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CT ELBOW CONTRAST

FOR ALL EXTREMITIES, PLEASE REFERENCE SIDE AND REGION OF INTEREST TO BE SCANNED IN CT REQUEST

INDICATIONS (1-3)

ELBOW CON INDICATIONS

  • Elbow Soft tissue mass (X-ray and US non-diagnostic & MRI contraindicated)

  • 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.

  • Post-operative evaluation

ELBOW CON PT PREP

PATIENT PREPARATION

  • Patient able to lie still for ten minutes

  • 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

  • Not allergic to Iodine based Contrast

  • No known kidney disease (eGFR below 30 as per RANZCR), however, acute setting consultant may sign to continue with poor renal function

  • No hyperthyroidism, may induce thyroid storm

  • Patient to have 20G cannula in anterior cubital fossa.

  • Preferably patient fasted for 4 hours

ELBOW CON ANATOMY

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 

ELBOW NONCON
FOR ALL EXTREMITIES, PLEASE REFERENCE SIDE AND REGION OF INTEREST TO BE SCANNED IN CT REQUEST

INDICATIONS (1-3)

ELBOW NONCON INDICATIONS

  • 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

  • Primary bone tumour suspected of the elbow- osteoid osteoma suspected on x-ray or clinical exam

  • Elbow trauma:
    - Distal humeral, proximal radius/ulna fractures (for further characterisation)
    - Elbow dislocation (consider angiography if vascular compromise is present)

  • Fracture union and healing

  • Post-operative follow-up

  • Pre-operative planning

ELBOW NON CON PT PREP

PATIENT PREPARATION

  • Patient able to lie still for five minutes

  • 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

ELBOW NON CON ANATOMY

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

  1. 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

  2. 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

  3. 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

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