Multidetector computed tomography (MDCT) has improved our ability to image patients
with skeletal trauma. The chief advantages of this technology include the extremely
rapid scan times, the ability to produce very-high-quality multiplanar reformations,
and the ability to reprocess raw data quickly and easily. Unlike soft tissue imaging,
CT of bony structures requires high spatial resolution. Each joint in the body presents
a unique challenge, and guidelines for imaging of each of the major joints is discussed
throughout this article. In general, use of the thinnest slice width and a bone-reconstruction
algorithm maximizes image quality. Imaging of larger joints such as the shoulder and
hip requires slightly thicker slices to ensure reasonable image quality, particularly
if surface rendering is to be performed. The demonstration of fracture line extension
to articular surfaces is a key function of imaging, and image postprocessing is an
integral component of high-resolution joint imaging. The introduction of MDCT has
enabled submillimeter slice widths, ensuring unparalleled joint visualization in multiple
planes from a single scan acquisition.
KEYWORDS
Computed tomography - multidetector - bone - trauma
REFERENCES
- 1
Buckwalter K A, Rydberg J, Kopecky K K, Crow K, Yang E L.
Musculoskeletal imaging with multislice CT.
Am J Roentgenol.
2001;
176
979-986
- 2
Hu H, He H D, Foley W D, Fox S H.
Four multidetector-row helical CT: image quality and volume coverage speed.
Radiology.
2000;
215
55-62
- 3
Shin J H, Lee H K, Choi C G, Suh D C, Lim T, Kang W.
The quality of reconstructed 3D images in multidetector-row helical CT: experimental
study involving scan parameters.
Korean J Radiol.
2002;
3(1)
49-56
- 4
Nickoloff E L, Alderson P O.
Radiation exposures to patients from CT: reality, public perception, and policy.
Am J Roentgenol.
2001;
177
285-287
- 5
Kuszyk B S, Heath D G, Bliss D F, Fishman E K.
Skeletal 3-D CT: advantages of volume rendering over surface rendering.
Skeletal Radiol.
1996;
25
207-214
- 6
Metz V M, Gilula L A.
Imaging techniques for distal radius fractures and related injuries.
Orthop Clin North Am.
1993;
24(2)
217-228
- 7
Ring D, Jupiter J B, Herndon J H.
Acute fractures of the scaphoid.
J Am Acad Orthop Surg.
2000;
8(4)
225-231
- 8
Young J WR.
Imaging of pelvic trauma.
J South Orthop Assoc.
1996;
5(1)
63-70
- 9
Kricun M E.
Fractures of the pelvis.
Orthop Clin North Am.
1990;
21(3)
573-590
- 10
MacLeod M, Powell J N.
Evaluation of pelvic fractures. Clinical and radiologic.
Orthop Clin North Am.
1997;
28(3)
299-319
- 11
Potok P S, Hopper K D, Umlauf M J.
Fractures of the acetabulum: imaging, classification, and understanding.
Radiographics.
1995;
15
7-23
- 12
Brandser E, Marsh J L.
Acetabular fractures: easier classification with a systematic approach.
Am J Roentgenol.
1998;
171
1217-1228
- 13
Fairbairn J, Mulligan M E, Murphey M D, Resnik C S.
Gas bubbles in the hip joint on CT: an indication of recent dislocation.
Am J Roentgenol.
1995;
164
931-934
- 14
Sirkin M, Sanders R.
The treatment of pilon fractures.
Orthop Clin North Am.
2001;
32(1)
91-102
- 15
Wechsler R J, Schweitzer M E, Karasick D, Deely D M, Glaser J B.
Helical CT of talar fractures.
Skeletal Radiol.
1997;
26
137-142
- 16
Wechsler R J, Schweitzer M E, Karasick D, Deely D M, Morrison W.
Helical CT of calcaneal fractures: technique and imaging features.
Skeletal Radiol.
1998;
27
1-6
- 17
Born C T, Tahernia A D.
Imaging of calcaneal fractures.
Clin Podiatr Med Surg.
1997;
14(2)
337-356
- 18
Mulligan M E.
Ankle and foot trauma.
Semin Musculoskelet Radiol.
2000;
4(2)
241-253
Kenneth A BuckwalterM.D.
Indiana University, Department of Radiology
Room 0615 E, 550 North University Blvd., Indianapolis, IN 46202
