Computed Tomography (CT) Scan of the Bones

What is a CT scan of the bones?

CT is a type of imaging test. It uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays. In an emergency, they can show internal injuries and bleeding quickly.

In standard X-rays, a beam of energy is aimed at the body part being studied. A plate behind the body part captures the variations of the energy beam after it passes through skin, bone, muscle, and other tissue. While your healthcare provider can get much information from a standard X-ray, it does not give a lot of detail about internal organs and other structures.

In a CT scan, an X-ray beam moves in a circle or spiral around the body. This allows many different views of the same organ or structure. The X-ray information is sent to a computer that interprets the X-ray data and displays it in a 2-dimensional (2D) form on a monitor.

CT scans may be done with or without "contrast." Contrast is a substance taken by mouth or injected into an IV (intravenous) line. It causes the particular organ or tissue under study to show up more clearly on the scan.

CT scans of the bones can give more detailed information about the bone tissue and bone structure than standard X-rays of the bone. CT scans can give healthcare providers more information about injuries or diseases of the bone.

Why might I need a CT scan of the bones?

A CT scan of the bones may be used to look at your bones for damage, lesions, fractures, or other problems. A CT scan can also look at joints and soft tissues, such as cartilage, muscles, and tendons. It is helpful in staging cancer, too.

A CT scan may be done when a physical exam or other test, such as an X-ray or magnetic resonance imaging (MRI) scan, does not give enough information.

There may be other reasons for your healthcare provider to recommend a CT scan of the bones.

What are the risks of a CT scan of the bones?

You may want to ask your healthcare provider about the amount of radiation used during a CT scan and the risks tied to your particular situation. Radiation from CT scans varies. But it may be up to 100 times greater than a normal chest X-ray. It is a good idea to keep a record of your radiation exposure, such as previous CT scans and other types of X-rays, so that you can inform your healthcare provider. Risks linked to radiation exposure may be related to the total number of X-ray exams and treatments over a long period.

If you are pregnant or think that you may be, tell your healthcare provider. Radiation exposure during pregnancy may lead to birth defects. If it’s necessary for you to have a CT scan of the bones, special precautions will be taken to reduce the radiation exposure to the fetus.

Nursing parents should talk with their provider about whether to delay breastfeeding after receiving contrast. There are conflicting recommendations on this topic.

If contrast dye is used, there is a risk for allergic reaction to the dye. If you are allergic to or sensitive to medicines, contrast, or iodine, tell your healthcare provider. Studies show that most people will not have an adverse reaction from contrast. But you will need to let your healthcare provider know if you have ever had a reaction to any contrast dye or any kidney problems. A seafood allergy does not mean you can't have contrast.

Tell your healthcare provider if you have kidney problems. In some cases, the contrast dye can cause kidney failure. People with kidney disease are more prone to kidney damage after contrast exposure.

There may be other risks depending on your specific health condition. Talk about any concerns with your healthcare provider before the scan.

How do I get ready for a CT scan of the bones?

• Your healthcare provider will explain the scan to you and give you a chance to ask any questions.

• If your CT scan involves the use of contrast dye, you will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.

• Tell the technologist if you have ever had a reaction to any contrast dye, or if you are allergic to iodine.

• Tell your healthcare provider of all medicines (prescribed and over-the-counter), vitamins, herbs, and supplements that you are taking.

• Generally, there is no fasting (not eating) requirement before a CT scan, unless a contrast dye is to be used. Your healthcare provider will give you special instructions ahead of time if contrast is to be used and if you will need to withhold food and drink.

• Tell the technologist if you are pregnant or think you may be.

• Tell the technologist if you have any body piercings on your chest or stomach.

• Based on your health condition, your healthcare provider may request other specific preparations.

• If you are claustrophobic, ask your healthcare provider about medicine to help with the test.

What happens during a CT scan of the bones?

CT scans may be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your healthcare provider's practices.

Generally, a CT scan of the bones follows this process:

1. You will be asked to remove any clothing, jewelry, or other objects that may interfere with the scan, such as eyeglasses, hairpins, dentures, and possibly hearing aids.

2. If you are asked to remove clothing, you will be given a gown to wear.

3. If you are to have a scan done with contrast, an IV (intravenous) line will be started in your hand or arm for injection of the contrast dye.

4. You will lie on a narrow scan table that slides into a large, circular opening of the ring-shaped scanning machine. Pillows and straps may be used to help prevent movement during the scan.

5. The technologist will be in another room where the scanner controls are located. But you will be in constant sight of the technologist through a window. Speakers inside the scanner will allow the technologist to talk to you and hear you. You will have a call button so that you can let the technologist know if you have any problems during the scan. The technologist will be watching you at all times and will be in constant communication.

6. The scanner will begin to rotate around you. X-rays will pass through your body for short amounts of time. You will hear clicking and whirring sounds, which are normal.

7. The X-rays absorbed by the body's tissues will be detected by the scanner and sent to the computer. The computer will transform the information into an image to be interpreted by the radiologist.

8. It will be important for you to stay very still during the scan. You may be asked to hold your breath for a short time at various times during the scan.

9. If contrast dye is used, you will be removed from the scanner after the first set of scans has been completed. A second set of scans will be taken after the contrast dye has been given.

10. If contrast dye is used, you may feel some effects when the dye is injected into the IV line. These effects include a warm, flushing sensation, a salty or metallic taste in the mouth, a brief headache, or nausea. These effects usually only last for a few moments.

11. Tell the technologist if you have trouble breathing, sweating, numbness, or heart palpitations.

12. When the scan has been completed, you will be removed from the scanner.

13. If an IV line was inserted, it will be removed.

14. You may be asked to wait for a short period while the radiologist examines the scans to make sure they are clear.

While the CT scan itself causes no pain, having to lie still for the length of the scan might be uncomfortable, particularly if you’ve recently been injured or had surgery. The technologist will use all possible comfort measures and complete the scan as quickly as possible to reduce any discomfort or pain.

What happens after a CT scan of the bones?

If contrast dye was used, you may be watched for a time for any side effects or reactions to the contrast dye, such as itching, swelling, rash, or trouble breathing. Tell the radiologist or your healthcare provider right away if you notice any of these symptoms.

If you notice any pain, redness, or swelling at the IV site after you go home, tell your healthcare provider. This could be a sign of infection or other type of reaction.

Otherwise, there is no special type of care needed after a CT scan of the bones. You may go back to your usual diet and activities unless your healthcare provider tells you differently.

Your healthcare provider may give you other instructions after the procedure depending on your particular situation.

Next steps

Before you agree to the test or procedure, make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure