Keywords:
Musculoskeletal joint, CT, Experimental, Diagnostic procedure, Trauma
Authors:
J. C. Hellund, �. T. Øverbø, K. Bjørklund, S. Tyrdal, A. C. Martinsen; Oslo/NO
DOI:
10.26044/ecr2019/C-1562
Results
4D CT showed a large osteophyte on the medial and posterior aspect of the elbow,
respectively near/on the edge of the coronoid process and at the olecranon fossa.
The selected dynamic images of the moving elbow joint showed clearly where the bony collision occurred at the medial side of the elbow joint.
A few of the possible CT volumes obtainable at the CT workstation is shown.
- Figure 3 displays for orientation the conventional 2D CT in sagittal plane.
- Figure 4 displays a 4D volume showing the whole movement at the most medial side of the elbow (Image A on Fig 2).
Note first the small extension and later flexion during the scan.
- Figure 5 displays a 4D volume showing the whole movement a little lateral than previous (Image B on Fig 2).
- Figure 6 displays a 4D movie of a given 3D volume.
Evaluating the different 4D volumes,
bony collision is observed both posteriorly and anteriorly at the beginning and end of the movement.
The total CTDIvol was 14,51 mGy,
with a total scanning time of 7,6 seconds (27 rotations).
DLP was 232,1 mGycm.
Calculated radiation dose was approx.
0,2 mSv,
using a modified conversion factor of 0,0008,
based on data from Biswas et al (6).
This radiation was in the vicinity of the previous 3 conventional CT (table 1).
|
CTDI vol
|
DLP
|
Effective dose
|
|
mGy
|
mGycm
|
mSv
|
4D CT - 2018
|
14,5
|
232,1
|
0,19
|
CT follow-up 2018
|
13,1
|
359,1
|
0,29
|
CT post-op 2016
|
15,5
|
229,5
|
0,18
|
CT pre-op 2016
|
15,0
|
186,9
|
0,15
|
Table 1: - CTDIvol,
DLP and effective dose of the 4 CT elbow patient had prior to last surgery.
2 months after open arthrolysis the ROM was 16-129 (improvement of 21 degrees),
with pro- and supination 48/85. The patient reported no symptoms from elbow at follow up and was now able to perform daily chores.