The use of bone scanning for the diagnosis and management of musculoskeletal trauma.

Bone scanning provides a unique way of monitoring early metabolic changes in bone and its adjacent soft tissues after trauma. An abnormal scan may often precede radiographic changes by days or weeks. This accounts for its usefulness in the early diagnosis of occult fractures and in fractures not clinically suspected or seen on initial x-ray films in the patient with multiple trauma. Dynamic imaging along with static imaging can be used to evaluate fracture healing and predict delayed union and nonunion. The combined technique is useful in assessing many of the complications arising after trauma and provides a reliable method of observing their treatment. It is also a useful noninvasive technique in the evaluation of pathologic fractures. Bone scanning is becoming an increasingly useful adjunctive procedure in the diagnosis and management of musculoskeletal trauma. However, as with any diagnostic technique, it provides only part of the overall picture and must always be carefully correlated with the history, physical findings, radiographic changes, and other laboratory data.