Bone scan Health Dictionary

Bone Scan: From 1 Different Sources


an imaging investigation of a patient’s bone using radioactive *tracers. *Technetium-99m phosphate is injected intravenously and absorbed into the hydroxyapatite crystals of bone. It concentrates in areas of increased blood flow and metabolism, such as areas of infection, trauma, and *neoplasia, and gives off radiation that can be detected by a *gamma camera, thereby producing a map or scan of activity in the target area. A bone scan is particularly useful in the diagnosis of subtle fractures (including stress fractures), avascular necrosis (see osteonecrosis), osteomyelitis, tumour spread (metastasis), and loosening of orthopaedic implants.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Bone

The framework upon which the rest of the body is built up. The bones are generally called the skeleton, though this term also includes the cartilages which join the ribs to the breastbone, protect the larynx, etc.

Structure of bone Bone is composed partly of ?brous tissue, partly of bone matrix comprising phosphate and carbonate of lime, intimately mixed together. The bones of a child are about two-thirds ?brous tissue, whilst those of the aged contain one-third; the toughness of the former and the brittleness of the latter are therefore evident.

The shafts of the limb bones are composed of dense bone, the bone being a hard tube surrounded by a membrane (the periosteum) and enclosing a fatty substance (the BONE MARROW); and of cancellous bone, which forms the short bones and the ends of long bones, in which a ?ne lace-work of bone ?lls up the whole interior, enclosing marrow in its meshes. The marrow of the smaller bones is of great importance. It is red in colour, and in it red blood corpuscles are formed. Even the densest bone is tunnelled by ?ne canals (Haversian canals) in which run small blood vessels, nerves and lymphatics, for the maintenance and repair of the bone. Around these Haversian canals the bone is arranged in circular plates called lamellae, the lamellae being separated from one another by clefts, known as lacunae, in which single bone-cells are contained. Even the lamellae are pierced by ?ne tubes known as canaliculi lodging processes of these cells. Each lamella is composed of very ?ne interlacing ?bres.

GROWTH OF BONES Bones grow in thickness from the ?brous tissue and lime salts laid down by cells in their substance. The long bones grow in length from a plate of cartilage (epiphyseal cartilage) which runs across the bone about 1·5 cm or more from its ends, and which on one surface is also constantly forming bone until the bone ceases to lengthen at about the age of 16 or 18. Epiphyseal injury in children may lead to diminished growth of the limb.

REPAIR OF BONE is e?ected by cells of microscopic size, some called osteoblasts, elaborating the materials brought by the blood and laying down strands of ?brous tissue, between which bone earth is later deposited; while other cells, known as osteoclasts, dissolve and break up dead or damaged bone. When a fracture has occurred, and the broken ends have been brought into contact, these are surrounded by a mass of blood at ?rst; this is partly absorbed and partly organised by these cells, ?rst into ?brous tissue and later into bone. The mass surrounding the fractured ends is called the callus, and for some months it forms a distinct thickening which is gradually smoothed away, leaving the bone as before the fracture. If the ends have not been brought accurately into contact, a permanent thickening results.

VARIETIES OF BONES Apart from the structural varieties, bones fall into four classes: (a) long bones like those of the limbs; (b) short bones composed of cancellous tissue, like those of the wrist and the ankle; (c) ?at bones like those of the skull; (d) irregular bones like those of the face or the vertebrae of the spinal column (backbone).

The skeleton consists of more than 200 bones. It is divided into an axial part, comprising the skull, the vertebral column, the ribs with their cartilages, and the breastbone; and an appendicular portion comprising the four limbs. The hyoid bone in the neck, together with the cartilages protecting the larynx and windpipe, may be described as the visceral skeleton.

AXIAL SKELETON The skull consists of the cranium, which has eight bones, viz. occipital, two parietal, two temporal, one frontal, ethmoid, and sphenoid; and of the face, which has 14 bones, viz. two maxillae or upper jaw-bones, one mandible or lower jaw-bone, two malar or cheek bones, two nasal, two lacrimal, two turbinal, two palate bones, and one vomer bone. (For further details, see SKULL.) The vertebral column consists of seven vertebrae in the cervical or neck region, 12 dorsal vertebrae, ?ve vertebrae in the lumbar or loin region, the sacrum or sacral bone (a mass formed of ?ve vertebrae fused together and forming the back part of the pelvis, which is closed at the sides by the haunch-bones), and ?nally the coccyx (four small vertebrae representing the tail of lower animals). The vertebral column has four curves: the ?rst forwards in the neck, the second backwards in the dorsal region, the third forwards in the loins, and the lowest, involving the sacrum and coccyx, backwards. These are associated with the erect attitude, develop after a child learns to walk, and have the e?ect of diminishing jars and shocks before these reach internal organs. This is aided still further by discs of cartilage placed between each pair of vertebrae. Each vertebra has a solid part, the body in front, and behind this a ring of bone, the series of rings one above another forming a bony canal up which runs the spinal cord to pass through an opening in the skull at the upper end of the canal and there join the brain. (For further details, see SPINAL COLUMN.) The ribs – 12 in number, on each side – are attached behind to the 12 dorsal vertebrae, while in front they end a few inches away from the breastbone, but are continued forwards by cartilages. Of these the upper seven reach the breastbone, these ribs being called true ribs; the next three are joined each to the cartilage above it, while the last two have their ends free and are called ?oating ribs. The breastbone, or sternum, is shaped something like a short sword, about 15 cm (6 inches) long, and rather over 2·5 cm (1 inch) wide.

APPENDICULAR SKELETON The upper limb consists of the shoulder region and three segments – the upper arm, the forearm, and the wrist with the hand, separated from each other by joints. In the shoulder lie the clavicle or collar-bone (which is immediately beneath the skin, and forms a prominent object on the front of the neck), and the scapula or shoulder-blade behind the chest. In the upper arm is a single bone, the humerus. In the forearm are two bones, the radius and ulna; the radius, in the movements of alternately turning the hand palm up and back up (called supination and pronation respectively), rotating around the ulna, which remains ?xed. In the carpus or wrist are eight small bones: the scaphoid, lunate, triquetral, pisiform, trapezium, trapezoid, capitate and hamate. In the hand proper are ?ve bones called metacarpals, upon which are set the four ?ngers, each containing the three bones known as phalanges, and the thumb with two phalanges.

