Pediatric Bone Scintigraphy Update

• Published in: Seminars in nuclear medicine 2010, Vol.40 (1), p.31-40
• Main Author: Nadel, Helen R., MD, FRCPC (Diag Rad) (Nuc Med), ABR (Diag Rad) (Ped Rad), ABNM
• Format: Article
• Language: English
• Subjects: Bone and Bones - diagnostic imaging; Bone Diseases, Infectious - diagnostic imaging; Bone Diseases, Infectious - pathology; Bone Diseases, Infectious - physiopathology; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - pathology; Bone Neoplasms - physiopathology; Child; Humans; Pain - diagnostic imaging; Pain - pathology; Pain - physiopathology; Radiology; Radionuclide Imaging - methods; Wounds and Injuries - diagnostic imaging; Wounds and Injuries - pathology; Wounds and Injuries - physiopathology
• ISSN: 0001-2998; 1558-4623
• DOI: 10.1053/j.semnuclmed.2009.10.001

Bone scintigraphy is a sensitive tool to evaluate the musculoskeletal system in children. Hybrid imaging using computed tomography (CT) in combination with conventional bone scan and single photon emission computed tomography improves specificity and diagnostic accuracy. It also improves laboratory efficiency and may save the patient an additional visit to the hospital for a separate cross-sectional imaging study. We have found this technique to be particularly helpful in localizing a cause for pain in children who are nonverbal and to better delineate small bone and soft-tissue lesions that can occur with diagnoses of trauma, infection, and tumor. Special attention to technique of positioning the patient for potential CT examination is an adaptation that must be made by the technologist. Because of radiation concerns of the additional CT, obviously these examinations should be tailored to the individual child and be performed for limited sites directed to the abnormality observed on the associated single photon emission computed tomography examination or directed by the appropriate history.