White blood cell nuclear scan

Overview

A white blood cell nuclear scan is a special type of scan that helps doctors find hidden infections or areas of inflammation in your body. First, a small amount of a safe radioactive substance is injected into your vein. This substance attaches to your white blood cells — the cells that fight infection. The scan then takes pictures to show where these cells have gathered, which can point to the source of a problem.

It is not a routine scan like an X-ray, but it is used fairly often when doctors suspect an infection or inflammation that is not easily found with other tests.

It is used for people of all ages who have symptoms of a hidden infection or inflammation, such as those with a fever of unknown cause, a painful joint after surgery, or a weakened immune system.

Symptoms

Common symptoms

• Unexplained fever that lasts for more than a few days
• Pain, redness, or swelling in a specific area that does not go away
• Unexplained loss of appetite or weight loss
• Night sweats
• Feeling generally unwell with no clear reason

Symptoms in children

• Persistent high temperature that does not improve
• Being very sleepy or hard to wake
• Vomiting or refusing to eat
• Complaining of pain in a bone or joint that gets worse

Symptoms in older adults

• Confusion or sudden change in mental state
• A fall or new difficulty moving
• Low energy and loss of interest in food
• A wound or sore that is not healing

Causes

Main causes

• Bacterial infection deep inside the body, such as in a bone, joint, or internal organ
• Inflammation that is not caused by infection, like in sarcoidosis, inflammatory bowel disease, or rheumatoid arthritis
• An infected medical device, such as a hip or knee replacement, or a heart valve (prosthetic valve endocarditis)

Risk factors

• A recent surgery or injury to a bone or joint
• A condition that weakens the immune system, such as diabetes, cancer treatment, or long-term use of steroids
• Having an artificial joint or other implant that can get infected
• A history of intravenous drug use or untreated dental infection

When to see a doctor

See a doctor urgently if:

• If you have a high fever with chills, confusion, or trouble breathing — call your local emergency number immediately
• If you have rapid swelling or redness around a joint or wound that is spreading

Book a routine appointment if:

• If you have had a fever for more than a few days with no obvious cause
• If you have ongoing pain in a bone or joint that your doctor has not yet explained
• If you feel generally unwell or have night sweats that bother you

Diagnosis

The diagnosis of a hidden infection or inflammation is often made using a combination of symptoms, blood tests, and imaging scans. A white blood cell nuclear scan is one of the imaging tests used when other scans, like X-ray or CT, are not clear.

Tests that may be done

• White blood cell nuclear scan (the main test)
• Blood tests to look for signs of infection (e.g., high white blood cell count, C-reactive protein)
• Other imaging like X-ray, ultrasound, CT, or MRI to support the findings
• Sometimes a biopsy (taking a small tissue sample) of the area that shows up on the scan

What to expect at your appointment

On the day of the scan, a small needle will be used to inject the radioactive tracer into a vein in your arm. You will then wait 1 to 4 hours for the tracer to travel to your white blood cells and for those cells to reach any areas of infection. During the wait, you can rest and drink water. Then you will lie on a table while a special camera takes pictures of your body. The scan itself is painless and takes about 30 to 60 minutes. Afterward, you can go home and return to normal activities. The tracer leaves your body naturally through urine or stool over a day or two.

Treatment

Treatment depends entirely on what the scan finds. If the scan shows an infection, treatment will focus on clearing that infection. If it shows non-infectious inflammation, treatment will aim to calm the immune system. The results will guide your doctor in choosing the right plan for you.

Self-care at home

• Get plenty of rest if you have a fever or feel unwell
• Drink lots of fluids to help your body fight infection
• If you have a wound or sore, keep it clean and covered
• Follow any instructions given by your doctor before and after the scan

Medical treatments

If an infection is found, your doctor will likely prescribe antibiotics (or other antimicrobial medicines) to treat the specific germ causing it. For non-infectious inflammation, medicines that reduce inflammation may be used, such as corticosteroids or other immune-modulating drugs. The exact medicine depends on your condition. In some cases, if an infected medical device is found, the device may need to be removed and replaced later.

When is surgery considered?

Surgery may be needed if the infection is in a bone or joint that does not respond to medicine, or if an infected implant (like a hip or heart valve) must be removed. Your doctor will discuss this with you if it is needed.

Living with this condition

After a white blood cell nuclear scan, you will mostly manage the underlying condition that the scan is helping to find. If an infection is diagnosed, you may need a course of antibiotics and follow-up appointments. If the scan is normal, your doctor will rule out certain problems and look for other causes of your symptoms.

Lifestyle tips

• Take all prescribed medicines exactly as directed and finish the full course, even if you feel better
• Keep a symptom diary to share with your doctor
• Attend all follow-up appointments and scans as scheduled
• If you have a weakened immune system, avoid close contact with people who are sick

Diet and exercise

Eat a balanced diet to support your immune system. If you are feeling unwell, focus on small, nutritious meals. Gentle activity, like short walks, can help if you have the energy, but rest is important during an active infection. Always follow your doctor's advice about activity levels.

Mental health and emotional wellbeing

Waiting for test results can be stressful. It is normal to feel anxious or worried. Talk to your doctor or a nurse about your concerns. If you feel overwhelmed, consider speaking with a counsellor or support group. Taking care of your emotional health is just as important as your physical health.

Prevention

The scan itself does not need to be prevented, but the conditions it detects (like infections) can sometimes be prevented. Practice good hygiene, care for wounds properly, and follow your doctor's advice about managing long-term health conditions.

Vaccines

Staying up to date with recommended vaccines (like flu, pneumonia, and COVID-19) can help prevent infections that might lead to the need for this scan. Talk to your doctor about which vaccines are right for you.

Screening programmes

There is no routine screening for the conditions that require this scan. If you have symptoms, your doctor will order the appropriate tests.

Complications

If left untreated

• A hidden infection can spread to other parts of the body, leading to a serious blood infection (sepsis)
• Infection in a bone can cause permanent bone damage (osteomyelitis)
• Infection in an artificial joint can cause the joint to fail and require removal
• Chronic inflammation can damage organs over time if not managed

Long-term outlook

The outlook is generally good if the cause is found early and treated properly. The scan is an important step in identifying the problem so that the right treatment can begin. With modern medicine, most infections and inflammation can be treated or controlled, allowing you to return to your normal life.

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