Four-dimensional computed tomography scan for dynamic elbow disorders: recommendations for clinical utility

Renyi Benjamin Seah, Wai Keong Mak, Kimberley Bryant, Mishelle Korlaet, Andrew Dwyer, Gregory I. Bain

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Abstract

Background: Four-dimensional computed tomography (4D CT) is rapidly emerging as a diagnostic tool for the investigation of dynamic upper limb disorders. Dynamic elbow pathologies are challenging to diagnose, and at present, limitations exist in current imaging modalities Objective: We aimed to assess the clinical utility of 4D CT in detecting potential dynamic elbow disorders. Methods: Twenty-eight elbow joints from 26 patients with symptoms of dynamic elbow pathology were included in this study. They were first assessed by a senior orthopedic surgeon with subsequent qualitative data obtained via a Siemens Force Dual Source CT scanner (Erlangen, Germany), producing two- and three-dimensional “static” images and 4D dynamic “movie” images for assessment in each clinical scenario. Clinical assessment before and after scan was compared. Results: Use of 4D CT scan resulted in a change of diagnosis in 16 cases (57.14%). This included a change in primary diagnosis in 2 cases (7.14%) and secondary diagnosis in 14 cases (50%). In 25 cases (89.29%), the 4D CT scan allowed us to understand the pathological anatomy in greater detail which led to a change in the management plan of 15 cases (53.57%). Conclusion: 4D CT is a promising diagnostic tool in the management of dynamic elbow disorders and may be considered in clinical practice. Future studies need to compare it with other diagnostic modalities such as three-dimensional CT.

Original languageEnglish
Pages (from-to)182-186
Number of pages5
JournalJSES International
Volume6
Issue number1
DOIs
Publication statusPublished - Jan 2022

Keywords

  • 4D CT
  • Case Series
  • Diagnostic Study
  • Dynamic CT
  • Dynamic elbow disorders
  • Elbow instability
  • Four-dimensional computed tomography
  • Level IV

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