The lower limb consists similarly of the region of the hip-bone and three segments – the thigh, the leg and the foot. The hip-bone is a large ?at bone made up of three – the ilium, the ischium and the pubis – fused together, and forms the side of the pelvis or basin which encloses some of the abdominal organs. The thigh contains the femur, and the leg contains two bones – the tibia and ?bula. In the tarsus are seven bones: the talus (which forms part of the ankle joint); the calcaneus or heel-bone; the navicular; the lateral, intermediate and medial cuneiforms; and the cuboid. These bones are so shaped as to form a distinct arch in the foot both from before back and from side to side. Finally, as in the hand, there are ?ve metatarsals and 14 phalanges, of which the great toe has two, the other toes three each.

Besides these named bones there are others sometimes found in sinews, called sesamoid bones, while the numbers of the regular bones may be increased by extra ribs or diminished by the fusion together of two or more bones.... bone

Bone Graft

See BONE TRANSPLANT.... bone graft

Brittle Bone Disease

Brittle Bone Disease is another name for OSTEOGENESIS IMPERFECTA.... brittle bone disease

Bone Marrow

Bone marrow is the soft substance occupying the interior of bones. It is the site of formation of ERYTHROCYTES, granular LEUCOCYTES and PLATELETS.... bone marrow

Bone Marrow Transplant

The procedure by which malignant or defective bone marrow in a patient is replaced with normal bone marrow. Sometimes the patient’s own marrow is used (when the disease is in remission); after storage using tissue-freezing technique (cryopreservation) it is reinfused into the patient once the diseased marrow has been treated (autologous transplant). More commonly, a transplant uses marrow from a donor whose tissue has been matched for compatibility. The recipient’s marrow is destroyed with CYTOTOXIC drugs before transfusion. The recipient is initially nursed in an isolated environment to reduce the risk of infection.

Disorders that can be helped or even cured include certain types of LEUKAEMIA and many inherited disorders of the immune system (see IMMUNITY).... bone marrow transplant

Bone, Disorders Of

Bone is not an inert sca?olding for the human body. It is a living, dynamic organ, being continuously remodelled in response to external mechanical and chemical in?uences and acting as a large reservoir for calcium and phosphate. It is as susceptible to disease as any other organ, but responds in a way rather di?erent from the rest of the body.

Bone fractures These occur when there is a break in the continuity of the bone. This happens either as a result of violence or because the bone is unhealthy and unable to withstand normal stresses.

SIMPLE FRACTURES Fractures where the skin remains intact or merely grazed. COMPOUND FRACTURES have at least one wound which is in communication with the fracture, meaning that bacteria can enter the fracture site and cause infection. A compound fracture is also more serious than a simple fracture because there is greater potential for blood loss. Compound fractures usually need hospital admission, antibiotics and careful reduction of the fracture. Debridement (cleaning and excising dead tissue) in a sterile theatre may also be necessary.

The type of fracture depends on the force which has caused it. Direct violence occurs when an object hits the bone, often causing a transverse break – which means the break runs horizontally across the bone. Indirect violence occurs when a twisting injury to the ankle, for example, breaks the calf-bone (the tibia) higher up. The break may be more oblique. A fall on the outstretched hand may cause a break at the wrist, in the humerus or at the collar-bone depending on the force of impact and age of the person. FATIGUE FRACTURES These occur after the bone has been under recurrent stress. A typical example is the march fracture of the second toe, from which army recruits suffer after long marches. PATHOLOGICAL FRACTURES These occur in bone which is already diseased – for example, by osteoporosis (see below) in post-menopausal women. Such fractures are typically crush fractures of the vertebrae, fractures of the neck of the femur, and COLLES’ FRACTURE (of the wrist). Pathological fractures also occur in bone which has secondary-tumour deposits. GREENSTICK FRACTURES These occur in young children whose bones are soft and bend, rather than break, in response to stress. The bone tends to buckle on the side opposite to the force. Greenstick fractures heal quickly but still need any deformity corrected and plaster of Paris to maintain the correction. COMPLICATED FRACTURES These involve damage to important soft tissue such as nerves, blood vessels or internal organs. In these cases the soft-tissue damage needs as much attention as the fracture site. COMMINUTED FRACTURES A fracture with more than two fragments. It usually means that the injury was more violent and that there is more risk of damage to vessels and nerves. These fractures are unstable and take longer to unite. Rehabilitation tends to be protracted. DEPRESSED FRACTURES Most commonly found in skull fractures. A fragment of bone is forced inwards so that it lies lower than the level of the bone surrounding it. It may damage the brain beneath it.

HAIR-LINE FRACTURES These occur when the bone is broken but the force has not been severe enough to cause visible displacement. These fractures may be easily missed. Symptoms and signs The fracture site is usually painful, swollen and deformed. There is asymmetry of contour between limbs. The limb is held uselessly. If the fracture is in the upper

limb, the arm is usually supported by the patient; if it is in the lower limb then the patient is not able to bear weight on it. The limb may appear short because of muscle spasm.

Examination may reveal crepitus – a bony grating – at the fracture site. The diagnosis is con?rmed by radiography.

Treatment Healing of fractures (union) begins with the bruise around the fracture being resorbed and new bone-producing cells and blood vessels migrating into the area. Within a couple of days they form a bridge of primitive bone across the fracture. This is called callus.

The callus is replaced by woven bone which gradually matures as the new bone remodels itself. Treatment of fractures is designed to ensure that this process occurs with minimal residual deformity to the bone involved.

Treatment is initially to relieve pain and may involve temporary splinting of the fracture site. Reducing the fracture means restoring the bones to their normal position; this is particularly important at the site of joints where any small displacement may limit movement considerably.

with plaster of Paris. If closed traction does not work, then open reduction of the fracture may

be needed. This may involve ?xing the fracture with internal-?xation methods, using metal plates, wires or screws to hold the fracture site in a rigid position with the two ends closely opposed. This allows early mobilisation after fractures and speeds return to normal use.

External ?xators are usually metal devices applied to the outside of the limb to support the fracture site. They are useful in compound fractures where internal ?xators are at risk of becoming infected.

Consolidation of a fracture means that repair is complete. The time taken for this depends on the age of the patient, the bone and the type of fracture. A wrist fracture may take six weeks, a femoral fracture three to six months in an adult.

Complications of fractures are fairly common. In non-union, the fracture does not unite

– usually because there has been too much mobility around the fracture site. Treatment may involve internal ?xation (see above). Malunion means that the bone has healed with a persistent deformity and the adjacent joint may then develop early osteoarthritis.

