CT scan hand – X-ray computed tomography of the bones of the distal upper limb. Allows you to examine in great detail the numerous bones of the wrist, metacarpal bones and finger bones, as well as the joints between them (carpo-metacarpal, metacarpophalangeal, interphalangeal joints). With contrast enhancement, visualization of the surrounding soft tissues of the hand (tendons, muscles, vascular network) improves. CT scan hand can be recommended in order to clarify radiography data, identify subluxations and dislocations, complex fractures and control their fusion, diagnose arthritis, arthrosis, gout, neoplasms, etc.
The procedure is prescribed for fractures of the hand of various etiologies, including senile and on the background of osteoporosis, with severe extensive injuries with damage to surrounding tissues. Manipulation is also used to control the standing of fragments after surgery or reposition and to assess the formation of a callus during treatment. CT scan hand is necessary in case of suspected neoplasms of bones and cartilage of the distal upper limb in order to clarify the localization of the pathological focus, its prevalence and involvement of surrounding tissues. The procedure is recommended for the detection of dislocations, damage to the ligaments of the hand, abnormalities in the development of bone or cartilage structures, diagnosis of arthritis, arthrosis, gout, osteoporosis. CT is indicated in preparation for surgical interventions, to monitor diseases in dynamics, to clarify the results of radiography and other studies.
CT is not performed in pregnant women due to the possibility of fetal abnormalities under the influence of X-rays. According to vital indications, CT is replaced by MRI or scans are performed after childbirth. The use of computer diagnostics in children under 14 years of age is limited due to the negative effect of X-rays on the cells of a growing organism. A relative contraindication is the patient’s obesity, which is associated with the technical characteristics of the tomograph (weight more than 120-200 kg). Sometimes CT is performed with contrast enhancement, in such cases, intolerance to iodine preparations, as well as severe kidney pathology (delayed withdrawal of contrast with symptoms of intoxication), liver, diabetes mellitus and thyroid diseases are considered contraindications to its implementation. Patients with hyperkinetic disorders are not prescribed the procedure, because absolute immobility is needed during its implementation.
Manipulation is prescribed by a doctor or performed at the request of the patient, on an outpatient basis or as an inpatient examination. When performing the procedure without contrast enhancement, no preparation is required. CT with contrast is performed on an empty stomach. Contrast tomography is usually used when oncological lesions of the hand tissues are suspected, that is, quite rarely. Before the study, do not take food for 6 hours. Immediately before the diagnosis, all metal products and clothing with metal fittings and threads are removed.
Methodology of conducting
The study is carried out in a separate room shielded from X-rays. The doctor is in the next office and communicates with the patient through a microphone mounted in the arch of the tomograph. If necessary, the radiopaque substance is injected intravenously, then they wait for a few minutes until the contrast colors the soft tissues and blood vessels, and only then begin scanning. Sometimes the drug is injected through a catheter, which is left in the vein for repeated or permanent infusion of contrast.
During a CT scan of the hand, the examinee is on a special table, which automatically moves through the ring of the device. At this time, X-ray radiation acts on the area under study, sensors take readings and transmit the image to the computer screen. The quality of the images depends on the patient’s immobility. The results and their transcript are usually prepared within 1 hour. They are handed out in paper form or on electronic media. With the results of the study, the patient turns to the attending physician, who chooses the management tactics: prescribes an additional examination or consultations with other specialists, draws up an outpatient treatment plan, directs to hospitalization in an emergency or planned manner.
CT of the brush has a number of advantages. Firstly, this procedure allows you to obtain scans with images of not only bone structures, but also nearby tissues. Secondly, the images can be enlarged without loss of image quality or converted into a three-dimensional model. Thirdly, the presence of gypsum or metal structures is not an obstacle to CT, and the procedure itself can be repeated several times due to minimal radiation load. In addition, tomography very rarely requires additional examination to clarify the diagnosis, which saves money and time for the patient. It is an alternative when an MRI cannot be performed. It is the diagnostic accuracy and relative safety that determines the demand for CT scan hand in medical practice.