Bonescans... if you had one, what were the results?
 

How many of you have had one? Did anything abnormal show up?

I had one a few months back and everything was completely NORMAL.

Hi, yes, I had a 3-phase bone scan; showed localised osteoporosis and my left forearm and hand were bright white against the black - and it's what convinced the docs it probably was RSD, not just me whingeing....
all the best :)

IHH - in the early stages of RSD, bone scans are often normal. My first ones were also.

Now, 8 years later, they show osteoporosis, but that often happens over time.

2 of them a year apart
 

The first showed low to normal in the hips and right leg. The second one showed Osteopenia in the rt hip, and leg.

That was 2 years ago, and I should go do it again as I am having lots of hip pain. Doc said fer sure RSD after reading results.

What is the point of having a bonescan? Like, even if it shows up abnormal, will that help you any??? :Scratch-Head:

The first one showed cellulitis in the non-affected hand and the second one showed normal.

These are apparently used primarily as a diagnostic tool. It sure seems building a machine which will image the firings of the nerves would be far more effective. If they're correct about the mechanism of the disease it would give positive results even when you're not hurting.

Best of all is that It could be used as a preventive measure in first aid. It would have wide applications throughout medicine.

We are talking about 2 different types of bone scans here.

One is a Bone Density which is done on healthy women (or man) and people who have RSD. This scan does not involve having a dye injected. I've had 4 of these done to check for osteoporosis.

The second scan is a Tri-Phasic Bone Scan which is done when docs suspect you have RDS. The sensitivity is 50-60%.
It involves injection of a radioactive tracer (dye) with scans done early after the injetion of dye and hours later, looking for increased or decreased uptake of the dye, which is indicative of RSD, but you can have RSD even if it is negative and not have RSD if it is positive.
(It can also show osteopenia)

I've had two of these. The first was positive and the second was negative.
This is a very helpful finding IF a doctor knows what that means.

What doctors don't usually know is that this is normal for people WITH RSD.

Quote from: http://podiatry.curtin.edu.au/encyclopedia/crps1

"Three phase bone scan: ... this is only sensitive within the first 20-26 weeks of the onset of CRPS and after 26 weeks there is a poor correlation. Even at 26 weeks the sensitivity is only 50% (Dilnot, 1998).

A quote from http://www.rsds.org/5/news/2005/bonescans.htm :

"....in the recent volume of Progress in Pain Research and Management1, only 16 percent of the patients diagnosed with CRPS/RSD 8 weeks after trauma had the characteristic bone scan pattern."
In only half the cases, the bone scan pattern was pathognomonic of CRPS/RSD I.
Furthermore, as the disease progresses, the changes in the bone scan go away.

Quote from Duke Orthopedics: http://www.ispub.com/ostia/index.php...vol2n1/cps.xml

Three phase bone scan demonstrates distinctive pattern of radiotracer uptake. Early stages shows increase in blood flow, whereas late stages shows total decrease in blood flow. The diagnostic sign is periarticular pooling specially in the late phase of the scan. However this is only sensitive within the first 20-26 weeks of the onset of CRPS and after 26 weeks there is a poor correlation. Even at 26 weeks the sensitivity is only 50%.

A three phase bone scan may demonstrate a reduction of blood flow during the early stages but does show increased peri-articular uptake during the third stage. "

Bone changes - X-rays may show wasting of bone (patchy osteoporosis) or a bone scan may show increased or decreased uptake of a certain radioactive substance (technecium 99m) in bones after intravenous injection http://www.rsdfoundation.org/en/en_c...uidelines.html

:) InHisHands, there are a couple of reasons where having a bone scan can make a difference!
If the scan shows osteoporosis then there is a treatment called Pamidronate Infusions which can lessen the pain of CRPS by helping to move calcium from the blood stream into the bone.
It is thought that osteoporosis is the cause of some of the deep bone pain of CRPS.
Another reason a bone scan can be useful is that it can sometimes help to make a diagnosis of CRPS and if your treatment is dependent on an Insurance company needing "proof" of the disease, then a scan that shows irregular osteoporosis which is confined to your areas of severe pain then this is often all they will need to give the OK for treatment.
My first scans several years ago at the beginning of the disease were normal, now, 7 years later I have severe osteoporosis in my CRPS affected areas.

Good to know
 

I would think the reason you would want to know, is one; do you have osteo?
Two; Is it related to RSD?

I had the bone density tests done, and after finding out there is bone density loss, I was able to do things to help the situation.

Information is power :)

Thanks very much!! I have a better understanding about them now.

Has anyone here had these "Pamidronate Infusions"?

This is exactly what just happened with mine except for one thing. My ortho sees bone changes all over the knee xrays (injury site) and even have borderline osteoporosis in hips, lumbar spine and wrist now too! The recent bonescan of legs is normal now though. It totally missed the bone loss that is pretty bad in the left knee though! Thanks so much for posting this! My first bonescan 2.5 yrs ago came back abnormal...*hot*. I was assuming that in late RSD it would be cold now?