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CT HIP CONTRAST 

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

INDICATIONS (1-7)

Hip Con Indications

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

  • Osteomyelitis/Septic arthritis of the hip:
    - Arthroplasty or implanted, intra articular surgical hardware
    - X-ray suggest or soft-tissue swelling

  • Soft tissue infection of the hip:
    - X-ray suggest joint effusion or soft tissue swelling 
    - Infection of hip prostheses
    - 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

  • Post-Operative evaluation

Hip 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

Hip Con Anatomy

ANATOMY INCLUDED
 

SCAN RANGE: Entire pelvis from iliac crest to below lesser trochanter (Multi-planar reconstructions are only of the affected hip).
CT Hip Contrast- Soft tissue window (axial)
CT Hip Contrast- Soft tissue window (coronal)
CT Hip Contrast- Soft tissue window (sagittal)
CT Hip Contrast- Bone window (axial)
CT Hip Contrast- Bone window (coronal)
CT Hip Contrast- Bone window (sagittal)

CT HIP NON CONTRAST 

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

INDICATIONS (1-7)

Hip Non Con Indications

  • Chronic Hip pain:
    - Osteoarthrosis
    - Gout or pseudogout suspected (x-ray inconclusive)

  • Osteonecrosis of the hip, articular collapse on radiography, preoperative planning

  • Stress (insufficiency) fracture suspected of the hip (x-ray inconclusive)

  • Hip replacement, symptomatic, history of acute injury (x-ray inconclusive)

  • Femoroacetabular impingement

  • Acetabular dysplasia

  • Complication of hip prostheses including peri-prosthetic fractures

  • Trauma:
    - Proximal femoral or acetabular fractures

  • Acetabular rim abnormalities (fragmentation, subchondral cysts, os acetabuli)

  • Pre-operative planning

  • Post-operative follow-up

Hip Non ConPt 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

Hip Non Con Anatomy

ANATOMY INCLUDED
 

SCAN RANGE: Entire pelvis from iliac crest to below lesser trochanter (Multi-planar reconstructions only of affected hip).
CT Hip Non Contrast- Bone window (axial)
CT Hip Non Contrast- Bone window (coronal)
CT Hip Non Contrast- Bone window (sagittal)
CT Hip 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 hip (protocol). [Internet]. 2010 [updated 23 March 2023, cited 04 Feb 2024]. Available from https://radiopaedia.org/articles/ct-hip-protocol-1?lang=gb

  3. Grabinski, R., Ou, D., Saunder, K., Rotstein, A., Singh, P., Pritchard, M., & O’Donnell, J. (2014). Protocol for CT in the position of discomfort: Preoperative assessment of femoroacetabular impingement – how we do it and what the surgeon wants to know. Journal of Medical Imaging and Radiation Oncology, 58(6), 649–656. https://doi.org/10.1111/1754-9485.12201

  4. Foex, B. A., & Russell, A. (2018). Bet 2: CT versus MRI for occult hip fractures. Emergency Medicine Journal, 35(10), 645–647. https://doi.org/10.1136/emermed-2018-208093.3

  5. Mascarenhas, V. V., Ayeni, O. R., Egund, N., Jurik, A. G., Caetano, A., Castro, M., Novo, J., Gonçalves, S., & Sutter, R. (2019). Imaging methodology for hip preservation: Techniques, parameters, and Thresholds. Seminars in Musculoskeletal Radiology, 23(03), 197–226. https://doi.org/10.1055/s-0039-1688714

  6. Huang, B. K., Tan, W., Scherer, K. F., Rennie, W., Chung, C. B., & Bancroft, L. W. (2019). Standard and advanced imaging of hip osteoarthritis. what the radiologist should know. Seminars in Musculoskeletal Radiology, 23(03), 289–303. https://doi.org/10.1055/s-0039-1681050

  7. Blum, A., Meyer, J.-B., Raymond, A., Louis, M., Bakour, O., Kechidi, R., Chanson, A., & Gondim-Teixeira, P. (2016). CT of hip prosthesis: New techniques and new paradigms. Diagnostic and Interventional Imaging, 97(7–8), 725–733. https://doi.org/10.1016/j.diii.2016.07.002

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