Pediatric bone scans are used to identify and diagnose bone diseases and disorders in children that do not typically show up on typical X-rays. Bone scans are performed on children who present to the doctor with growth retardation, bone pain or fractures. In preparation for a pediatric bone scan, a technician injects a small amount of a radioactive substance known as 99mTc-Medronate into the child's vein. This ensures that areas of abnormal bone growth and bone mineral density show up on the bone scan.
Epiphyseal Plate Ossification
I's important to diagnose any pediatric bone disorders before the ossification of the child's epiphyseal plates. The epiphyseal plates are areas of cartilage at the ends of long bones, such as the femur. These cartilage plates allow the child to grow and reach his full adult height. Normally, the epiphyseal plates ossify, or turn to bone, when the child reaches adulthood. However, bone diseases during childhood can expedite this process, halting bone growth at an earlier age and preventing a child from reaching her full adult stature.
Diagnosing Skeletal Abnormalities
Pediatric bone scans are useful in diagnosing skeletal abnormalities related to idiopathic juvenile osteoporosis, a disease in which bone is insufficiently formed or too much bone calcium is lost, resulting in bone pain and weakness; osteogenesis imperfecta, a genetic disorder that results in easily fractured bones; fibrous dysplasia of bone, a developmental abnormality of connective tissue and bone that causes abnormal growth, bone pain and deformity; and cerebral palsy, a neurological disorder that can also cause scoliosis, or curvature of the spine.
Diagnosing Bone Cancer
The radioactive injection of 99mTc-Medronate given during a bone scan travels throughout the child's bones and reveals areas of bony tissue where cells are atypically active. Unusually active bone cells can indicate osteosarcomas, or cancerous tumors arising in the bone near a child's epiphyseal plates. Children who are experiencing bone pain, limping or swelling without any sign of trauma or decreased movement in their limbs should be evaluated for osteosarcomas.
Diagnosing Bone Fractures
Bone scans are quite useful in diagnosing fractures that are missed on typical radiographic X-rays. Because children have areas of bone that have not yet calcified--the epiphyseal plates--they're more susceptible to fractures. Bone scans can be helpful in diagnosing fractures in these epiphyseal plates, as well as on areas where fractures don't clearly show up on X-ray. These include the child's ribs and spine, or hairline fractures in the diaphyseal (long) bones.
Diagnosing Bone Infections
Infections in the bone, called osteomyelitis, can occur in children who are exposed to insect or animal bites, skin abrasions or puncture wounds. Skin breakdown leaves children vulnerable to bacterial infections, which can travel through the bloodstream and into the bones. Other common childhood ailments--such as ear infections, upper respiratory infections, and strep throat--can also affect the bones. Bone scans can diagnose areas of bone affected by osteomyelitis by revealing areas of increased radioactive uptake.
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