Myositis ossi?cans may occur at the elbow after a fracture. A big mass of calci?ed material develops around the fracture site which restricts elbow movements. Late surgical removal (after 6–12 months) is recommended.

Fractured neck of FEMUR typically affects elderly women after a trivial injury. The bone is usually osteoporotic. The leg appears short and is rotated outwards. Usually the patient is unable to put any weight on the affected leg and is in extreme pain. The fractures are classi?ed according to where they occur:

subcapital where the neck joins the head of the femur.

intertrochanteric through the trochanter.

subtrochanteric transversely through the upper end of the femur (rare). Most of these fractures of the neck of femur

need ?xing by metal plates or hip replacements, as immobility in this age group has a mortality of nearly 100 per cent. Fractures of the femur shaft are usually the result of severe trauma such as a road accident. Treatment may be conservative or operative.

In fractures of the SPINAL COLUMN, mere damage to the bone – as in the case of the so-called compression fracture, in which there is no damage to the spinal cord – is not necessarily serious. If, however, the spinal cord is damaged, as in the so-called fracture dislocation, the accident may be a very serious one, the usual result being paralysis of the parts of the body below the level of the injury. Therefore the higher up the spine is fractured, the more serious the consequences. The injured person should not be moved until skilled assistance is at hand; or, if he or she must be removed, this should be done on a rigid shutter or door, not on a canvas stretcher or rug, and there should be no lifting which necessitates bending of the back. In such an injury an operation designed to remove a displaced piece of bone and free the spinal cord from pressure is often necessary and successful in relieving the paralysis. DISLOCATIONS or SUBLUXATION of the spine are not uncommon in certain sports, particularly rugby. Anyone who has had such an injury in the cervical spine (i.e. in the neck) should be strongly advised not to return to any form of body-contact or vehicular sport.

Simple ?ssured fractures and depressed fractures of the skull often follow blows or falls on the head, and may not be serious, though there is always a risk of damage which is potentially serious to the brain at the same time.

Compound fractures may result in infection within the skull, and if the skull is extensively broken and depressed, surgery is usually required to check any intercranial bleeding or to relieve pressure on the brain.

The lower jaw is often fractured by a blow on the face. There is generally bleeding from the mouth, the gum being torn. Also there are pain and grating sensations on chewing, and unevenness in the line of the teeth. The treatment is simple, the line of teeth in the upper jaw forming a splint against which the lower jaw is bound, with the mouth closed.

Congenital diseases These are rare but may produce certain types of dwar?sm or a susceptibility to fractures (osteogenesis imperfecta).

Infection of bone (osteomyelitis) may occur after an open fracture, or in newborn babies with SEPTICAEMIA. Once established it is very di?cult to eradicate. The bacteria appear capable of lying dormant in the bone and are not easily destroyed with antibiotics so that prolonged treatment is required, as might be surgical drainage, exploration or removal of dead bone. The infection may become chronic or recur.

Osteomalacia (rickets) is the loss of mineralisation of the bone rather than simple loss of bone mass. It is caused by vitamin D de?ciency and is probably the most important bone disease in the developing world. In sunlight the skin can synthesise vitamin D (see APPENDIX 5: VITAMINS), but normally rickets is caused by a poor diet, or by a failure to absorb food normally (malabsorbtion). In rare cases vitamin D cannot be converted to its active state due to the congenital lack of the speci?c enzymes and the rickets will fail to respond to treatment with vitamin D. Malfunction of the parathyroid gland or of the kidneys can disturb the dynamic equilibrium of calcium and phosphate in the body and severely deplete the bone of its stores of both calcium and phosphate.

Osteoporosis A metabolic bone disease resulting from low bone mass (osteopenia) due to excessive bone resorption. Su?erers are prone to bone fractures from relatively minor trauma. With bone densitometry it is now possible to determine individuals’ risk of osteoporosis and monitor their response to treatment.

By the age of 90 one in two women and one in six men are likely to sustain an osteoporosis-related fracture. The incidence of fractures is increasing more than would be expected from the ageing of the population, which may re?ect changing patterns of exercise or diet.

Osteoporosis may be classi?ed as primary or secondary. Primary consists of type 1 osteoporosis, due to accelerated trabecular bone loss, probably as a result of OESTROGENS de?ciency. This typically leads to crush fractures of vertebral bodies and fractures of the distal forearm in women in their 60s and 70s. Type 2 osteoporosis, by contrast, results from the slower age-related cortical and travecular bone loss that occurs in both sexes. It typically leads to fractures of the proximal femur in elderly people.

Secondary osteoporosis accounts for about 20 per cent of cases in women and 40 per cent of cases in men. Subgroups include endocrine (thyrotoxicosis – see under THYROID GLAND, DISEASES OF, primary HYPERPARATHYROIDISM, CUSHING’S SYNDROME and HYPOGONADISM); gastrointestinal (malabsorption syndrome, e.g. COELIAC DISEASE, or liver disease, e.g. primary biliary CIRRHOSIS); rheumatological (RHEUMATOID ARTHRITIS or ANKYLOSING SPONDYLITIS); malignancy (multiple MYELOMA or metastatic CARCINOMA); and drugs (CORTICOSTEROIDS, HEPARIN). Additional risk factors for osteoporosis include smoking, high alcohol intake, physical inactivity, thin body-type and heredity.

Individuals at risk of osteopenia, or with an osteoporosis-related fracture, need investigation with spinal radiography and bone densitometry. A small fall in bone density results in a large increase in the risk of fracture, which has important implications for preventing and treating osteoporosis.

Treatment Antiresorptive drugs: hormone replacement therapy – also valuable in treating menopausal symptoms; treatment for at least ?ve years is necessary, and prolonged use may increase risk of breast cancer. Cyclical oral administration of disodium etidronate – one of the bisphosphonate group of drugs – with calcium carbonate is also used (poor absorption means the etidronate must be taken on an empty stomach). Calcitonin – currently available as a subcutaneous injection; a nasal preparation with better tolerance is being developed. Calcium (1,000 mg daily) seems useful in older patients, although probably ine?ective in perimenopausal women, and it is a safe preparation. Vitamin D and calcium – recent evidence suggests value for elderly patients. Anabolic steroids, though androgenic side-effects (masculinisation) make these unacceptable for most women.

With established osteoporosis, the aim of treatment is to relieve pain (with analgesics and physical measures, e.g. lumbar support) and reduce the risk of further fractures: improvement of bone mass, the prevention of falls, and general physiotherapy, encouraging a healthier lifestyle with more daily exercise.

