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Bone and/or joint imaging; 3 phase study

CPT4 code

Name of the Procedure:

Bone and/or Joint Imaging; 3 Phase Study
Common Name: Three-phase bone scan
Technical Term: Triphasic bone scintigraphy

Summary

A three-phase bone scan is a specialized imaging procedure to look closely at bones and joints to detect abnormalities. It involves injecting a small amount of radioactive material and taking images in three separate phases to assess blood flow, bone activity, and bone density.

Purpose

The procedure addresses conditions involving bone and joint abnormalities, such as fractures, infections, or cancer. The goal is to obtain detailed images that help diagnose conditions affecting bone structure and function early on.

Indications

  • Unexplained bone pain
  • Suspected bone infection (osteomyelitis)
  • Evaluation of bone tumors or cancer metastasis
  • Detection of fractures not visible on X-rays
  • Assessment of bone diseases like Paget's disease or arthritis

Preparation

  • No fasting required.
  • Inform your doctor if you are pregnant or breastfeeding.
  • May need to stop certain medications temporarily.
  • Undergo preliminary blood tests to evaluate kidney function.

Procedure Description

  1. Injection Phase: A small amount of radioactive tracer is injected into a vein, usually in the arm.
  2. Initial Imaging Phase (Flow Phase): Images are immediately taken to observe blood flow to the area.
  3. Blood Pool Imaging Phase: About 5-10 minutes post-injection, more images are taken to assess blood pooling and soft tissue involvement.
  4. Delayed Imaging Phase: After 2-4 hours, final images are captured to see how the bones have absorbed the tracer.

The procedure uses a gamma camera to detect the tracer within your bones. It's non-invasive and typically doesn't require sedation or anesthesia.

Duration

Around 4-6 hours in total, with most of the time allotted for waiting periods between imaging phases.

Setting

Conducted in a hospital or an outpatient clinic that has specialized nuclear medicine facilities.

Personnel

  • Nuclear medicine technologist
  • Radiologist specializing in bone imaging

Risks and Complications

  • Minimal risk from the low-level radiation exposure.
  • Rare risk of an allergic reaction to the radioactive tracer.
  • Slight discomfort at the injection site.

Benefits

  • Early and accurate diagnosis of bone conditions.
  • Can pinpoint exact locations of bone abnormalities.
  • Helps guide treatment decisions and monitor the effectiveness of therapies.

Recovery

  • No significant recovery time required.
  • Drink plenty of fluids to help flush the radioactive material from your body.
  • Resume normal activities almost immediately.
  • Follow-up appointments to discuss the results with your healthcare provider.

Alternatives

  • X-rays: Less sensitive for some conditions, especially early-stage bone pathologies.
  • MRI: Provides detailed images but can be more expensive and time-consuming.
  • CT Scan: Excellent for detailed bone imaging but involves higher radiation exposure than a bone scan.

Patient Experience

Patients might feel a brief sting from the injection. During the imaging, you will need to remain still, which might cause minor discomfort. Most patients find the process non-invasive and manageable. Pain management isn't typically necessary since the procedure is generally painless.

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