The role of whole body bone scintigraphy in the diagnosis and follow-up of renal osteodystrophy

Abstract

Bone scintigraphy (BS) is one of the most successfully applied imaging methods in nuclear medicine. Skeletal uptake of Technetium-99m-Diphosphonates depends primarily upon osteoblastic activity. A whole body bone scan image therefore presents a functional display of total skeletal metabolism and such has a valuable role to play in the assesment of patients with metabolic bone disorders. Bone scintigraphy is succesfully applied in the diagnosis and follow-up of renal osteodystrophy (ROD) as well as in the detection of local anomalies such as pseudofractures or Brown tumours. Renal osteodystrophy is present in the majority of the patients with chronic renal failure and has become a considerable clinical problem to confront. Routinely used parameters in the follow-up of the disease are the plasma levels of calcium, phosphorus, alkaline phosphatase, hydroxyproline and parathormone as well as conventional bone radiographic findings. Due to the insufficient common use of BS in ROD, there is a general lack of experience in the interpretation of radionuclide images. In this article, we aimed to clarify the basic principle of bone scanning as well as the general and focal pathological scintigraphic findings in ROD.