dem bones

Lars went for x-rays of his hips a couple weeks ago. We're trying to get a sense of why he's such a flamingo, holding that left leg up and not wanting to bear weight on it.

The thought has been that it's about tight muscles in his calves and thighs, which he certainly has, but also at play seems to be a hip issue. As I understand it, walking and weight-bearing are part of what help your hip bones form and grow and change properly with time. Since he's not doing those things, particularly on the left, he is becoming increasingly at risk for hip displacement. I'm also wondering if some of his crying is due to bone pain.

This Tuesday--assuming he's well enough & the current nasty cold has cleared enough--he'll have a sedated bone scan, skeletal scintigraphy. This is a fairly non-invasive nuclear medicine test that shows exquisite anatomical detail, and also bone metabolism, giving a functional image of the bones, showing how the cells are actually performing—normally or abnormally, and to what degree.

We go in at 10:30 & they injects a radiotracer directly into a vein. The radiotracer is a compound made of a radioactive isotope & a pharmaceutical agent that bones absorb like calcium. We wait 3-4 hours while the radioactive isotope releases energy, and then they do the sedation & a 1-2 hour scan with a "gamma camera." The images show areas where too much or too little of the radiotracer has been absorbed, indicating irregular cell function.

Indicators of a bone scan are: stress fractures, shin splints, arthritis, Paget's disease, bone tumors, infection of the joints or bones, fibrous dysplasia, avascular necrosis or impaired bone blood supply. They say it can be helpful to evaluate damage to the bones due to trauma, bone infection, abnormal growth patterns, or other causes of unexplained bone pain. It will help determine whether he will need surgery to correct the way the left hip bones are growing.

Since next week is school vacation, my fingers are crossed that we can get it done then. This past week he got sick at school Tuesday, and missed most of Tuesday & all of Wednesday.