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CT FOOT CONTRAST 

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

INDICATIONS (1-4)

Foot Con Indications

  • Post-Operative evaluation

  • Foot Soft tissue mass (X-ray and US non-diagnostic & MRI Contraindicated)

  • Osteomyelitis/Septic arthritis of the foot:

  • - Arthroplasty or implanted intra-articular surgical hardware

  • - X-ray suggests effusion or soft tissue swelling

  • Soft tissue infection of the foot:

  • - wound, possible foreign body,

  • - X-ray normal, necrotizing fasciitis highly suspected

  • - Soft tissue gas on radiography, no puncture wound

Foot 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

Foot Con Anatomy

ANATOMY INCLUDED
 

SCAN RANGE: Above ankle joint to toes
CT Foot Contrast- Soft tissue window (axial)
CT Foot Contrast- Bone window (axial)
CT Foot Contrast- Soft tissue window (coronal)
CT Foot Contrast- Bone window (coronal)
CT Foot Contrast- Soft tissue window (sagittal)
CT Foot Contrast- Bone window (sagittal)

CT FOOT NON CONTRAST 

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

INDICATIONS (1-4)

Foot Non Con Indications

  • Chronic Foot pain, gout or pseudogout suspected (x-ray inconclusive), consider dual energy CT if available

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

  • Soft tissue infection of the foot:
    - Necrotizing fasciitis highly suspected
    - Soft tissue gas on radiography, no puncture wound

  • Foot trauma:
    - Dislocation suspected (x-ray non-diagnostic)
    - Lis franc injury
    - Occult fracture suspected (midfoot instability present, or x-ray non diagnostic)

  • Chronic Midfoot pain
    - X-ray negative, accessory ossicles suspected
    - X-ray negative, occult fracture suspected

  • Fracture union and healing

  • Post-operative evaluation

  • Pre-operative planning

Foot 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

Foot Non Con Anatomy

ANATOMY INCLUDED
 

SCAN RANGE: Above ankle joint to toes
CT Foot Non Contrast- Bone window (axial)
CT Foot Non Contrast- Bone window (coronal)
CT Foot Non Contrast- Bone window (sagittal)
CT Foot Non Contrast- Soft tissue window (axial)
Extra reconstruction: 3D VR

REFERENCES

  1. Radiopaedia. CT foot (protocol). [Internet]. 2010 [updated 23 March 2023, cited 04 Feb 2024]. Available from https://radiopaedia.org/articles/ct-foot-protocol-1?lang=gb

  2. Melenevsky Y, Mackey R, Abrahams R, Thomson N. Talar Fractures and Dislocations: A Radiologist’s Guide to Timely Diagnosis and Classification. Radiographics. 2015;35(3):765-79. doi:10.1148/rg.2015140156 – Pubmed

  3. Johnson, P. T., Fayad, L. M., & Fishman, E. K. (2007). CT of the foot. Journal of Computer Assisted Tomography, 31(6), 961–969. https://doi.org/10.1097/rct.0b013e318043a1d8

  4. 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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