MSK CT PROTOCOL[2] - jefferson.edu · AC joint. SHOULDER Coronal Imaging Plane Coronal Imaging...

UPPER EXTREMITY

SHOULDER

PositioningPatient supineAffected arm by side of bodyContralateral arm raised above head.

SHOULDER

SHOULDER

-Axial-Coronal -Sagittal

22Reformat

-Bone-Soft Tissue

0.621.25Reconstruct

Type/PlaneInterval (mm)Slice (mm)

200140Large0

mAKVFOVGantry Tilt

SHOULDERScanning Plane

•Prescribe plane parallel to humeral shaft. •Cover from AC joint through proximal humeral diaphysis.

Relevant Anatomy

ClavicleAcromium

Humeral Head

AC joint

SHOULDERCoronal Imaging Plane

Coronal Imaging Plane•Prescribe coronal plane off of axial images parallel

to supraspinatus muscle

Relevant Anatomy

SupraspinatusInfraspinatus

SHOULDERSagittal Imaging Plane

Humeral Head

Bony Glenoid

Relevant Anatomy Sagittal Imaging Plane•Prescribe sagittal plane off axial images with

line parallel to bony glenoid. •Image from scapular wing through deltoid muscle.

Deltoid Muscle

ELBOW

PositioningPatient supineArm by side or raised above headPalm up

ELBOW

ELBOW

-Axial-Coronal -Sagittal

1.50.8Reformat

-Bone-Soft Tissue

0.30.625Reconstruct

Type/PlaneInterval (mm)Slice (mm)

150120Small0

mAKVFOVGantry Tilt

ElbowScanning Plane

•Prescribe plane perpendicular to coronal plane (©).

•Scan from humeral diaphysis past radial tuberosity

Relevant Anatomy

ELBOWCoronal Imaging Plane

Relevant AnatomyCoronal Imaging Plane

*Prescribe plane parallel to anterior humerus at condyles. Scan through entire elbow.

*

*

Lateral Humeral Condyle

Medial Humeral Condyle

Olecranon processof Ulna

Humerus

ELBOWSagittal Imaging Plane

Sagittal Imaging Plane*Prescribe plane perpendicular to coronal plane (©). Scan

through entire elbow.

©

©

*

*Lateral Humeral Condyle

Medial Humeral Condyle

Olecranon processof Ulna

Humerus

Relevant Anatomy

WRIST

PositioningPatient proneArm over head (“Mighty Mouse Position”)Arm as straight as possibleWrist centered in gantry

WRIST

WRIST

-Axial-Coronal -Sagittal

1.50.8Reformat

-Bone-Soft Tissue

0.30.625Reconstruct

Type/PlaneInterval (mm)Slice (mm)

150120Small0

mAKVFOVGantry Tilt

WRISTScanning Plane

•. Prescribe plane parallel to distal radius. •Scan from proximal metacarpals through distal

radial/ulnar metaphysis.

Relevant Anatomy

cap

triqscaph

ham

lun

trapm

Distradius

Distalulna

metacarpalstrapz

WRISTCoronal Imaging Plane

Relevant Anatomy Coronal Imaging Plane•Prescribe plane parallel to line drawn from

ulnar styloid through radial styloid. •Scan through entire wrist.

UlnarStyloid

RadialStyloid

WRISTSagittal Imaging Plane

Relevant Anatomy

UlnarStyloid

RadialStyloid

Sagittal Imaging Plane*Prescribe plane perpendicular to coronal plane (©).

Scan through entire wrist.

WRISTSagittal Imaging Plane

UlnarStyloid

RadialStyloid

Relevant AnatomySagittal Imaging Plane

*Prescribe plane perpendicular to coronal plane (©).Scan through entire wrist.

©

©

**

UlnarStyloid

RadialStyloid

LOWER EXTREMITY

HIP

PositioningPatient SupineLegs flat on table

HIPS

HIP

-Axial-Coronal -Sagittal

22Reformat

-Bone-Soft Tissue

0.621.25Reconstruct

Type/PlaneInterval (mm)Slice (mm)

200140Large0

mAKVFOVGantry Tilt

HIPScanning Plane

•Prescribe plane parallel to acetabular roof•Scan from acetabular roof through lesser trochanter

Relevant Anatomy

GreaterTrochanter

AcetabularRoof

LesserTrochanter

HIPCoronal Imaging Plane

Greater Trochanter

FemoralNeck

Superior Pubic Ramus

Relevant AnatomyCoronal Imaging Plane

*Prescribe plane parallel femoral heads. Scan from ischium through pubic

symphesis.

Ischium

*

FemoralHead

HIPSagittal Imaging Plane

Greater Trochanter

FemoralNeck

Superior Pubic Ramus

Femoral Head

Ischium

Relevant AnatomySagittal Imaging Plane

*Prescribe plane perpendicular to coronal plane. Scan from acetabulum through greater

trochanter.

*

*

KNEE

Positioning:Patient Supine with feet first into scannerKeeps knees extended, side-by-side.Tape the feet together with toes pointing up to help keep the knees from moving.Slide patient so that the knee being scanned is in the center of the table

KNEE

KNEE

-Axial-Coronal -Sagittal

1.50.8Reformat

-Bone-Soft Tissue

0.50.625Reconstruct

Type/PlaneInterval (mm)Slice (mm)

150120Small0

mAKVFOVGantry Tilt

KNEE

Relevant AnatomyScanning Plane

• Prescribe plane parallel to axis of the tibial plateau.• Scan knee from suprapatellar region to the proximal tibia

Tibia

Femur

Plateau

Patella

Suprapatellar

Region

KNEECoronal Imaging

Relevant Anatomy

MedFemCondyle

LatFemCondyle

Patella

Coronal Imaging PlanePrescribe plane with line parallel to

femoral condyles. Image entire knee.

KNEESagittal Imaging Plane

MedFemCondyle

LatFemCondyle

Patella

Relevant AnatomySagittal Imaging Plane

*Prescribe plane perpendicular to coronal plane (©).Scan from the medial to the lateral femoral condyle.

©©

*

*

ANKLE

Positioning:Patient supineCenter in scanner both feet or foot of interest (use foot holder, if available). If imaging both feet, bring them togetherToes pointing straight up.Foot inverted slightly

ANKLE

-Axial-Coronal -Sagittal

1.50.8Reformat

-Bone-Soft Tissue

0.30.625Reconstruct

Type/PlaneInterval (mm)Slice (mm)

150120Small0

mAKVFOVGantry Tilt

ANKLE

ANKLE

Relevant Anatomy

Scanning Plane•Prescribe plane parallel to axis of calcaneus.•Scan ankle from distal tibia through beyond

the inferior calcaneous

Tibia

Talus

Calcaneous

ANKLECoronal Imaging Plane

Coronal Imaging PlanePrescribe plane perpendicular

to axial imaging plane. Scan ankle from calcaneus through metatarsal bases.

Calcaneus

Talus

Cuboid

METATARSALS

Relevant Anatomy

ANKLESagittal Imaging Plane

Sagittal Imaging PlanePrescribe plane with line bisecting

calcaneus. Scan through entire foot.Relevant Anatomy

Calc

aneu

s

Cuboid

Late

ral

Cune

iform

Med

ial

Cun

eifo

rm

Inte

rmed

iate

Cune

iform