This is an education resource only. Ordering of all procedure codes on this website are subject to the Canberra Health Services guidelines for imaging orders.
CT ELBOW CONTRAST
FOR ALL EXTREMITIES, PLEASE REFERENCE SIDE AND REGION OF INTEREST TO BE SCANNED IN CT REQUEST
INDICATIONS (1-3)
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Elbow Soft tissue mass (X-ray and US non-diagnostic & MRI contraindicated)
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Osteomyelitis/Septic arthritis of the Elbow:
- arthroplasty or implanted, intra articular surgical hardware
- X-ray suggest joint effusion or soft-tissue swelling -
Osteomyelitis/Soft tissue infection of the elbow:
- X-ray suggest joint effusion or soft tissue swelling
- puncture wound, possible foreign body retained (x-ray normal)
- x-ray normal, necrotizing fasciitis highly suspected
- soft tissue gas on x-ray, no puncture wound -
Trauma, particularly dislocation and concern for vascular injury.
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Post-operative evaluation
PATIENT PREPARATION
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Patient able to lie still for ten minutes
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Not claustrophobic (sedation may be given)
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Cognitively capable of following basic instructions
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Metal artefacts removed from the region of interest
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No respiratory distress when lying supine
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Not allergic to Iodine based Contrast
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No known kidney disease (eGFR below 30 as per RANZCR), however, acute setting consultant may sign to continue with poor renal function
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No hyperthyroidism, may induce thyroid storm
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Patient to have 20G cannula in anterior cubital fossa.
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Preferably patient fasted for 4 hours
ANATOMY INCLUDED
SCAN RANGE: To include distal third of Humerus, elbow joint and proximal third of radius/ulna (or limited to area of interest i.e fracture)
CT Elbow Contrast- Soft tissue window (axial)
CT Elbow Contrast- Soft tissue window (coronal)
CT Elbow Contrast- Soft tissue window (sagittal)
CT Elbow Contrast- Bone window (axial)
CT Elbow Contrast- Bone window (coronal)
CT Elbow Contrast- Bone window (sagittal)
CT ELBOW NON CONTRAST
FOR ALL EXTREMITIES, PLEASE REFERENCE SIDE AND REGION OF INTEREST TO BE SCANNED IN CT REQUEST
INDICATIONS (1-3)
-
Chronic Elbow pain:
- Gout or pseudogout suspected (x-ray inconclusive)
- Bone abnormality suspected (x-ray inconclusive)
- Mechanical symptoms, intra-articular pathology suspected (x-ray inconclusive)
- Mechanical symptoms, osteocartilaginous body suspected (x-ray inconclusive)
- Mechanical symptoms, osteochondral lesion suspected (x-ray inconclusive)
- Mechanical symptoms, synovial abnormality suspected (x-ray inconclusive) -
Osteonecrosis of the elbow, articular collapse on x-ray, preoperative planning
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Primary bone tumour suspected of the elbow- osteoid osteoma suspected on x-ray or clinical exam
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Elbow trauma:
- Distal humeral, proximal radius/ulna fractures (for further characterisation)
- Elbow dislocation (consider angiography if vascular compromise is present) -
Fracture union and healing
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Post-operative follow-up
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Pre-operative planning
PATIENT PREPARATION
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Patient able to lie still for five minutes
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Not claustrophobic (sedation may be given)
-
Cognitively capable of following basic instructions
-
Metal artefacts removed from the region of interest
-
No respiratory distress when lying supine
-
Beneficial to be able to extend elbow and/or raise arm above head
ANATOMY INCLUDED
SCAN RANGE: To include distal third of Humerus, elbow joint and proximal third of radius/ulna (or limited to area of interest i.e fracture)
CT Elbow Non Contrast- Bone window (axial)
CT Elbow Non Contrast- Bone window (coronal)
CT Elbow Non Contrast- Bone window (sagittal)
CT Elbow Non Contrast- Soft tissue window (axial)
REFERENCES
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Radiopaedia. CT elbow (protocol). [Internet]. 2010 [updated 23 March 2023, cited 05 Feb 2024]. Available from https://radiopaedia.org/articles/ct-elbow-protocol-1?lang=gb
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American College of Radiology (ACR). Appropriateness Criteria. [Internet]. 2022 [Updated 2023, Cited 20 Jan 2024]. Available from https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria
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Gómez, M., Bartoloni, A., Guglielmi, G., & Bazzocchi, A. (2017). Emergency and trauma of the elbow. Seminars in Musculoskeletal Radiology, 21(03), 257–281. https://doi.org/10.1055/s-0037-1602415