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Bone metastases - bone scans (description)

        BONE METASTASES - BONE SCANS (DESCRIPTION)
Bone scans are a Very useful means of looking for secondaries. They can also pick up cancer deposits in bones which look normal on plain X-ray. A spot which has hardly weakened the bone at all still produces a reaction in the normal bone cells nearby. It is in these active bone cells that the radioactive substance is concentrated. Thus the bone scan can detect cancer deposits which are at an earlier stage than those visible on a plain X-ray. The problem is that the bone scan shows up all reactive bone cells regardless of the reason for the reaction. Fractures (recent or old), arthritis and infections also can show up on bone scans as 'hot spots'. Bones which show 'hot spots' on scan usually have to be X-rayed to find out what is causing them. Occasionally the normal bone cells do not react to cancer cells nearby. In this case the bone scan will be falsely negative, that is, will miss the cancer spots. This happens especially with myeloma. The most reliable way of looking for bone secondaries is with a combination of bone scan and X-rays.
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