Radionuclide Bone Scan Knees (NBKNBD)

Introduction

You are receiving this information leaflet because you have been referred for a dual phase bone scan in the nuclear medicine department. Nuclear medicine involves the use of small amounts of radioactive tracers to help diagnose and sometimes treat medical conditions. These tests are valuable in identifying a wide range of health conditions. Your referring clinician will have already discussed with you why this test is necessary.

This leaflet aims to provide an overview of your test and answer general questions. A member of our team will explain the procedure in detail when you arrive. If you have any concerns beforehand, please feel free to contact us using the details at the back of the leaflet.

Radionuclide Bone Scan Knees

A radionuclide bone scan of the knees is a nuclear medicine test where a small amount of radioactive tracer is injected into your vein. This tracer collects in your bones, highlighting areas of unusual activity within your knees to help doctors detect problems like prosthetic loosening, infection or inflammation.

Will it hurt?

The injection is quick and simple, like a blood test. There are no side effects from the tracer, and no restrictions following the test. You will be able to continue with your usual daily activities.

How long will I be in the department?

From start to finish your appointment may require up 5 hours.

What to do when you arrive

Upon arrival, please check in at the reception desk located on level 3. Once checked-in, kindly take a seat in the waiting area. This allows our team to confirm your attendance and prepare for your test. This process typically takes about 15 minutes.

Staff you are likely to meet

Your care will be provided by our specialist team, including nurses, nuclear medicine technologist and radiographers, who will guide you through each step of the procedure.

Preparation for examination

No special preparation is required. You may eat, drink, and take medications as usual. We advise drinking extra fluids (2-3 extra glasses) between your injection and scan and emptying your bladder regularly.

Please wear clothing without metal fastenings. You may need to remove metal items (belts, jewellery, coins) during imaging. Prosthetic implants do not interfere with the scan.

If you require mobility assistance, please notify the department in advance so we can accommodate your needs.

Please contact us in advance of your procedure/examination on 01223 217145 if you:

• Have additional requirements that may require a longer appointment
• Are claustrophobic
• Are pregnant or breastfeeding
• Require hospital transport
• Have mobility issues
• Require clarification on your preparation

Benefits

Nuclear medicine investigations provide doctors with information to help them diagnose a variety of conditions. These investigations help to confirm or rule out a suspected diagnosis, or occasionally identify a condition that was not suspected.

Risks

You have been referred for a nuclear medicine scan to help make a diagnosis or monitor your treatment. A specialist in radiology agrees that this is the best test to answer the clinical question that has been asked and that the benefit of the examination is greater than the risk. The CT scan involves a dose of ionising radiation equivalent to a few months or years of natural background radiation which we are all exposed to every day. Ionising radiation can cause cell damage that may turn cancerous however the risk of this happening from your examination is considered low. The dose delivered will be kept as low as is practicable

What will happen on the day of my scan?

This test involves three stages:

1.Tracer Injection

A member of our team will explain the procedure and review your medical bone history. Then a small amount of radioactive trace will be injected into a vein in your arm. At this stage we will perform a quick image of your knees that will take up to 5 minutes.

2.Waiting period

There is a waiting period of between 2 ½ to 4 hours to allow sufficient time for the tracer to distribute and accumulate in your bones. During this interval you will be able to leave the department. You will be given a return time for your scan.

3.Imagine Procedure

When you return for your scan, we will carry out a 5-minute image of your knees. Depending on the findings, we may then perform a more detailed scan called a SPECT/CT. This scan involves lying on a scanning bed for up to 30 minutes. We will ask you to remain still during the scan to ensure optimal image quality.

Accessibility requirements

If you require support for your appointment, e.g. if you find it hard to hear, see or be understood by others, please let the receptionist or healthcare professional know on arrival or contact us by email: cuh.accessibility@nhs.net or telephone: 01223 256998.

Pregnancy status

As a standard precaution, it is normally recommended to avoid radioactive tests during pregnancy. Please note that certain radioactive substances may pass into breast milk in small quantities. If you are currently breastfeeding, or if you know or suspect you may be pregnant, please contact our department in advance to discussion your situation. We also ask that you inform our staff upon arrival so we can ensure your safety and provide appropriate guidance.

We have a legal responsibility to enquire if you are pregnant. Women aged between 12-55 years will be asked if there is a possibility they could be pregnant. This is important for us to know before you have your examination involving ionising radiation. You can discuss this with a healthcare professional in private if you wish.

Can I bring someone with me?

To ensure the safety and comfort of all patients, we kindly request that you limit your companions to one adult during your visit. Please note that children and pregnant women are unable to accompany you in the department due to safety precautions. Your companion may be asked to wait outside during your procedure. We appreciate your cooperation and understanding. Should you require any special assistance,

Childcare whilst in department

Staff are unable to look after or supervise children whilst your procedure/examination is taking place. Please make alternative arrangements for the care of your children whilst you attend for your examination. If you attend an appointment with children with no one to look after them whilst you have your examination, then your appointment will unfortunately have to be cancelled and rescheduled.

Personal belongings

Please keep all your personal belongings with you at all times during your visit as we cannot accept responsibility for any lost, stolen or damaged items. Rest assure that you will be able to take these items with you into the scanning rooms.

Travelling abroad?

Please be aware that most airports have sensitive radiation monitors which detect very small amounts of radiation and may detect a residual trace from your test.

We advise you keep and travel with your appointment letter if you are travelling within 4 days after your scheduled scan. If you inform us of your travel, we can provide you with a signed travel letter at your appointment. If residual trace is detected, the airport may have to contact our department as a precaution.

What happens after my procedure/examination?

Once we have verified the quality of your scan and have confirmed we have all the necessary information, you will be able to leave the department. You may resume all normal activities as there no restrictions following this test.

Possible side effects and additional aftercare

This test has no significantly known side effects, and you can resume normal activities right way. There’s no need to avoid contact with others. However, please avoid having blood tests within 24 hours of your test.

How, when and by whom will my results be communicated?

Imaging examinations are reported in order of clinical priority to ensure those with the highest urgency are reported first. Your referring team or clinician will be responsible for communicating reports back to you.

While results are available through MyChart, please note there is a standard 3 week delay between when the examination is reported to when it appears on your portal. This allows your clinical team adequate time to review and act on your results before they are released to you.

Are there any alternative tests?

If this test isn’t suitable for you, please contact your referring clinician to discuss alternatives. They can recommend the best options based on your individual needs.

Contacts/Further information

If you have any queries or cannot make your appointment, please contact the department as soon as possible on 01223 217145.

Opening times: Monday-Friday 8am-5pm.

Facilities available

Our clinic provides a toilet with disability access for your convenience, as well as a dedicated baby changing room and an alternative waiting area for returning patients. Please note that the waiting area and toilet facilities are reserved for radioactive patients only, as part of our safety protocols. If you are not a radioactive patient alternative restroom facilities can be found around the corner in the outpatient department.

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Directions to the department

The nuclear medicine department is located on level 3, at the outpatient end of the hospital.

Question, concern or complaint?

Firstly, speak to your nurse, doctor or other staff member as soon as you can so they can do their best to put things right straightaway.

If you don’t feel able to speak directly to the people caring for you, contact the patient advice and liaison service (PALS). Please call 01223 216756 9am to 4pm Monday to Friday, via email at cuh.pals@nhs.net, or via a form available via link on the CUH PALS webpage.

PALS is open every weekday, and you can leave a message in the evenings and weekends.

My Chart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on our website.