Can a bone scan detect compression fractures

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Can a bone scan detect compression fractures

by violet2 on Sat Mar 13, 2010 07:39 PM

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Does anyone know if a bone scan can detect compression fractures?   I had an MRI for increasing back pain, and when I looked at the images, one of the vertebrae was visibly shorter in height in one side, than on the other side.  The radiology report glossed over it, I think because this practice is only used to looking for major herniated discs.  I don't want to waste my insurance company's money if this test doesn't ususally show anything.  I thought I read that myeloma fractures don't always show up as increased activity, because unlike in other patients, there is a lack of bone rebuilding, which is what bone scans show. Should I ask for a PET scan instead?  My ribs have been more sore, and sometimes I keep my hand on them during the day, because they hurt so much.  Will this show on the bone scan?  I don't like doing medical tests just for the fun of it, if they are not helpful.  The information that I am seeing almost indicates that I might as well cancel this test.

RE: Can a bone scan detect compression fractures

by violet2 on Sat Mar 13, 2010 08:41 PM

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Actually, I just read the posts to the other message thread, and it looks like I'll ask for a PET instead.

RE: Can a bone scan detect compression fractures

by DebJr on Sat Mar 13, 2010 11:19 PM

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Hello,

YES, it can... abosolutely. When we were trying to find out what was wrong with my father re: his horrific back pain and hip pain, aside from some initial x-rays when nothing cancer related was suspected yet - he was then sent for an abdominal/pelvic CT scan and a Bone Scan. Aside from the multiple lytic lesions in his hip/pelvic area, the bone scan showed "severe compression fracture of the spine". It also showed a 'hairline rib fracture'. 

Although i have read lately that several people on this board think a bone scan is a waste (and maybe it is) - i'm just letting you know about my experience and that yes, it can detect a compression fracture. I have heard that CT scans are good and the best is a PET scan.

Good luck & i hope you find some quick relief.

RE: Can a bone scan detect compression fractures

by DebJr on Sat Mar 13, 2010 11:21 PM

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PS - it was this test that first indicated a likelyhood of Multiple Myeloma specifically, and then once we took him to the Oncologist, she did a bone marrow biopsy within minutes and then the next day his diagnosis was confirmed.

RE: Can a bone scan detect compression fractures

by UTboy on Sun Mar 14, 2010 01:36 AM

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Certainly not a waste; a bone scan has its place.  However, for myeloma, a PET/CT and/or a MRI is better.  It's the type of lesion, tumor, and bone marrow involvement that make the PET/CT and MRI best for myeloma.  For other cancers, a bone scan may be better than a PET/CT.  An MRI pentrates to the marrow while a PET/CT brings the high resolution of a CT with the nuc med of a PET.   

That's my take from the cheap seats. 

Best of luck to you.

Doug

 

RE: Can a bone scan detect compression fractures

by violet2 on Sun Mar 14, 2010 06:42 PM

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Thanks for the information, that was helpful. Maybe I'll just keep the bone scan scheduled to see what it shows. And if it shows nothing but my back doesn't get better in a couple months, then I'll ask for a PET scan too. Also, I thought the MRI was very helpful, but the doctors didn't. When I was looking at the different images, I pointed and asked "What are those white dots on my spine? Could that be why my back hurts?" And the doctor was like he didn't know but he didn't care, because he said it was probably just "image scatter" or something.

RE: Can a bone scan detect compression fractures

by poppycath on Mon Mar 15, 2010 09:25 AM

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Hi Violet -- I have had all the various scans and each of them has a purpose.  The compression fractures can be seen on skeletal survey, PET, MRI and CT -- all at different levels of clarity.  I had one today called a Sistamibi scan, which is a nuclear scan which shows the 'active hot spots' using radioactive dye.  The secret to it all is having qualified oncologists and radiotherapy staff who can actually 'read' what they are seeing.  It sounds to me that this is your problem!!  You seem to have a doctor who does not understand Myeloma, which lets face it, is not unusual!!  It is very important to find an oncologist who specialises in myeloma so that you get the best treatment available.  Don't hesitate to contact the oncology department of your nearest BIG hospital and ask for an expert in this area.  Failing that, go on line and ask people on this message board for names of qualified people in your district/area.  Having a myeloma specialist is the very first step to getting a control on your own treatment.  I have had MM since 2003 and was given a very limited life span, but here I am, still living a very reasonable quality of life having undergone all forms of treatment except the transplant (due to problems with side effects from the various chemo's) but doing very well on very low dose Revlimid!!  Good luck to you Violet, but please, find an MM specialist.  Cheers, Cath alias poppy

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