At a glance
A bone scintigraphy (bone scan) is a nuclear medicine imaging test that uses a small amount of radioactive tracer to produce a detailed map of activity inside your bones.
A radioactive tracer is injected into a vein and travels through the bloodstream to the bones. Wherever bone tissue is unusually active, such as at a fracture site, a tumour, or an area of infection, the tracer accumulates in higher amounts. A special camera called a gamma camera detects the radiation emitted by the tracer and converts it into images. Areas of high accumulation appear as bright spots, sometimes called "hot spots", while areas of reduced activity appear darker.
Medical Condition
Doctors order a bone scan when they need to detect bone abnormalities that may not yet show up clearly on a standard X-ray, or when they want to check how far a known disease has spread across the skeleton.
- Suspected spread (metastasis) of cancer to the bones, most often from breast, prostate, lung, or kidney cancer
- Unexplained bone pain that has not been explained by X-ray alone
- Stress fractures (hairline cracks from repeated pressure) that are too small to appear on a plain X-ray
- Osteomyelitis (bone infection) to confirm its presence and map its extent
- Paget's disease of bone, a condition where bone breaks down and regrows abnormally
- Monitoring the response of bone tumours or bone metastases to treatment
- Avascular necrosis (AVN), where part of a bone loses its blood supply and begins to die
- Assessing the health of a bone graft or a joint prosthesis after surgery
A bone scan is not always the right choice. Doctors usually avoid it in the following situations.
- Pregnancy, because radiation exposure carries a risk to the developing baby
- Breastfeeding mothers, unless the feed is interrupted for a period the nuclear medicine team specifies
- Patients who cannot lie still for the duration of the scan, as movement blurs the images
- When very recent blood tests or other imaging have already provided a clear enough answer
Risks & Complications
A bone scan is a low-risk diagnostic procedure. The radioactive tracer is used in a very small amount and leaves the body through the urine within a day or two. The risks that do exist are minor.
- Low-level radiation exposure, comparable to many standard X-ray examinations; the tracer dose is carefully calculated to keep exposure as low as possible
- Mild discomfort or bruising at the injection site where the tracer is given
- Allergic reaction to the tracer, which is rare and usually limited to a skin rash or flushing
- Temporary anxiety or claustrophobia (discomfort in enclosed spaces) for some patients, as the camera passes close to the body during the scan
- A very small risk of radiation to others in close and prolonged contact immediately after the scan, particularly pregnant women or young children, which is why nuclear medicine teams give specific advice about contact for the rest of that day
Preparation & Procedure
In most hospitals, no fasting is required before a bone scan. You can eat, drink, and take your regular medications as normal on the day of the appointment, unless your doctor gives different instructions. If you take medications containing bismuth or barium, which are used in some stomach treatments, the team may ask you to stop them for a day or two beforehand, as these substances can interfere with imaging. Tell the nuclear medicine team about all medications you take, any allergies, and whether there is any chance you could be pregnant.
No specific blood tests or pre-procedure imaging are routinely required just for the scan itself, though your doctor may have already ordered tests related to the underlying condition being investigated. Wear comfortable, loose clothing without metal fasteners, as you may be asked to change into a gown. Leave jewellery at home.
The procedure itself takes place in two stages on the same day.
- Step 1: Tracer injection. A nuclear medicine technologist injects a small amount of radioactive tracer into a vein, usually in the arm. The injection feels like any standard blood test.
- Step 2: Waiting period. You are asked to wait for roughly two to four hours while the tracer travels through the bloodstream and is absorbed by the bones. During this time you are encouraged to drink water to help clear any tracer that is not absorbed by bone, and to urinate before the scan begins.
- Step 3: Imaging. You lie still on a flat table while the gamma camera moves slowly over your body, scanning the entire skeleton or the specific area your doctor has requested. This part usually takes between thirty minutes and an hour, depending on how much of the body is being imaged.
- Step 4: Additional views, if needed. The technologist may take extra close-up images of particular areas for a more detailed look. In some cases a SPECT (single-photon emission computed tomography, a three-dimensional type of bone scan) is also performed, which adds more time to the appointment.
Aftercare
Because this is a diagnostic scan and not a surgical procedure, recovery is straightforward. Most patients leave the nuclear medicine department and go about their normal activities the same day. The main advice is to drink plenty of water for the rest of the day to flush the remaining tracer out of the body through urine, and to wash hands thoroughly after using the toilet.
- No driving restrictions or sedation is involved, so you can drive yourself home unless your underlying condition makes this inadvisable
- Avoid prolonged close contact with pregnant women, newborns, and young children for the remainder of the day the tracer is given; the nuclear medicine team will give you specific guidance on this
- If you are breastfeeding, follow the team's instructions on when it is safe to resume feeding
- The injection site may be slightly sore; this settles quickly and requires no special wound care
- Your doctor will receive the scan report, usually within a day or a few days depending on the hospital; follow up with your referring doctor to discuss the results and what they mean for your treatment plan
- Carry the radiation card or document the department gives you for a day or two afterward, in case you pass through security systems that detect radiation, such as at an airport
Cost & What Determines It
The cost of a bone scan varies widely from one country to another and even between hospitals in the same city. Unlike many surgical procedures, the price is driven less by operating theatre time and more by the nuclear medicine infrastructure, the radioactive tracer itself, and the expertise required to both perform and interpret the scan.
- Complexity and scope of the scan: a whole-body scan costs more than a single-region scan, and adding SPECT (three-dimensional) imaging increases the price further
- Type of hospital: a university hospital or specialist nuclear medicine centre typically charges differently from a general private hospital
- Country where the scan is performed: regulatory costs, staff salaries, and tracer supply chains differ significantly across countries
- Radiologist or nuclear medicine specialist's fee for reporting and interpreting the images, which is sometimes billed separately from the scanning fee
- Additional imaging ordered on the same visit, such as CT or MRI to correlate with the bone scan findings
- Consultation fee with the nuclear medicine physician before or after the scan
A hospital package for a bone scan often includes the tracer, the scanning session, and the written report. What tends to be billed separately are the specialist consultation, any additional imaging such as SPECT-CT, and the referring doctor's follow-up appointment. Always ask the hospital for a written itemised cost estimate before your appointment.
BPJS Kesehatan does not cover treatment received abroad, and most Indonesian private health insurance policies also exclude overseas medical care. Patients who travel for this scan typically pay out of pocket or claim through international private insurance if they hold such a policy. Requesting a detailed written cost estimate from the hospital before travelling is the most reliable way to understand what you will pay and to avoid unexpected charges on the day.
Frequently Asked Questions
Does a bone scan hurt?
A bone scan itself is painless. You will receive a small injection of a radioactive tracer into a vein, which may feel like a brief pinch, and then the scanner passes over your body without touching you.
How do I prepare for a bone scan, and do I need to fast beforehand?
You do not need to fast before a bone scan. You will be asked to drink plenty of water in the hours before the scan to help the tracer spread through your body, and you should remove any metal objects such as jewellery before lying on the scanning table.
How long does a bone scan take from start to finish?
The whole appointment usually takes three to five hours in total. After the injection you wait two to four hours for the tracer to travel to your bones, and then the actual scanning part takes around thirty to sixty minutes.
How much does a bone scan cost?
The cost depends mainly on the class of hospital you choose and whether additional images or a combined CT scan are needed. Requesting a written cost estimate from the hospital before booking is the clearest way to know what you will pay.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