Further information is available from the National Osteoporosis Society.

Paget’s disease (see also separate entry) is a common disease of bone in the elderly, caused by overactivity of the osteoclasts (cells concerned with removal of old bone, before new bone is laid down by osteoblasts). The bone affected thickens and bows and may become painful. Treatment with calcitonin and bisphosphonates may slow down the osteoclasts, and so hinder the course of the disease, but there is no cure.

If bone loses its blood supply (avascular necrosis) it eventually fractures or collapses. If the blood supply does not return, bone’s normal capacity for healing is severely impaired.

For the following diseases see separate articles: RICKETS; ACROMEGALY; OSTEOMALACIA; OSTEOGENESIS IMPERFECTA.

Tumours of bone These can be benign (non-cancerous) or malignant (cancerous). Primary bone tumours are rare, but secondaries from carcinoma of the breast, prostate and kidneys are relatively common. They may form cavities in a bone, weakening it until it breaks under normal load (a pathological fracture). The bone eroded away by the tumour may also cause problems by causing high levels of calcium in the plasma.

EWING’S TUMOUR is a malignant growth affecting long bones, particularly the tibia (calfbone). The presenting symptoms are a throbbing pain in the limb and a high temperature. Treatment is combined surgery, radiotherapy and chemotherapy.

MYELOMA is a generalised malignant disease of blood cells which produces tumours in bones which have red bone marrow, such as the skull and trunk bones. These tumours can cause pathological fractures.

OSTEOID OSTEOMA is a harmless small growth which can occur in any bone. Its pain is typically removed by aspirin.

OSTEOSARCOMA is a malignant tumour of bone with a peak incidence between the ages of ten and 20. It typically involves the knees, causing a warm tender swelling. Removal of the growth with bone conservation techniques can often replace amputation as the de?nitive treatment. Chemotherapy can improve long-term survival.... bone, disorders of

Collar-bone

See CLAVICLE.... collar-bone

Frontal Bone

The bone which forms the forehead and protects the frontal lobes of the brain. Before birth, the frontal bone consists of two halves, and this division may persist throughout life – a deep groove remaining down the centre of the forehead. Above each eye is a heavy ridge in the bone, most marked in men; behind this, in the substance of the bone, is a cavity on each side (the frontal sinus) which communicates with the nose. CATARRH in these cavities produces the frontal headache characteristic of a ‘cold in the head’, and sometimes infection develops known as SINUSITIS (see NOSE, DISORDERS OF).... frontal bone

Parietal Bone

Either one of a pair of bones that form the top and sides of the cranium of the SKULL.... parietal bone

Pet Scanning

Positron-emission tomography is a NUCLEAR MEDICINE diagnostic technique that works by identifying positrons – positively charged electrons – given o? by substances labelled with radioactive varieties of elements. The result is three-dimensional images that identify metabolic and chemical activities of tissues, especially brain tissues. The images provide information about tissue and organ functions, and can be collated with structural images using COMPUTED TOMOGRAPHY or magnetic resonance imaging (MRI). The equipment is very expensive and available only in selected hospitals in the United Kingdom. The technique is especially valuable in the assessment of neurological disorders.... pet scanning

Scan

An image produced by one of several scanning techniques.... scan

Scanning Speech

A speech disorder in which articulated syllables are wrongly spaced and each is given the same vocal emphasis. The condition occurs as a result of disease in the cerebellum (see BRAIN) or its connecting nerves. (See also VOICE AND SPEECH.)... scanning speech

Scanning Techniques

Ways of producing images of body organs that record, process and analyse sound waves, radio waves or X-RAYS passing through or generated by the body’s tissues. ULTRASOUND scanning using high-frequency, inaudible sound waves directed at the area of the body being studied is the most generally used scanning procedure. Sound waves are re?ected more powerfully by some structures than others, and a pattern of those re?ections is detected and shown on a screen. Other screening methods include COMPUTED TOMOGRAPHY, magnetic resonance imaging (MRI), positron emission tomography (PET SCANNING) and RADIONUCLIDE scanning, which measures the di?erential uptake of radioactive materials in the body’s tissues.... scanning techniques

Scaphoid Bone

The outside bone on the thumb side of the HAND in the row of carpal (wrist) bones nearest to the forearm. Fracture of the scaphoid is a common wrist injury that usually occurs when someone falls on to their outstretched hand. The fracture may not be diagnosed at ?rst (even an X-ray may not be abnormal). Pain in and permanent damage to the wrist can occur.... scaphoid bone

Marble Bone Disease

See osteopetrosis.... marble bone disease

Bone Transplant

The insertion of a piece of bone from another site or from another person to ?ll a defect, provide supporting tissue, or encourage the growth of new bone.... bone transplant

Ct Scan

See COMPUTED TOMOGRAPHY.... ct scan

Ct Scanner

The machine which combines the use of a computer and X-rays to produce cross-sectional images of the body (see COMPUTED TOMOGRAPHY).... ct scanner

Delima Scandens

Burkill.

Tetracera scandens

Family: Dilleniaceae.

Habitat: Forests of Bengal, Assam and the Andamans.

Ayurvedic: Paaniya Valli.

Action: A decoction of the plant is given in dysentery and coughs. Leaves—used for the treatment of boils. Root—astringent, used as external application for burns.... delima scandens

Entada Scandens

auct. non-Benth.

Synonym: E. phaseoloides Merrill. E. pursaetha DC. Mimosa entada Linn.

Family: Momosaceae.

Habitat: Eastern Himalayas, hills of Bihar, Orissa and South India.

English: Garbee Bean, Mackay Bean, Elephant Creeper.

Ayurvedic: Gil.

Siddha/Tamil: Chillu, Vattavalli.

Folk: Gil-gaachh.

Action: Seed—carminative, anodyne, spasmolytic bechic, anti-inflammatory, anthelmintic, antiperiodic. Used in liver complaints, glandular swellings, debility, skin diseases. The seed, stems and bark are poisonous. A paste of the seeds is applied locally for inflammatory glandular swellings. The juice of wood and bark is used as an external application for ulcers. The leaves are reported to be free from the toxic saponins. After soaking in water and roasting toxic principles can be removed from the white kernels of the seeds.

The seeds gave saponins of entagenic acid; a triterpenoid glucoside entanin; beta-sitosterol, alpha-amyrin, querce- tin, gallic acid, cyamidin chloride, lu- peol and a saponin mixture which gave prosapogenin A. Entanin exhibits anti- tumour activity. It inhibits Walker 256 tumours in rats without deaths.

