Emergency radionuclide scans.

Abstract

Radionuclide diagnostic imaging is an important adjunct to the diagnosis and treatment of several conditions that present to the emergency department. The emergency physician should be able to properly apply these tests. A normal radionuclide perfusion lung scan can reliably rule out pulmonary embolism. The use of the radionuclide ventilation lung scan may help interpretation of a perfusion lung scan that is of intermediate probability for pulmonary embolism. A radionuclide venogram of the lower extremities is both sensitive and accurate for detecting the presence of deep venous thrombosis. A radionuclide testicular scan is invaluable in the workup of the acute scrotum, as long as the test is available in a timely manner and the diagnosis has not been established by another means. A multiple-gated acquisition cardiac scan can help make the diagnosis of cardiac contusion after other causes of cardiac instability have been corrected. The renal radionuclide scan is useful in the workup of obstructive uropathy, especially if intravenous pyelography is contraindicated. The hepatobiliary nuclear scan is able to help differentiate acute cholecystitis from other causes of right upper quadrant pain. Proper and timely use of these tests can prevent serious sequelae from a missed diagnosis, and in some cases eliminate the need for invasive tests, dangerous treatment, or even exploratory surgery when it is unwarranted.