The bone scan: where are we now?

The isotope bone scan continues to be the most widely performed nuclear medicine investigation in the UK. The detection of skeletal metastases remains the most common clinical indication. However, the use of the bone scan is changing as it becomes subject to cost pressures, competing imaging modalities, and altering clinical indications. Overall, fewer studies are being performed for investigation of skeletal metastases, but this decrease in numbers has been compensated by increasing use in benign orthopaedic conditions. Advances such as correlative imaging and single photon emission computer tomography have increased its value and provided new clinical roles. Quantitation has still not achieved widespread usage, although it continues to be helpful to investigate sacroiliitis. Bone positron emission tomography imaging is now possible, although definite clinical roles have yet to be identified. Bone densitometry using dual x-ray absorptiometry is rapidly increasing in availability and usage throughout the UK, and this can be expected to continue to increase over the next few years.