Entadamide A (the sulphur-containing amide from the seed) is a 5-lipo-xygenase inhibitor and is found to be effective in the treatment of bronchial asthma. The bark is used for hair wash.

Entagenic acid, a sapogenin of entada saponin IV, imparts antifungal activity to the bark.... entada scandens

Pothos Scandens

Linn.

Family: Araceae.

Habitat: Cultivated as an ornamental. Found in Bihar, North Bengal, Orissa, Western Ghats and Southwards.

Siddha/Tamil: Aanaparuga.

Action: Leaves—anti-inflammatory, antiseptic, antimicrobial. Applied to smallpox pustules. Root—bruised and fried in oil, applied to abscesses.... pothos scandens

Ct Scanning

A diagnostic technique in which the combined use of a computer and X-rays passed through the body at different angles produces cross-sectional images of tissues. (computed tomography) scanning has revolutionized the diagnosis and treatment of tumours, abscesses, and haemorrhages in the brain, as well as head injuries and strokes. scanning is also used to locate and image tumours, investigate diseases, and aid needle biopsy in organs of the trunk.

Newer types of scanners use a spiral technique: the scanner rotates around the body as the patient is moved slowly forwards on a bed, causing the X-ray beams to follow a spiral course. The computer produces 3-D images. Injected or swallowed contrast media (chemicals opaque to X-rays) may be used to make certain tissues more visible.... ct scanning

Mastoid Bone

The lower part of the temporal bone in the skull. It has a projection, known as the mastoid process, which can be felt behind the ear. The mastoid bone is honeycombed with air cells. These are connected to a cavity called the mastoid antrum, which leads into the middle ear. Infections of the middle ear (see otitis media) occasionally spread through the mastoid bone to cause acute mastoiditis.... mastoid bone

Metacarpal Bone

One of 5 long, cylindrical bones within the hand. The bones run from the wrist to the base of each digit, with the heads of the bones forming the knuckles.... metacarpal bone

Metatarsal Bone

One of 5 long, cylindrical bones within the foot. The bones make up the central skeleton of the foot and are held in an arch by the surrounding ligaments.... metatarsal bone

Nuchal Thickness Scan

Ultrasound scanning performed in early pregnancy in order to identify fetuses at high risk of chromosomal abnormalities such as Down’s syndrome. The scan investigates the nuchal fold, an area of skin at the back of the neck. Excessive thickness of the skin is an indicator of possible chromosomal abnormalities.... nuchal thickness scan

Pubic Bone

The front part of the fused bones that form the pelvis.... pubic bone

Radioisotope Scanning

See radionuclide scanning.... radioisotope scanning

Radionuclide Scanning

A diagnostic technique based on detection of radiation emitted by radioactive substances introduced into the body. Substances are taken up to different degrees by different tissues, allowing specific organs to be studied. For example, iodine is taken up mainly by the thyroid gland, so by “tagging” a sample of iodine with a radioactive marker (radionuclide), the uptake of iodine can be monitored to investigate the functioning of the gland. A radionuclide is swallowed or injected into the blood and accumulates in the target organ. It emits radiation in the form of gamma radiation, which is detected by a gamma camera to produce an image. Cross-sectional images (“slices”) can be obtained using a computer-controlled gamma camera that rotates around the patient. This specialized form of radionuclide scanning is known as (single photon emission computed tomography). Moving mation on blood flow, the movement of the heart walls, the flow of urine through the kidneys, and bile flow through the liver.

Radionuclide scanning is a safe procedure, requiring only minute doses of radiation that are excreted within hours. The radionuclides carry virtually no risk of toxicity or hypersensitivity.... radionuclide scanning

Thyroid Scanning

Techniques, such as radionuclide scanning and ultrasound scanning, that are used to provide information about the location, anatomy, and function of the thyroid gland.... thyroid scanning

Ultrasound Scanning

A diagnostic technique in which very high frequency sound waves are passed into the body and the reflected echoes analysed to build a picture of the internal organs or of a fetus in the uterus. The procedure is painless and considered safe.Ultrasonic waves are emitted by a transducer, which is placed on the skin over the part of the body to be viewed. The transducer contains a crystal that converts an electric current into sound waves. These pass readily through soft tissues and fluids, making this procedure useful for examining fluid-filled or soft organs.

One of the most common uses of ultrasound is to view the uterus and fetus, at any time during pregnancy, but often at 18–20 weeks. The age, size, and growth rate of the fetus can be determined; multiple pregnancies detected; and certain problems, such as neural tube defects, diagnosed. Scans may be taken early in pregnancy if problems, such as an ectopic pregnancy, are suspected.

Ultrasound scanning can also be used in newborn babies to examine the brain through a gap in the skull (for example, to investigate hydrocephalus). Ultrasound can help to diagnose disorders such as cirrhosis, gallstones, hydronephrosis, and pancreatitis, as well as problems in the thyroid gland, breasts, bladder, testes, ovaries, spleen, and eyes. The technique is also used during needle biopsy to help guide the needle.Doppler ultrasound is a modified form of ultrasound that uses the Doppler effect to investigate moving objects.

This can be used to examine the fetal heartbeat and to obtain information about the rate of blood flow in vessels.... ultrasound scanning

A-scan

n. examination of ocular tissue, including measurement of the length of the eye (axial length), by means of a high-frequency ultrasound machine. See also B-scan.... a-scan

Bone-anchored Hearing Aid

(BAHA) a specialized form of *hearing aid for patients with certain forms of conductive *deafness. A small titanium screw is surgically fixed into the bone of the skull behind the external ear using a process called *osseointegration. Sound energy is passed from a miniature microphone and amplifier to the screw, through the bone, to the *cochlea.... bone-anchored hearing aid

Bone Growth Factors

a group of *growth factors that promote new bone formation. Bone morphogenic protein (BMP), a naturally occurring substance that induces *osteoblast formation, has been genetically synthesized to form bone morphogenetic protein, which stimulates new bone formation and assists with fracture healing. Other bone growth factors include a type of transforming growth factor (TGF?) and insulin-like growth factor II (IGF-II), which encourage collagen formation.... bone growth factors

B-scan

examination of the tissues of the eye in cross section by means of a high-frequency ultrasound machine. It is useful in the diagnosis of eye disease, especially in the posterior segment of the eye when direct viewing is obscured (e.g. by dense cataracts). See also A-scan.... b-scan

