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 HAND CONTRAST
FOR ALL EXTREMITIES, PLEASE REFERENCE SIDE AND REGION OF INTEREST TO BE SCANNED IN CT REQUEST
INDICATIONS (1-5)
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Soft tissue mass of the hand (x-ray and US non-diagnostic & MRI contraindicated)
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Soft tissue infection of the hand:
- Puncture wound, possible foreign body (x-ray normal)
- Necrotizing fasciitis highly suspected
- Soft tissue gas on x-ray, no puncture wound -
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: Includes whole hand or area of interest to the wrist joint
CT Hand Contrast- Soft tissue window (axial)
CT Hand Contrast- Bone window (axial)
CT Hand Contrast- Soft tissue window (coronal)
CT Hand Contrast- Bone window (coronal)
CT Hand Contrast- Soft tissue window (sagittal)
CT Hand Contrast- Bone window (sagittal)
CT HAND NON CONTRAST
FOR ALL EXTREMITIES, PLEASE REFERENCE SIDE AND REGION OF INTEREST TO BE SCANNED IN CT REQUEST
INDICATIONS (1-5)
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Chronic Hand pain:
- Gout or pseudogout suspected (x-ray inconclusive) -
Primary bone tumour suspected of the hand- osteoid osteoma suspected on x-ray or clinical exam
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Hand trauma:
- Fracture suspected (clinical suspicion or x-ray inconclusive)
- Penetrating foreign body (x-ray inconclusive)
- Carpal or DRUJ instability, consider dynamic studies if available -
Fracture union and healing
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Pre-operative planning
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Post- operative follow up
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
ANATOMY INCLUDED
SCAN RANGE: Includes whole hand or area of interest to the wrist joint
CT Hand Non Contrast- Bone window (axial)
CT Hand Non Contrast- Bone window (coronal)
CT Hand Non Contrast- Bone window (sagittal)
CT Hand Non Contrast- Soft tissue window (axial)
*Extra 3D Reconstructions Available
REFERENCES
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American College of Radiology (ACR). Appropriateness Criteria. [ Internet]. 2022 [Updated 2023, Cited 22 Jan 2024]. Available from https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria
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Radiopaedia. CT hand and wrist (protocol). [Internet]. 2010 [updated 22 Nov 2023, cited 05 Feb 2024]. Available from https://radiopaedia.org/articles/ct-hand-and-wrist-protocol-1?lang=gb
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Welling, R. D., Jacobson, J. A., Jamadar, D. A., Chong, S., Caoili, E. M., & Jebson, P. J. (2008). MDCT and radiography of wrist fractures: Radiographic sensitivity and fracture patterns. American Journal of Roentgenology, 190(1), 10–16. https://doi.org/10.2214/ajr.07.2699
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Ahlawat, S., Corl, F. M., Fishman, E. K., & Fayad, L. M. (2014). MDCT of the hand and wrist: Beyond trauma. Emergency Radiology, 22(3), 307–314. https://doi.org/10.1007/s10140-014-1274-5
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Grunz, J.-P., Gietzen, C. H., Grunz, K., Bley, T., & Schmitt, R. (2020). Imaging of carpal instabilities. Rofo, 193(02), 139–150. https://doi.org/10.1055/a-1219-8158