12 Skeleton System

Bone and soft tissue disease is kind of detrimental disease and the precise diagnosis and timely therapy is also the clinical doctors’ object of a prolonged endeavour. This chapter will introduce the diagnostic and therapeutic methods of bone and soft tissue diseases with nuclear medicine techniques. The singular advantages of skeletal scintigraphy are high sensitivity in detecting early disease and its ability to survey the entire skeleton quickly and reasonable expense. Most broadly, the uptake of skeletal seeking radiotracers depicts osteoblastic activity and regional blood flow to bone. Any medical condition that changes either of these factors in a positive or negative way can result in an abnormal skeletal scintigram. Radionuclide distribution has played an important role in understanding normal bone metabolism, in addition to the metabolic effects of pathologic involvement. Radionuclide imaging of the skeleton is being used with increasing frequency in the evaluation of abnormalities involving bones and joints. Several studies have demonstrated that different information can be obtained by radionuclide bone imaging compared with radiography and blood chemistry analysis. Innovations in equipment design and other advances, such as single-photon emission computed tomography (SPECT), positron emission tomography (PET), positron emission tomography/computed tomography (PET/CT), positron emission tomography/magnetic resonance imaging (PET/MR) and hybrid SPECT/CT have been incorporated into the investigation of various musculoskeletal diseases. The first part of this chapter introduces the mechanism of skeletal radionuclide imaging, which also reviews part knowledge of skeletal anatomy and physiology. The remainder of the chapter discusses radionuclide imaging of the bones and joints, with an emphasis on the applications of the imaging procedures, and the radionuclide therapy of some bone tumors.