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CT KNEE CONTRAST

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

INDICATIONS (1-4)

Knee Con Indications

  • Post-Operative evaluation

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

  • Osteomyelitis/Septic arthritis of the Knee:
    - Arthroplasty or implanted intra-articular surgical hardware
    - X-ray suggests a joint effusion or soft tissue swelling

  • Soft tissue infection of the Knee:
    - Puncture wound, possible foreign body, joint effusion and/or soft tissue swelling.
    - X-ray normal, necrotizing fasciitis highly suspected
    - Soft tissue gas on radiography, no puncture wound
    - X-ray findings suggest joint effusion or soft tissue swelling
    - Infection of knee prostheses

Knee 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

Knee Con Anatomy

ANATOMY INCLUDED
 

SCAN RANGE: Above patella to below tibial tuberosity (or to include area of interest i.e fracture)
CT Knee Contrast- Soft tissue window (axial)
CT Knee Contrast- Bone window (axial)
CT Knee Contrast- Soft tissue window (coronal)
CT Knee Contrast- Bone window (coronal)
CT Knee Contrast- Soft tissue window (sagittal)
CT Knee Contrast- Bone window (sagittal)

CT KNEE NON CONTRAST 

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

INDICATIONS (1-4)

Knee Non Con Indicaions

  • Chronic Knee pain:
    - gout or pseudo gout suspected (X-ray inconclusive)

  • Osteonecrosis of the knee, articular collapse on x-ray, peri-operative planning

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

  • Knee trauma:
    - Fall or twisting, tibial plateau fracture on x-ray, additional bone or soft tissue injury suspected
    - Distal femoral, patella or proximal tibial fractures (for further characterisation)
    - Dislocations (for further characterisation, consider angiography if vascular compromise present)

  • Knee replacement and pain:
    - Aseptic loosening suspected, no infection (x-ray inconclusive)
    - Peri-prosthetic fracture suspected (x-ray inconclusive)
    - Instability suspected, no infection
    - Osteolysis suspected, no infection

  • Post-operative follow-up

  • Pre-operative planning

  • Patellofemoral dysplasia and maltracking

Knee Non Con Pt Pre

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

Knee Non Con Anatomy

ANATOMY INCLUDED
 

SCAN RANGE: Above patella to below tibial tuberosity (or to include area of interest i.e fracture)
CT Knee Non Contrast- Bone window (axial)
CT Knee Non Contrast- Bone window (coronal)
CT Knee Non Contrast- Bone window (sagittal)
CT Knee Non Contrast- Soft tissue window (axial)
*Extra 3D Reconstructions Available

REFERENCES

  1. American College of Radiology (ACR). Appropriateness Criteria. [ Internet]. 2022 [Updated 2023, Cited 23 Jan 2024]. Available from https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria

  2. De Filippo, M., Bertellini, A., Pogliacomi, F., Sverzellati, N., Corradi, D., Garlaschi, G., & Zompatori, M. (2009). Multidetector computed tomography arthrography of the knee: Diagnostic accuracy and indications. European Journal of Radiology, 70(2), 342–351. https://doi.org/10.1016/j.ejrad.2008.01.034

  3. Cyteval, C. (2016). Imaging of knee implants and related complications. Diagnostic and Interventional Imaging, 97(7–8), 809–821. https://doi.org/10.1016/j.diii.2016.02.015

  4. Konda, S. R., Goch, A. M., Leucht, P., Christiano, A., Gyftopoulos, S., Yoeli, G., & Egol, K. A. (2016). The use of ultra-low-dose CT scans for the evaluation of limb fractures. The Bone & Joint Journal, 98-B(12), 1668–1673. https://doi.org/10.1302/0301-620x.98b12.bjj-2016-0336.r1

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