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CT HAND CONTRAST

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

INDICATIONS (1-5)

Hand Con Indications

  • Soft tissue mass of the hand (x-ray and US non-diagnostic & MRI contraindicated)

  • 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

Hand 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

Hand Con Anatomy

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 

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

INDICATIONS (1-5)

Han Non Con Indications

  • 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

  • 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

  • Pre-operative planning

  • Post- operative follow up

Hand 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

Hand Non Con Anatomy

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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

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