Nuclear medicine technhiques for the musculoskeletal system

Question 1

Whatchu use for bones

Answer 1

99 Tc-MDP
Technetium Disphosphonate.

Indicates osteoblastic activity.

Scanned with a gamma camera or SPECT.
Emits single photons of gamma radiation.

Question 2

What are radiopharmacons for the PET?

Answer 2

Isotopes of Carbon, Oxygen, Fluorine, or Nitrogen
Carbon, Nitrogen, and Oxygen isotopes have really short half lives and must be able to be made on site, so they aren’t used much.

FDG is the main one, it has a 110 minute half life.

Question 3

What is the most sensitive to the radiopharmacons

Answer 3

PET - picomolar range
then
SPECT - nanomolar range.

Question 4

Most common radiopharmacon for PET?

Answer 4

FDG, fluorodeoxyglucose.

Question 5

What nuclear medicine techniques are used for bones and musculoskeleton

Answer 5

Bone scintigraphy – for MULTIPLE things:?

Cancer and metastases
Osteomyelitis. It is sensitive in the early stages while X-ray/CT is not. Positive in 24-72 hours.
Normally show increased uptake, but can show decreased activity in bone ischemia, called cold osteomyelitis.

Traumatic bone lesions, especially to locate occult fractures on X-ray:
such as Stress Fractures
Multiple occult Fractures related to child abuse

Aseptic necrosis aka Avascular necrosis: scintigraphy is very sensitive and can detect much earlier than X rays or CT scans. Showing a lack of perfusion to the region and no tracer accumulation.