Capitate Bone

the largest bone of the wrist (see carpus). It articulates with the scaphoid and lunate bones behind, with the second, third, and fourth metacarpal bones in front, and with the trapezoid and hamate laterally.... capitate bone

Cuboid Bone

the outer bone of the *tarsus, which articulates with the fourth and fifth metatarsal bones in front and with the calcaneus (heel bone) behind.... cuboid bone

Ethmoid Bone

a bone in the floor of the cranium that contributes to the nasal cavity and orbits. The part of the ethmoid forming the roof of the nasal cavity – the cribriform plate – is pierced with many small holes through which the olfactory nerves pass. See also nasal concha; skull.... ethmoid bone

Hamate Bone

(unciform bone) a hook-shaped bone of the wrist (see carpus). It articulates with the capitate and triquetral bones at the sides, with the lunate bone behind, and with the fourth and fifth metacarpal bones in front.... hamate bone

Hip Bone

(innominate bone) a bone formed by the fusion of the ilium, ischium, and pubis. It articulates with the femur by the acetabulum of the ilium, a deep socket into which the head of the femur fits (see hip joint). Between the pubis and ischium, below and slightly in front of the acetabulum, is a large opening – the obturator foramen. The right and left hip bones form part of the *pelvis.... hip bone

Hyoid Bone

a small isolated U-shaped bone in the neck, below and supporting the tongue. It is held in position by muscles and ligaments between it and the styloid process of the temporal bone.... hyoid bone

Innominate Bone

see hip bone.... innominate bone

Interparietal Bone

(inca bone, incarial bone) the bone lying between the *parietal bones, at the back of the skull.... interparietal bone

Lacrimal Bone

the smallest bone of the face: either of a pair of rectangular bones that contribute to the orbits. See skull.... lacrimal bone

Lamellar Bone

mature *bone, in which the collagen fibres are arranged parallel to each other to form multiple layers (*lamellae) with the osteocytes lying between the lamellae. It exists in two structurally different forms: cortical (compact) and cancellous (spongy) bone. See also woven bone.... lamellar bone

Lunate Bone

a bone of the wrist (see carpus). It articulates with the capitate and hamate bones in front, with the radius behind, and with the triquetral and scaphoid at the sides.... lunate bone

Malar Bone

see zygomatic bone.... malar bone

Membrane Bone

a bone that develops in connective tissue by direct *ossification, without cartilage being formed first. The bones of the face and skull are membrane bones.... membrane bone

Muga Scan

(multiple-gated acquisition scan) a technique used in *nuclear medicine for studying the left-ventricular function and wall motion of the heart. The patient’s red cells are labelled with radioactive technetium-99m. A gamma camera, connected to an ECG, collects information over a prolonged period for each phase of heart movement (ECG gating) to form an image of the blood pool within the heart at specific points in the cardiac cycle. Tomographic reconstructions can be made to give cross-sectional images of the heart in different phases of the cardiac cycle, using reconstruction *algorithms comparable to CT scanning (see SPECT scanning).... muga scan

Myocardial Perfusion Scan

(thallium scan) a method to detect and quantify myocardial *ischaemia. An intravenously injected *radionuclide that is taken up by normal heart muscle can be imaged using a *gamma camera. Areas of scar due to *myocardial infarction emit little or no radioactivity and are seen as ‘cold spots’. Exercise is mimicked by infusing drugs to increase the heart rate in order to provoke cold spots in the diagnosis of ischaemic heart disease.... myocardial perfusion scan

Nasal Bone

either of a pair of narrow oblong bones that together form the bridge and root of the nose. See skull.... nasal bone

Luvunga Scandens

(Roxb.) Buch.-Ham. ex Wight.

Family: Rutaceae.

Habitat: Bengal, Assam and Khasi Hills.

Ayurvedic: Lavanga-lataa. Folk: Sugandh-kokilaa (Bengal).

Action: Essential oil—antifungal.

Mature berries contain coumarins. The essential oil from berries contains cinnamyl cinnamate, cineole, d- camphor and methyl cinnamate as major components.

Dried fruits are used in medicinal hair oils, prescribed for treating baldness.

The bark contains myricadiol, tara- xerol and myricolal.... luvunga scandens

Olax Scandens

Roxb.

Oenothera odorata Jacq.

Family: Onagraceae.

Habitat: Native to Chile; cultivated as a garden plant in South Australia. Introduced into Indian gardens.

English: Evening Primrose (var.); Sundrop (var.).

Action: Oil from seeds—prescribed for eczema (in children); premenstrual syndrome and cyclical breast pain.

Family: Olacaceae.

Habitat: Sub-Himalayas tract of Kumaon and Bihar, Orissa, Madhya Pradesh, Deccan and Western Ghats.

Ayurvedic: Dheniaani, Karbudaar (doubtful synonym).

Siddha/Tamil: Malliveppam, Kadalranchi.

Folk: Rimil-beeri (Bihar).

Action: Bark—used in anaemia and as a supporting drug in diabetes; also in the treatment of fever.... olax scandens

Paget’s Disease Of Bone

Also called osteitis deformans, this is a chronic disease in which the bones (see BONE) – especially those of the skull, limbs, and spine – gradually become thick and also soft, causing them to bend. It is said to be the most common form of bone disease in the world, and it is estimated that some 600,000 people in England may suffer from it. It seldom occurs under the age of 40. Pain is its most unpleasant manifestation. The cause is not known, and there is no known cure, but satisfactory results are being obtained from the use of CALCITONIN and a group of drugs known as BISPHOSPHONATES

(e.g. etidronate). Those with the disease can obtain help and advice from the National Association for the Relief of Paget’s Disease.... paget’s disease of bone

Bone Disorders

May be present at birth or due to infection (osteomyelitis, tuberculosis, etc), fractures from injury or accident, osteoporosis, Paget’s disease (deformity due to mineral deficiency), tumour or sarcoma, osteomalacia, rickets due to Vitamin D deficiency. Brittle-bone disease. Arthritis. See separate entries.

Comfrey decoction. 1 heaped teaspoon to cup water gently simmered 5 minutes; strain when cold; 1 cup – to which is added 20 drops Tincture Calendula (Marigold), thrice daily. Fenugreek seeds may be used as an alternative to Comfrey.

Alternative:– Mixture: equal parts liquid extracts: Comfrey, Marigold, St John’s Wort. One teaspoon in water or honey thrice daily.

