Table 4.

Role of Radionuclide Bone Scans in the Diagnosis of PDB

Risk‐benefit balance

Radionuclide bone scans are more sensitive than radiographs at detecting bone lesions in PDB, but radiographic evidence of PDB may be observed in about 3.7% of sites when the bone scan is negative. However, the majority of sites detected by imaging are asymptomatic.

Quality of evidence

Very low

Patient values and preferences

It is likely that many patients may not object to having a bone scan in addition to targeted radiographs to fully assess the extent of PDB.

Costs and use of resources

Radionuclide bone scans are widely available but are more expensive than plain X‐rays.

Recommendation

Radionuclide bone scans, in addition to targeted radiographs, are recommended as a means of fully and accurately defining the extent of the metabolically active disease in patients with PDB.