bone pain after an injury or if you cannot move a limb.
• If you have a fever with bone pain and redness, see a doctor within 24 hours.

Book a routine appointment if:

• If you have bone pain that lasts more than a few weeks or gets worse slowly, make an appointment with your doctor.
• If you have a known condition like cancer or osteoporosis and develop new bone pain, tell your doctor.

Diagnosis

A bone scan is one way doctors look at your bones. They will first ask about your symptoms and medical history, and may do a physical exam. If they suspect a bone problem that is not clear on an X-ray, they may order a bone scan.

Tests that may be done

• Bone scan (nuclear medicine scan) – the main test for this topic
• X-ray – often done first to look for obvious fractures or arthritis
• MRI (magnetic resonance imaging) – shows soft tissues and bone in detail
• CT scan (computed tomography) – gives a 3D picture of bones
• Blood tests – to check for infection, inflammation, or signs of cancer

What to expect at your appointment

A bone scan is usually done as an outpatient procedure. You will be given an injection of a small amount of radioactive tracer into a vein in your arm. Then you will wait about 2 to 3 hours while the tracer travels to your bones. During the wait, you can drink water and move around normally. When it is time for the scan, you will lie on a table while a camera moves slowly over your body. The scan takes about 30 to 60 minutes. It does not hurt. After the scan, you can go home and do your normal activities. The tracer leaves your body through urine within 24 hours. Drink plenty of water to help flush it out.

Treatment

A bone scan itself does not treat anything. It is a test that helps your doctor find the cause of your bone problem. Treatment will depend on what the scan shows. For example, if a fracture is found, you may need rest, a cast, or sometimes surgery. If an infection is found, antibiotics will be needed. If cancer is discovered, your doctor will discuss cancer treatments like radiation, chemotherapy, or targeted therapy. Always talk to your doctor about the specific treatment plan for your condition.

Self-care at home

• Rest the painful area until you know the cause.
• Apply ice or heat as advised by your doctor for muscle-related pain.
• Take over-the-counter pain relievers like paracetamol (acetaminophen) or ibuprofen, as long as your doctor says it is safe for you. (Do not exceed recommended doses.)
• Stay well hydrated – drink water regularly.
• Eat a diet rich in calcium and vitamin D to keep your bones strong.

Medical treatments

Medical treatments for bone problems depend on the diagnosis. For fractures, doctors may use splints, casts, or surgery to stabilise the bone. For bone infections, antibiotics are given for several weeks, sometimes through a drip (IV). For arthritis, treatments include anti-inflammatory medicines, physiotherapy, and sometimes injections. For cancer in the bones, treatment may involve radiation therapy to shrink tumours, chemotherapy, or targeted drug therapy. Your doctor will explain the options that are best for you.

When is surgery considered?

Surgery may be needed for serious fractures that do not heal with casting, for bone infections that do not clear with antibiotics, or to remove a tumour from the bone. Your doctor will recommend surgery only if it is the best option for your condition.

Living with this condition

After a bone scan, you can return to your normal daily activities right away. The test itself does not cause any side effects for most people. If you had an injection, you might have a small bruise at the site. If the scan found a bone problem, your doctor will give you instructions on managing that condition. Follow their advice, take any prescribed medicines, and attend follow-up appointments.

Lifestyle tips

• Stay active with low-impact activities like walking or swimming, as your doctor advises.
• Avoid smoking and limit alcohol – both can weaken bones.
• Get enough calcium and vitamin D from foods like milk, yoghurt, cheese, leafy greens, and fortified cereals.
• Do weight-bearing exercises (like brisk walking or dancing) to keep bones strong, if your doctor says it is safe.
• Use good posture and safe lifting techniques to protect your back.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein. Calcium-rich foods include dairy products, almonds, and sardines. Vitamin D helps your body use calcium – you can get it from sunlight, fatty fish, and fortified foods. If needed, your doctor may suggest supplements. Exercise such as walking, yoga, or tai chi can improve bone strength and balance, reducing fall risk.

Mental health and emotional wellbeing

Having bone pain or waiting for test results can be stressful and worrying. It is normal to feel anxious or frustrated. If you find yourself feeling down, talk to your doctor or a counsellor. Connecting with friends, family, or support groups can also help. Remember that many bone problems are treatable.

Prevention

You cannot always prevent bone problems, but you can lower your risk. Keep your bones strong with a healthy diet, regular exercise, and avoiding smoking and heavy drinking. Use safety gear during sports and prevent falls at home by removing tripping hazards. If you are at risk for osteoporosis, talk to your doctor about bone density testing and prevention strategies.

Vaccines

Some bone infections are caused by bacteria like Staphylococcus aureus. While there is no vaccine specifically for bone infection, staying up to date with vaccines like the flu shot and pneumonia vaccine can help prevent infections in general.

Screening programmes

Screening for bone problems is not routine for everyone. However, if you are a woman over 65 or a man over 70, or if you have risk factors for osteoporosis, your doctor may recommend a bone density scan (DXA). This measures how strong your bones are and can help prevent fractures.

Complications

If left untreated

• A small fracture may become a larger one or heal poorly, leading to chronic pain.
• A bone infection can spread to the blood (sepsis), which is life-threatening.
• Cancer that has spread to bones can cause severe pain, fractures, or nerve problems if not treated.
• Arthritis can get worse and lead to permanent joint damage.

Long-term outlook

Most bone problems found on a bone scan can be treated successfully. With proper care, many people recover fully and return to their normal activities. Even for more serious conditions like cancer, treatment options have improved greatly, and many people live well for years. Your doctor will work with you to create a plan that gives you the best possible outcome.

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