Friday, September 7, 2012
Bone Scan from Talus Injury
There are many reasons I will order a bone scan for a patient. A radioactive dye is utilized to glue itself to phosphorus molecules. Bone is made up of water, calcium, and phosphorus. If a bone scan is hot, there is active bone metabolism going on. This patient injured her talus bone wearing unsupportive shoes. If you look at the upper left and right images, the marker points to the talus as a bright spot that is not present on the other side. Bone scans are wonderful since you do get both sides as part of the normal exam for comparison. It is the comparison of the injured side to the noninjured side that makes bone scans unique and quite special. Comparing the two sides by location and intensity of dye uptake can give you a great idea of what bone activity is occurring. In this case, the dye uptake in the talus clearly shows that strong healing is occurring.
The image on the lower left further localizes the spot (and this is the exact location seen on the MRI). The image on the lower right shows me in Quimper, France, in 2007 in front of one of those famous French doors.
So, the bone scan was very positive. The patient was told that great healing is going on. We have to continue for the next 6 months in a great pain free environment to let the healing continue. It is impossible to know how fragile the system is. This particular patient will not be running soon, but walking has been fine, elliptical will be introduced soon, and she is using orthotics to stabilize her ankle, a bone stimulator from Exogen, and daily icing and contrast bathing.