CT wrist is a method of X-ray imaging, involving the execution of thin-cut images of the wrist area and their digital processing. Gives an idea of the main structural elements forming the joint: the articular surface of the radius and wrist bones, ligamentous-tendon apparatus. The study of the bone-cartilaginous skeleton does not require additional contrast, soft tissue structures are better visualized after the introduction of iodine-containing contrast. CT is prescribed to diagnose traumatic injuries (dislocations, subluxations, complex fractures), degenerative-dystrophic changes, pathology of the surrounding soft tissues.
Indications
CT wrist is prescribed to patients for the diagnosis of traumatic injuries. During the scan, it is possible to identify fractures of the wrist bones, distal parts of the radius and ulna, fractures, dislocations of the wrist bones. Also, with the help of the study, it is possible to determine long-standing post-traumatic changes in the bone and cartilage apparatus. Tomography is indicated if carpal tunnel syndrome is suspected. The technique is effective in the diagnosis of inflammatory processes – arthritis, osteomyelitis. Using computed tomography, it is possible to assess the vastness of the pathological focus and the prevalence of changes in the surrounding tissues. Also, this method is used to detect pus, blood in the joint cavity.
CT is informative for determining benign and malignant tumors. Obtaining layer-by-layer images allows you to diagnose neoplasms of insignificant size, not accompanied by clinical manifestations, to detect metastases. Scanning is used to detect degenerative-dystrophic changes, in particular, arthrosis, osteoporosis. The indication for the study is the suspicion of congenital or acquired abnormalities of the structure of the joint. As an additional diagnostic method, the X-ray method is used for rheumatological diseases, systemic lesions of connective tissue, in preparation for surgery or to monitor the effectiveness of surgical intervention.
Contraindications
CT is contraindicated during pregnancy due to the possible radiation load on the fetus, which can lead to the formation of intrauterine developmental abnormalities. Scanning with the use of contrast is not carried out with severe renal insufficiency, allergies to iodine-containing drugs. During lactation, contrast scanning is performed provided that breastfeeding is excluded for 2 days. Relative contraindications are neurological disorders, hyperkinesis, intense pain syndrome. In such cases, the study can be carried out with the use of sedatives. There is also a restriction for obese patients, since the load is designed for 120-200 kg, depending on the model of the tomograph.
Preparation
CT wrist is usually performed after a standard X-ray examination. Preliminary preparation is needed only when contrast scanning is prescribed. In this case, it is necessary to assess the functionality of the kidneys. Also, the patient should refuse to eat 5-6 hours before the planned contrast procedure. Immediately before the examination, you need to remove all metal objects and accessories, including jewelry. At the time of manipulation, the patient should be wearing cotton underwear or a disposable bathrobe.
Methodology of conducting
To perform a CT scan of the wrist joint, the patient is placed on a couch, which is then moved into the tomograph ring. After launching the device, a tube that emits X-rays rotates around the body of the subject. The received information is transmitted to the installed sensors, and then to the computer, where it is processed using software. At the same time, it is important to keep a stationary position so that the pictures are as clear as possible. The duration of the study is no more than 5 minutes. When using contrast, the procedure takes about 20 minutes.
CT results are issued on the same day, a few hours after the scan. In conclusion, the diagnostician indicates the identified changes: foci of inflammation, degenerative-destructive processes, structural anomalies, traumatic injuries, neoplasms. Also, during the CT scan, blood or pus in the joint can be determined. Together with the conclusion, images are issued on digital media, film or disk. With the results obtained, the patient should go to his attending physician, who will establish the final diagnosis and determine the subsequent tactics.
Advantages
CT wrist is similar in its effectiveness to MRI, but the latter involves the use of a magnetic field and radio waves. With computer scanning, it is possible to visualize bone elements in as much detail as possible, while magnetic resonance examination provides comprehensive information about the condition of soft tissues. Another advantage of MRI is the absence of X-ray irradiation. However, CT is more affordable in terms of cost, so it is used much more often. The procedure can be prescribed even in childhood, if there are difficulties in making a diagnosis.