31 The EANM practice guideline for Bone Scintigraphy Preamble The aim of this document is to provide general information about bone scintigraphy. This guideline describes current routine clinical procedures but should not be interpreted as excluding alternative procedures also employed to obtain equivalent data. It is important to remember that the resources and facilities available for patient care may vary from one country to another and from one medical institution to another. This document has been prepared primarily for nuclear medicine physicians, physicists and technicians and intends to offer assistance in optimising the procedural protocols and diagnostic information that can currently be obtained from bone scintigraphy. The guideline has been written by the EANM Bone & Joint and Oncology Committees and then reviewed and approved by all EANM Committees and the Board, as well as by the National Societies represented within the EANM. The European Association of Nuclear Medicine (EANM) has written and approved guidelines to promote the use of high-quality nuclear medicine procedures. These guidelines are intended to assist practitioners in providing appropriate nuclearmedicine care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the EANM caution against the use of these guidelines in litigation in which the clinical decisions of a practitioner are called into question. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by medical professionals taking into account the unique circumstances of each case. Thus, an approach that differs from the guidelines does not necessarily imply that the approach was below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the guidelines. The practice ofmedicine involves not only the science, but also the art of dealingwith the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditionsmake it impossible at times to identify themost appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be recognized that adherence to these guidelines will not assure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safemedical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective. 2