CT of fractures
Author:
Mikael Häggström [notes 1]
Contents
Planning
Indication in trauma
CT in trauma is generally the first choice with suspected sudden physical injury to the head, abdomen and/or pelvis. X-ray in trauma is generally the first choice for the upper and lower limbs, but CT or MRI of fractures are possible next steps in remaining fracture suspicion despite a normal X-ray. CT can also better map complicated fracture systems, mainly for pre-operative planning.
- Further information: Trauma#Choice of modality
Settings
Thin slices. No need for contrast CT unless indicated by other suspected conditions.
Evaluation
Use a bone window and look for fracture lines through the bone cortex. Rarely, compression fractures are seen as a radiodense line:
X-ray showing a suspected compressive subcapital hip fracture as a radiodense line
CT scan shows the same, atypical for a fracture since the cortex is coherent
T1-weighted, turbo spin echo, MRI confirms a fracture, as the surrounding bone marrow has low signal from edema.
Also, use a soft tissue window to look for hematomas or other apparent injuries.
Misalignment
Types of fracture misalignment:[1]
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Specific locations
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
References
- ↑ . Introduction to Trauma X-ray. Radiology Masterclass. Retrieved on 2018-07-03.
