Why Might I Need a CT Scan for my Orthopaedic Problem?

Orthopaedic & Spine Center


Mark W. McFarland, DO

A Computerized Tomography Scan, also known as a CT scan, or CT, is a quick and painless diagnostic imaging study that enables me to view detailed images of the bones, organs and soft tissues of the patient’s body. CT uses multiple x-rays, taken at various angles and guided by a computer, to create 3-D images, which are cross-sectional “slices” of the area of the body that is scanned.

CT scans are utilized heavily by Emergency Room Physicians, for patients who have been involved in accidents or violence, because they provide rapid images of internal organs and skeletal structures necessary for the doctors to make a fast diagnosis and order the appropriate treatment.  If a patient should require emergency surgery, these CT images can also be used to pinpoint the location of internal bleeding that must be stopped or fractures that need to be reduced (set).  When I am on call at the hospital and need to perform emergency orthopaedic surgery, I will often refer to these images before and during surgery.

In a non-emergent setting, CT scans are typically ordered by Orthopaedic physicians when we want to see a larger area of the body and when less detail is required than of an MR scan.  For example, a CT scan will provide me with a very good image of a bone fracture but may not give me the level of detail I will need to fully visualize a herniated disc, torn ligament, or tendon.  Some orthopaedic physicians utilize CT scans for knee joint replacements. Specialized cutting jigs can be created, specific to the patient’s own anatomy, using the CT images of the knee.  These jigs are then used during the knee replacement surgery to help provide a more “custom” fit and alignment  for the implant.

CT scans are commonly performed using a contrast agent, also known as dye. This dye is used to expose and delineate areas that may be of concern, as the contrast agent blocks the x-rays and shows up as white on the CT scan. It is especially helpful when looking at the brain, spine, vasculature and other organs and structures.  Contrast may be administered orally, intravenously, or anally. Patients who have a history of heart disease, diabetes, kidney disease, asthma, or thyroid disorders, may be ordered to have the CT scan without contrast. Allergies, especially to iodine or shellfish, may also affect whether or not a patient should receive contrast.

At OSC, our Orthopaedic or Pain Management physicians may order a CT scan, instead of a MR scan, for the following reasons:

  • A CT scan is often faster than a MR scan – some take only a few minutes.  An MR scan can take anywhere from 20-60 minutes.
  • A CT scan is typically half the cost of a MR scan.
  • A MR scanner uses a powerful magnet to generate the images of the body.  Some patients have metal fragments, stents, pacemakers or other medical hardware in their body.  Having a MR scan would be dangerous for these individuals.
  • Some patients cannot lie flat and still for 30-40 minutes for a MR scan, due to pain or cognitive issues
  • Some patients are extremely claustrophobic and cannot tolerate a MR scan for 30-40 minutes

Once the CT scan is complete, the radiologist will review and interpret the images, using computer software to enhance and sharpen them. The radiologist will then provide a written report for me to review.  I will also go over the results with the patient, in-person, so that we can discuss the best course of treatment for their orthopaedic issue.


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