Obligatory medical device diagnostics.
- Conventional radiography of the affected body region, in two planes – as primary diagnostics.
- Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging (using magnetic fields, i.e., without X-rays)) of the spine – as the method of choice.
Optional medical device diagnostics – depending on the results of the medical history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification.
- Computed tomography (CT; cross-sectional imaging procedure (radiographs taken from different directions with computer-based evaluation)) of the spine when MRI is not feasible or when the findings of other imaging procedures are unclear (e.g., rib fracture versus pathologic rib fracture)
- Skeletal scintigraphy (nuclear medicine procedure that can represent functional changes in the skeletal system, in which regionally (locally) pathologically (pathologically) increased or decreased bone remodeling processes are present) – sensitive search procedure for certain primary tumors and for staging (stage determination).
- Positron emission tomography (PET; procedure of nuclear medicine, which allows the creation of cross-sectional images of living organisms by visualizing the distribution patterns of weak radioactive substances) – serves to show the altered metabolism or the detection of tumor tissue (e.g., vertebral metastases)
- Biopsy (tissue sampling) – this can be done openly surgically, or percutaneously (through the skin) X-ray or CT-assisted.
Further notes
- Only the combination of bone scintigraphy, conventional radiography (native X-ray) and magnetic resonance imaging (MRI) of the entire spine results in a sufficiently high sensitivity (percentage of diseased patients in whom the disease is detected by the use of the procedure, i.e., a positive finding occurs) and specificity (probability that actually healthy people who do not suffer from the disease in question are also detected as healthy by the procedure) for the detection of bone metastases of the spine!
- Whole-body MRI and PET-CT (combined nuclear medicine (PET) and radiological (CT) imaging procedure, in which the distribution pattern of radioactive substances (tracers) can be very precisely localized with the help of cross-sectional imaging) – procedure with the highest sensitivity and specificity for the detection of skeletal metastases.
- In Paget’s disease (malignant systemic disease, which is one of the non-Hodgkin’s lymphomas of B lymphocytes), the vertebral bodies are particularly affected; in carcinoma metastases, the vertebral arches are preferred.
