Basics of musculoskeletal computed tomography

Ingrid Gielen

doi:10.22233/9781910443293.3

British Small Animal Veterinary Association , 28 (2016); https://doi.org/10.22233/9781910443293.3

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Basics of musculoskeletal computed tomography

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Author: Ingrid Gielen
From: BSAVA Manual of Canine and Feline Musculoskeletal Imaging
Item: Chapter 3, pp 28 - 32
DOI: 10.22233/9781910443293.3
Copyright: © 2016 British Small Animal Veterinary Association
Publication Date: January 2016

Abstract

CT permits unobscured visualization of anatomical structures and pathology in the transverse plane. Different algorithms can be applied to emphasize different tissues and MPR in any other plane or three-dimensional reconstructions can be made. This cross-sectional technique is indicated in any musculoskeletal pathology where the radiographic examination is inconclusive regarding the origin and the extent of pathology. CT is particularly valuable to in the evaluation of intra-articular abnormalities, subtle or complex fractures, bone or soft tissue tumours, and in the detection of small bony fragments. This chapter examines the value of CT compared with other imaging techniques; equipment; restraint and patient preparation; examination method; principles of CT image interpretation and abnormalities.

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Figures

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3.1

Dorsal reconstructed bone window arthro-CT image of a normal shoulder joint. The hyperattenuating contrast can be appreciated as well as the hypoattenuating delineation of the cartilage at the level of the glenoid and the humeral head (black arrows). The biceps tendon silhouette (white arrow) is surrounded by contrast medium. © 2016 British Small Animal Veterinary Association

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3.1 Dorsal reconstructed bone window arthro-CT image of a normal shoulder joint. The hyperattenuating contrast can be appreciated as well as the hypoattenuating delineation of the cartilage at the level of the glenoid and the humeral head (black arrows). The biceps tendon silhouette (white arrow) is surrounded by contrast medium.

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3.2

Transverse CT slices in (a) bone and (b) soft tissue windows at the level of the humeral condyles. Hypoattenuating areas showing fluid and joint distension are visible on the soft tissue image (arrowed). © 2016 British Small Animal Veterinary Association

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3.2 Transverse CT slices in (a) bone and (b) soft tissue windows at the level of the humeral condyles. Hypoattenuating areas showing fluid and joint distension are visible on the soft tissue image (arrowed).

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3.3

Sagittal reconstructed (a) (MPR) and (b) 3D CT of the tarsal joint in a young dog. An oblique fracture of the calcaneus and a subluxation between talus and calcaneus are present. © 2016 British Small Animal Veterinary Association

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3.3 Sagittal reconstructed (a) (MPR) and (b) 3D CT of the tarsal joint in a young dog. An oblique fracture of the calcaneus and a subluxation between talus and calcaneus are present.

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3.4

Dorsal reconstructed (MPR), (a) survey and (b) arthro-CT image of a tarsal joint in a bone window. There is tibiotarsal soft tissue swelling, particularly visible medially. The enlarged joint space at the medial talar ridge is visible on the survey image (arrowed). On the arthro-CT image, contrast medium is present in the tarsocrural joint space, the capsule and pouches (white arrows). Loss of cartilage and subchondral bone at the medial talar ridge is seen (black arrow). © 2016 British Small Animal Veterinary Association

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3.4 Dorsal reconstructed (MPR), (a) survey and (b) arthro-CT image of a tarsal joint in a bone window. There is tibiotarsal soft tissue swelling, particularly visible medially. The enlarged joint space at the medial talar ridge is visible on the survey image (arrowed). On the arthro-CT image, contrast medium is present in the tarsocrural joint space, the capsule and pouches (white arrows). Loss of cartilage and subchondral bone at the medial talar ridge is seen (black arrow).

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3.6

Transverse CT image in a bone window at the level of the femoral condyles. The avulsed proximal attachment (arrowed) of the cranial cruciate ligament medially on the lateral condyle is clearly shown. L = lateral; M = medial. © 2016 British Small Animal Veterinary Association

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3.6 Transverse CT image in a bone window at the level of the femoral condyles. The avulsed proximal attachment (arrowed) of the cranial cruciate ligament medially on the lateral condyle is clearly shown. L = lateral; M = medial.

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3.7

Transverse CT image at the level of the shoulder region in a soft tissue window. Swelling of the right shoulder area is present. A hypoattenuating area (10 HU, representing fluid-like content) is visible medial to the right scapula. © 2016 British Small Animal Veterinary Association

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3.7 Transverse CT image at the level of the shoulder region in a soft tissue window. Swelling of the right shoulder area is present. A hypoattenuating area (10 HU, representing fluid-like content) is visible medial to the right scapula.

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3.8

Transverse CT image of an elbow joint at the level of the flexor tendons in a soft tissue window after IV contrast injection. A calcified body (black arrow) and obvious contrast enhancement of the medial flexor tendons (white arrow) are demonstrated, representing flexor enthesopathy. © 2016 British Small Animal Veterinary Association

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3.8 Transverse CT image of an elbow joint at the level of the flexor tendons in a soft tissue window after IV contrast injection. A calcified body (black arrow) and obvious contrast enhancement of the medial flexor tendons (white arrow) are demonstrated, representing flexor enthesopathy.

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3.9

Transverse CT image at the level of the distal humerus in a soft tissue window after IV contrast injection. A hypoattenuating fluid pocket surrounded by a rim of contrast enhancement is seen caudal to the humerus (white arrows). The black arrows denote the tips of the olecranon tubercles. © 2016 British Small Animal Veterinary Association

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3.9 Transverse CT image at the level of the distal humerus in a soft tissue window after IV contrast injection. A hypoattenuating fluid pocket surrounded by a rim of contrast enhancement is seen caudal to the humerus (white arrows). The black arrows denote the tips of the olecranon tubercles.

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3.10

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3.10 Transverse CT image of an elbow joint in a bone window. Several metal objects have caused streaking artefacts which hamper image interpretation.

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3.11

Transverse CT image in a bone window at the level of the distal tibia showing the entry spot of the bone biopsy needle. White streaks, metal artefacts (white arrows) from the biopsy needle (black arrow), obscure the image. © 2016 British Small Animal Veterinary Association

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3.11 Transverse CT image in a bone window at the level of the distal tibia showing the entry spot of the bone biopsy needle. White streaks, metal artefacts (white arrows) from the biopsy needle (black arrow), obscure the image.