Computerized tomography in the evaluation of musculoskeletal system

Abstract

With the advances in multidetector computerized tomography (MDCT) technology, indications for CT in the evaluation of musculoskeletal system have increased. Although magnetic resonance (MR) imaging of the musculoskeletal system has gained much attention over the years, indications for CT especially after MDCT got multiplied. While MR imaging is undoubtedly superior to CT in detecting soft tissue and bone marrow abnormalities with its inherited high-contrast resolution, MDCT is essential in several settings. With CT imaging, no absolute contraindications (such as cardiac pacemakers, electronic stimulators) have been identified as has been with MR imaging. The ease in availability of this modality has contributed to its indications mainly in the emergency departments especially with very short scanning times. CT is an excellent technique for detailed evaluation of skeletal trauma with the use of multiplanar reformations and three-dimensional-rendering techniques available, especially when complex fractures with articular involvement are suspected. Besides trauma patients, as an alternative to MR imaging in many situations, MDCT is particularly useful in patients who have metal hardware which otherwise metal artifact typically prohibits MR imaging evaluation. CT is also used to diagnose complications in fracture healing and selected bone tumors especially in evaluating the matrix mineralization and infectious diseases and to guide musculoskeletal interventions. The better delineation of skeletal structures adds to its advantages with multislice scanning and 3D-displaying capability.