Assessment of metabolic bone disease: review of new nuclear medicine procedures.

In the management of patients with metabolic bone disease, nuclear medicine laboratories offer two nontraumatic procedures of potential clinical importance: bone mineral measurements and bone scintigraphy. Bone mineral measurements from the radius, lumbar spine, and hip obtained with use of absorptiometry or computed tomography can be used to predict the risk of fracture at these skeletal sites, can determine the severity of bone loss for the assessment of a benefit-versus-risk ratio on which appropriate therapy can be based, and can substantiate the effectiveness of therapy over time. Bone scintigraphy with use of labeled diphosphonate allows assessment of focal and, in defined circumstances, of total skeletal bone turnover in patients with normal kidney function. Both of these techniques have been used successfully in studies of population groups for the evaluation of trends. Their application to the management of individual patients is currently being evaluated.