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 SHOULDER CONTRAST
FOR ALL EXTREMITIES, PLEASE REFERENCE SIDE AND REGION OF INTEREST TO BE SCANNED IN CT REQUEST
INDICATIONS (1-4)
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Post-operative evaluation
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Soft tissue mass of the shoulder (X-ray and US non-diagnostic & MRI Contraindicated)
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Osteomyelitis/Septic arthritis of the shoulder:
- Arthroplasty or implanted intra-articular surgical hardware
- X-ray suggests soft tissue swelling -
Soft tissue infection of the shoulder:
- Puncture wound, possible foreign body, soft tissue swelling.
- X-ray normal, necrotizing fasciitis highly suspected
- Soft tissue gas on radiography, no puncture wound
- X-ray findings suggest soft tissue swelling
- Infection of shoulder prostheses
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: Include AC Joints to inferior angle of scapula (Scan range for localized disease of humeral head or glenoid can be limited)
CT Shoulder Contrast- Soft tissue window (axial)
CT Shoulder Contrast- Bone window (axial)
CT Shoulder Contrast- Soft tissue window (coronal)
CT Shoulder Contrast- Bone window (coronal)
CT Shoulder Contrast- Soft tissue window (sagittal)
CT Shoulder Contrast- Bone window (sagittal)
CT SHOULDER NON CONTRAST
FOR ALL EXTREMITIES, PLEASE REFERENCE SIDE AND REGION OF INTEREST TO BE SCANNED IN CT REQUEST
INDICATIONS (1-4)
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Chronic Shoulder pain:
- Osteoarthrosis
- Gout or pseudo gout suspected (x-ray inconclusive) -
Osteonecrosis of the shoulder, articular collapse on x-ray, pre-operative planning
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Shoulder replacement & symptomatic:
- Loosening suspected, no infection (x-rays inconclusive) -
Shoulder trauma:
- Humeral head or neck fracture (for further characterisation)
- AC joint dislocation and classification
- Scapular fracture (for further characterisation) -
Fracture union and healing
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Post-operative follow-up
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Pre-operative planning (shoulder arthroplasty, laterjet etc.).
PATIENT PREPARATION
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Patient able to lie still for five minutes
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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: Include AC Joints to inferior angle of scapula (Scan range for localized disease of humeral head or glenoid can be limited)
CT Shoulder Non Contrast- Bone window (axial)
CT Shoulder Non Contrast- Bone window (coronal)
CT Shoulder Non Contrast- Bone window (sagittal)
CT Shoulder 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 23 Jan 2024]. Available from https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria
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Radiopaedia. CT shoulder (protocol). [Internet]. 2010 [updated 23 March 2023, cited 04 Feb 2024]. Available from https://radiopaedia.org/articles/ct-shoulder-protocol-1?lang=gb
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Gustas-French, C., Petscavage-Thomas, J., & Bernard, S. A. (2018). Imaging of Shoulder Arthroplasties. American Journal of Roentgenology, 211(3), 485–495. https://doi.org/10.2214/ajr.18.19529
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Kadi, R., Milants, A., & Shahabpour, M. (2017). Shoulder anatomy and normal variants. Journal of the Belgian Society of Radiology, 101(S2), 3. https://doi.org/10.5334/jbr-btr.1467
