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CT WRIST CONTRAST

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

INDICATIONS (1-5)

wrist con indications

  • Post-operative evaluation

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

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

  • Soft tissue infection of the Wrist:
    - 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 wrist hardware

wris 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

wrist con anatomy

ANATOMY INCLUDED
 

SCAN RANGE: To include distal third radius/ulna and the carpal-metacarpal joints
CT Wrist Contrast- Soft tissue window (axial)
CT Wrist Contrast- Bone window (axial)
CT Wrist Contrast- Soft tissue window (coronal)
CT Wrist Contrast- Bone window (coronal)
CT Wrist Contrast- Soft tissue window (sagittal)
CT Wrist Contrast- Bone window (sagittal)

CT WRIST NON CONTRAST 

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

INDICATIONS (1-5)

wris non indications

  • Chronic Wrist pain:
    - Gout or pseudo gout suspected (x-ray inconclusive)
    - Old scaphoid fracture on x-ray, evaluation for instability, mal-union, non-union or osteonecrosis

  • Osteonecrosis of the wrist, articular collapse on x-ray, pre-operative planning

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

  • Wrist trauma:
    - Fracture suspected (high clinical suspicion or x-ray inconclusive)
    - Complex distal ulna/radius, carpal or scaphoid fractures (for further characterisation)
    - Carpal instability
    - Penetrating, foreign body suspected (x-ray inconclusive)
    - Stener lesion (UCL avulsion at thumb MCP joint)
    - Subluxation on x-ray

  • Post-operative follow-up

  • Pre-operative planning

wrist 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

wrist non con anatomy

ANATOMY INCLUDED
 

SCAN RANGE: To include distal third radius/ulna and the carpal-metacarpal joints
CT Wrist Non Contrast- Bone window (axial)
CT Wrist Non Contrast- Bone window (coronal)
CT Wrist Non Contrast- Bone window (sagittal)
CT Wrist 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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