Matthew A. Twarogowski
July 27, 2011
Case Study # 1
Whole Body Bone Scan
Study Symptoms
Usual symptoms preceding Bone Scans include localized pain within long bones such as femur and humerus.   Heightened immobility from Pagets or skeletal metastases is commonly felt and evaluated with Bone Scans.   Joint pain within hands, knees, feet, or spine is also very typical.   In Mrs. Fozio’s case; she complained of warmth and discomfort near the inner portion of her right knee while initially being admitted for diarrhea.   She is suspicious of an additional infection as was the case for her left knee; which was previously incised and drained.
Bone Scans harbor some contraindications as do most nuclear medicine procedures.   Common bone scan concerns for technologists are tracer studies within a 48 hours, excessive weight, pregnancy, and recent barium studies.   Risk benefit ratio is always considered when exposing patients to radioactive doses, hence the reason for multiple coordinated nuclear medicine tests.   Exam tables, while strong, due have a weight limit which may negate the completion of a procedure.   Pregnancy necessitates the need for extra precautions but does not always void the need for the examination; while barium ordinarily attenuates these tests, yielding ambiguous results.   Technologists are very cognizant of patient’s daily schedule and work diligently to coordinate procedures to avoid repeat trips and excessive in-patient stays.
Patient History Questions  
Do you have diabetes?   Have you had any pain; is so, how long?   Have you had any recent surgery; is so, when and where?   Have you had any recent trauma; if so, when and where?   Have you ever had a nuclear medicine examination before; if so, when and what?   Do you have any prosthesis or implants?   Did you empty you bladder?  
Typical indications for ordering bone scans include evaluation of osteoarthritis, possible surgery such as total knee or hip replacement,...