Three Phase Bone Scans?

[Katie]

I had one of these done last fall, and didn't get a great explanation of what it meant, so thought I'd see what the 'experts' here had to say

It seems to be telling me about the condition of my facets, in relation to arthritis. The summary said "Very mild facet arthropathy at L4 on the left and L5 bilaterally."

It talks about blood flow and pool images of the posterior lumbar spine...unremarkable.

It continues: "On the delayed whole-body images, including tomographic images of the thoracolumbar spine, there is minimally increased uptake in the left L4 and bilateral L5 facet joints, consistent with mild facet arthropathy. The remainder of the scan shows degenerative changes in the patellofemoral joints bilaterally and the first MTP joints bilaterally."

Sooooo my facets are fine, but my knees and hips are a little toasty?

If this is correct, then the bigwig spine surgeon that I saw over a year ago was wrong? He said I had such bad arthritis that I would never be a candidate for ADR. Even my MRI written report said that the facet joints had very mild arthritis, but he disagreed.

Can someone please translate, and I hope this is in the right forum.

[KBear]

Sounds like the big wig surgeon was wrong, which isn't surprising. He probably doesn't do ADR, or felt your case was out of his league; but was too prideful to admit it. So, instead he said you weren't an ADR canidate, to do a fusion, because that was in his comfort and pride zone. Just my opinion.

[Katie]

You are right on the second count Kathy He does do limited numbers of ADR, not much more than 60 in the past half dozen years, but is supposed to be the 'gold standard' or expert in the province.

He said I had way too much arthritis, just by looking at my MRI. Funny, Dr. Bitan didn't think so

So this would be a good test, almost as good as a block? I know it isn't a pain indicator, but it does sound like arthritis isn't an issue from this test? Has anyone else ever heard of it before? More Googling is in order!

[Katie]

So I just looked it up on line, and it said that the techs are supposed to take some kind of reading at one hour, four hours and twenty-four hours post injection of the nuclear stuff (so scientific hey ).

But, they only did some readings one hour after the injection, so it sounds like it was a one phase scan . I'll call the radiology department tomorrow and get some answers. Thanks.

[KBear]

I've never heard of the scan, so not sure. Would be interested to hear more....

[Justin]

Hey Katie,

Definitely follow up with the Radiology Department. They are the absolute best resource when it comes to questions regarding the study you had done.

Despite what the surgeons say, radiologists are the experts when it comes to reading films. However, this doesn't mean that their reports spell out everything your surgeon is "looking for."

Good luck!

[Katie]

Thanks Justin. It is hard to know who to ask about questions like this. The doctor is of very little use right now, the one who ordered it. I had almost forgotten all about this test until I came across the paperwork for it when sending reports out to the surgeons I'm trying to get a consult with.

I feel like I'm getting a bit scatterbrained, and for me to notice, well it must be bad!

[Katie]

Kathy, I'm surprised that this test isn't used more, if it is that easy to identify arthritis throughout the body, including at the facets. It was completely painless, more of an inconvenience as it took up most of the day. I'll have to look into it a lot more.