Tablets/capsules. Fenugreek, St John’s Wort.

Topical. Comfrey, Fenugreek or Horsetail poultice.

Supplements. Vitamin A, C, E. Dolomite, Zinc.

Supportive. Exposure of site to sunlight.

Comfrey. The potential benefit of Comfrey root outweighs possible risk for bone disorders. ... bone disorders

Cancer – Bone

May be myeloma (tumour-like over-growth of bone marrow tissue, a giant cell sarcoma, a medullary tumour or secondary deposit from breast, lung, prostate cancer etc. Risk of fracture. Inflammation of the bone – Yarrow. Comfrey. See: MYELOMA, SARCOMA. ... cancer – bone

Bone Abscess

A localized collection of pus in a bone (see osteomyelitis).... bone abscess

Bone Age

A measure of skeletal maturity used to assess physical development in children. X-rays, which show how

much bones have grown in a particular body area, are used to determine bone age. (See also age.)... bone age

Bone Cyst

An abnormal cavity in a bone.

Bone cysts typically develop at one end of a long bone and maybe discovered only by chance after a bone fracture at the site of the cyst.

Minor surgery to scrape out the cyst and fill the the cavity with bone chips usually cures the condition, although many small cysts do not need treatment.... bone cyst

Breasts, Milk Scanty

To promote milk production: Alfalfa, Aniseed, Borage, Caraway, Centuary, Balm, Dill, Fennel, Goat’s Rue, Holy Thistle, Nettles, Burnet Saxifrage, Bitter Milkwort, Marshmallow root, Raspberry leaves, Vervain. John Parkinson (1640) recommended Agnus Castus. Formula (1). Fenugreek seeds 2; Aniseeds 1. Mix. 2 teaspoons to each cup water gently simmered 2 minutes in a covered vessel. Dose: 1 cup 3 or more times daily. Consume seeds.

Formula (2). Equal parts: Goat’s Rue, Raspberry leaves. Mix. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes. Dose: 1 cup 3 or more times daily.

Tablets/capsules. Agnus Castus, Fenugreek, Borage. ... breasts, milk scanty

Bone Cancer

Malignant growth in bone, which may originate in the bone itself (primary bone cancer) or, more commonly, occur as a result of cancer spreading from elsewhere in the body (secondary, or metatastic, bone cancer). Primary bone cancers are rare. The type that occurs most often is osteosarcoma. Other types include chondrosarcoma and fibrosarcoma. Bone cancer can also start in the bone marrow (see multiple myeloma and leukaemia). The treatment of primary bone cancer depends on the extent to which the disease has spread. If it remains confined to bone, amputation may be recommended; but it may be possible to remove the cancer and fill the defect with a bone graft. Radiotherapy or chemotherapy, or both, may also be needed

The cancers that spread readily to form secondary bone cancer are those of the breast, lung, prostate, thyroid, and kidney.

These bone metastases occur commonly in the spine, pelvis, ribs, and skull.

Pain is usually the main symptom.

Affected bones are abnormally fragile and may easily fracture.

Bone cancer that affects the spine may cause collapse or crushing of vertebrae, damaging the spinal cord and causing weakness or paralysis of one or more limbs.

Secondary bone cancers from the breast and prostate often respond to treatment with hormone antagonists.... bone cancer

Bone Density

The compactness of bone tissue in relation to its volume. A decrease in bone density is a normal part of aging. However, in some people, excessive loss of density (see osteoporosis) can lead to fractures. Less commonly, an increase in bone density (see osteosclerosis) occurs in certain disorders (see osteopetrosis; Paget’s disease). Bone density can be measured by a technique known as densitometry, which uses low-dose X-rays.... bone density

Bone Imaging

Techniques for providing pictures that show the structure or function of bones. X-ray images are the most commonly used technique for diagnosing fractures and injuries. More detailed information is provided by tomography, CT scanning, or MRI, which can show tumours

cavities; it may be red or yellow. Red bone marrow is present in all bones at birth and is the factory for most of the blood cells. During the teens, red bone marrow is gradually replaced in some bones by less active yellow marrow. In adults, red marrow is confined chiefly to the spine, sternum, (breastbone), ribs, pelvis (hip-bones), scapulae (shoulderblades), clavicles (collarbones), and bones of the skull.

Stem cells within the red marrow are stimulated to form blood cells by the hormone erythropoietin.

Yellow marrow is composed mainly of connective tissue and fat.

If the body needs to increase its rate of blood formation, some of the yellow marrow will be replaced by red.

Sometimes marrow fails to produce sufficient numbers of normal blood cells, as occurs in aplastic anaemia (see anaemia, aplastic) or when marrow has been displaced by tumour cells.

In other cases, marrow may overproduce certain blood cells, as occurs in polycythaemia and leukaemia.... bone imaging

Bone Marrow Biopsy

A procedure to obtain a sample of cells from the bone marrow (aspiration biopsy) or a small core of bone with marrow inside (trephine biopsy). The sample is usually taken, under local anaesthesia, from the sternum (breastbone) or iliac crests (upper part of the hip-bones). Microscopic examination gives information on the development of the blood components

surrounding tissues. Radionuclide scanning detects areas throughout the skeleton in which there is high bone-cell activity. This type of scanning and on the presence of cells foreign to the marrow.

It is useful in the diagnosis of many blood disorders, including leukaemia and anaemia.

It can also show whether bone marrow has been invaded by lymphoma or cells from other tumours.... bone marrow biopsy

Bone Tumour

A bone swelling that may be cancerous (see bone cancer) or noncancerous.

The most common type of noncancerous bone tumour is an osteochondroma.

Other types are osteoma and chondroma (see chondromatosis).

Treatment is only necessary if the tumour becomes very large or causes symptoms by pressing on other structures.

In such cases, the tumour can be removed by surgery.

