Application of multidetector CT in skeletal trauma

Multidetector computed tomography (MDCT) has improved our ability to image patients with skeletal trauma. The chief advantages of this technology include the extremely rapid scan times, the ability to produce very-high-quality multiplanar reformations, and the ability to reprocess raw data quickly and easily. Unlike soft tissue imaging, CT of bony structures requires high spatial resolution. Each joint in the body presents a unique challenge, and guidelines for imaging of each of the major joints is discussed throughout this article. In general, use of the thinnest slice width and a bone-reconstruction algorithm maximizes image quality. Imaging of larger joints such as the shoulder and hip requires slightly thicker slices to ensure reasonable image quality, particularly if surface rendering is to be performed. The demonstration of fracture line extension to articular surfaces is a key function of imaging, and image postprocessing is an integral component of high-resolution joint imaging. The introduction of MDCT has enabled submillimeter slice widths, ensuring unparalleled joint visualization in multiple planes from a single scan acquisition.