MDCT versus digital radiography in the evaluation of bone healing in orthopedic patients

OBJECTIVE. Assessment of bone healing in orthopedic patients is usually monitored by radiographs in two views. The purpose of our study was to compare multiplanar reconstructions from MDCT data sets with digital radiographs for assessing the extent of bone healing. MATERIALS AND METHODS. Forty-three orthopedic patients (19 women, 24 men) who underwent MDCT and radiography after arthrodesis, fractures, or spinal fusions were included in our study. MDCT was performed on an MX 8000IDT scanner and served as the gold standard. The technical parameters were adapted to the anatomic region. A bone algorithm for reconstruction was used (3,500/600 H). Multiplanar reconstructions were calculated in two orthogonal planes. All patients underwent digital radiography on a Multix FD system in two views according to standard procedures. Multiplanar reconstructions and radiographs were analyzed by two musculoskeletal radiologists in a consensus interpretation to determine bone healing using a semiquantitative approach. RESULTS. In 27 patients (63%), MDCT and digital radiography were concordant with regard to the extent of bone healing, whereas in 16 patients (37%) the results were not concordant. In eight patients (19%) digital radiographs underestimated the extent of bone healing, whereas in another eight patients (19%) they overestimated the degree of fusion. CONCLUSION. MDCT using high-quality 2D reformatting is recommended as the primary imaging technique for the evaluation of bone healing.