Osteoclastoma (also called a giant cell tumour), which usually occurs in the arm or leg of a young adult, is tender and painful and has to be removed.... bone tumour

Cat Scanning

An abbreviation for computerized axial tomographic scanning, commonly known as CT scanning.... cat scanning

Dexa Scan

Dual-energy X-ray absorptiometry, a technique that measures bone density by passing beams of lowdose radiation through bone. scans are used to assess the severity of osteoporosis. (See also densitometry.)... dexa scan

Dmsa Scan

A type of kidney imaging technique (see radionuclide scanning).... dmsa scan

Funny-bone

A popular term for the small area at the back of the elbow where the ulnar nerve passes over a prominence of the humerus (upper-arm bone). A blow to the nerve causes acute pain, numbness, and a tingling sensation in the forearm and hand.... funny-bone

Isotope Scanning

See radionuclide scanning.... isotope scanning

Marrow, Bone

See bone marrow.... marrow, bone

Navicular Bone

a boat-shaped bone of the ankle (see tarsus) that articulates with the three cuneiform bones in front and with the talus behind.... navicular bone

Nuchal Translucency Scanning

(NT scanning) an ultrasound screening test performed during pregnancy at 11 weeks of gestation that measures the maximum thickness of the translucency between the skin and the soft tissue overlying the cervical (neck) region of the spine of the fetus. Increased NT is associated with an increased risk of chromosomal abnormalities and of a wide variety of structural abnormalities (e.g. heart defects). See also ultrasound marker.... nuchal translucency scanning

Occipital Bone

a saucer-shaped bone of the *skull that forms the back and part of the base of the cranium. At the base of the occipital are two occipital condyles: rounded surfaces that articulate with the first (atlas) vertebra of the backbone. Between the condyles is the foramen magnum, the cavity through which the spinal cord passes.... occipital bone

Palatine Bone

either of a pair of approximately L-shaped bones of the face that contribute to the hard *palate, the nasal cavity, and the orbits. See skull.... palatine bone

Perfusion Scan

a technique for demonstrating an abnormal blood supply to an organ by injecting a radioactive *tracer or *contrast medium. One of the most common uses, often in conjunction with ventilation scanning (see ventilation-perfusion scanning), is to detect obstruction of pulmonary arteries due to embolism by thrombus (see pulmonary embolism). Particles labelled with radioactive tracer are injected intravenously and become temporarily lodged in the capillaries in the lungs. Areas not being perfused show up as holes on the gamma-camera images. In *magnetic resonance imaging or *computerized tomography, contrast medium is injected and a series of images is obtained. The rate of change of enhancement is an index of the blood supply to the area of interest. This technique can be used to study blood supply to the brain, heart, or kidneys (in particular), to help diagnose arterial strictures or blockages, or tumours in which blood supply may be increased by abnormal vessels.... perfusion scan

Pet/ct Scanning

an imaging system that allows a PET scan (see positron emission tomography) and a CT scan (see computerized tomography) to be performed very close together, with minimal movement of the patient between scans. This means that the images produced can be co-registered (see co-registration), giving very accurate anatomical localization (from the CT scan) of areas of increased activity (identified on the PET scan). This is very important for determining the site of disease in order to plan treatment.... pet/ct scanning

Petrous Bone

see temporal bone.... petrous bone

Pisiform Bone

the smallest bone of the wrist (*carpus): a pea-shaped bone that articulates with the triquetral bone and, indirectly by cartilage, with the ulna.... pisiform bone

Replacement Bone

a bone that is formed by replacing cartilage with bony material.... replacement bone

Scanning Laser Ophthalmoscope

see ophthalmoscope.... scanning laser ophthalmoscope

Sesamoid Bone

an oval nodule of bone that lies within a tendon and slides over another bony surface. The patella (kneecap) and certain bones in the hand and foot are sesamoid bones.... sesamoid bone

Sestamibi Parathyroid Scan

(in *nuclear medicine) a scan that can help to localize the site of a parathyroid adenoma before surgical removal, to treat primary *hyperparathyroidism. The tracer is technetium-99m-labelled sestamibi (a small protein), which is selectively absorbed by overactive parathyroid glands.... sestamibi parathyroid scan

Spect Scanning

(single photon emission computing tomography) (in nuclear medicine) a *cross-sectional imaging technique for observing an organ or part of the body using a *gamma camera; images are produced after injecting a radioactive *tracer. The camera is rotated around the patient being scanned. Using a computer reconstruction *algorithm similar to that of a *computerized tomography scanner, multiple ‘slices’ are made through the area of interest. SPECT scanning is used particularly in cardiac nuclear medicine imaging (see MUGA scan). It differs from PET scanning in that radioactive decay gives off only a single gamma ray.... spect scanning

Sphenoid Bone

a bone forming the base of the cranium behind the eyes. It consists of a body, containing air spaces continuous with the nasal cavity (see paranasal sinuses); two wings that form part of the orbits; and two pterygoid processes projecting down from the point where the two wings join the body. See skull.... sphenoid bone

Spiral Ct Scanning

(helical CT scanning) a development of conventional *computerized tomography (CT) scanning in which the X-ray tube rotates continuously around the patient as he or she passes through the scanner. This allows the acquisition of images throughout a specified volume of tissue much more quickly. Since these images are digitally acquired (see digitization), *post-processing can produce images in numerous planes, without further exposure of the patient to ionizing radiation. See also multidetector computerized tomography.... spiral ct scanning

Squamous Bone

see temporal bone.... squamous bone

Temporal Bone

either of a pair of bones of the cranium. The squamous portion forms part of the side of the cranium. The petrous part contributes to the base of the skull and contains the middle and inner ears. Below it are the *mastoid process, *styloid process, and zygomatic process (see zygomatic arch). See also skull.... temporal bone

Thallium Scan

see myocardial perfusion scan.... thallium scan

Trapezoid Bone

a bone of the wrist (see carpus). It articulates with the second metatarsal bone in front, with the scaphoid bone behind, and with the trapezium and capitate bones on either side.... trapezoid bone

Turbinate Bone

see nasal concha.... turbinate bone

Unciform Bone

see hamate bone.... unciform bone

Ventilation-perfusion Scanning

(V/Q scanning) a nuclear medicine technique in which two different isotopes are used, one inhaled (usually *xenon-133 or *krypton-81m), to examine lung ventilation, and the other injected into a vein, to examine lung perfusion. In *pulmonary embolism, the area of lung supplied by the blocked artery is not being perfused with blood – which gives a perfusion defect on the film – but has normal ventilation. This technique is highly sensitive for pulmonary embolism.... ventilation-perfusion scanning

Wormian Bone

one of a number of small bones that occur in the cranial sutures.... wormian bone

Woven Bone

immature bone, in which the collagen fibres are arranged haphazardly and the cells have no specific orientation. It is typically found in the early stages of fracture healing, eventually being replaced by mature *lamellar bone.... woven bone

Zygomatic Bone

(zygoma, malar bone) either of a pair of bones that form the prominent part of the cheeks and contribute to the orbits. See skull.... zygomatic bone



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