Shoulder Position: Supine arm in the neutral position. Collateral arm above head Indication: fracture humerus, fracture scapula No instrumentation With metal or cast KV/ Effective mas/rotation time 140/300/1.0 140/300/1.0 (sec) Detector collimation (mm) 0.6 0.6 Slice thickness (mm) 0.75 0.75 Pitch 0.9 0.9 Extended CT scale box off optional Kernel Bone (B=70) Soft tissue(b=30) Bone (B=45) Soft tissue(b=30) Reconstruction Increment (mm) 0.5 0.5 Start position Above clavicle Above clavicle Finish position Lower pole of scapula or entire fracture Lower pole of scapula or entire fracture Reconstruction Plane/Window Axial (bone) Sagittal of the glenoid (bone/soft tissue) Coronal of the glenoid(bone) Axial (bone) Sagittal of the glenoid (bone/soft tissue) Coronal of the glenoid(bone) Reconstruction interval 2.0 mm thick x 2.0 mm interval 2.0 mm thick x 2.0 mm interval 3D reconstruction For scapula fracture : glenoid surface (figure1) : (Optional) rotation of the shoulder joint For humerus fracture : rotation of the shoulder joint(figure2) For scapula fracture : glenoid surface (figure1) : (Optional) rotation of the shoulder joint For humerus fracture : rotation of the shoulder (figure2) 1
Shoulder Coverage Sagittal reconstruction Coronal reconstruction 2
3D for Humerus fracture 3D of glenoid surface in scapula and glenoid fracture 3
Wrist Position: Prone arm over head : In scaphoid fracture with screw, align the screw follow the beam (figure 1) No instrumentation With metal or cast KV/ Effective mas/rotation time 120/300/1.0 140/300/1.0 (sec) Detector collimation (mm) 0.3 (x 16) 0.3 (x 16) Slice thickness (mm) 0.4 0.4 Pitch 0.9 0.9 Extended CT scale box off optional Kernel Bone (U=90) Soft tissue(u=40) U=40 Reconstruction Increment (mm) 0.5 0.5 Start position Proximal metacarpals Proximal metacarpals Finish position 2 cm of distal radius (or through fracture) 2 cm of distal radius (or through fracture) Reconstruction Plane/Window Axial (soft, bone) Sagittal (bone) Coronal (bone) * along the scaphoid in scaphoid fracture Axial (soft, bone) Sagittal (bone) Coronal (bone) * along the scaphoid in scaphoid fracture Reconstruction interval 1.0 mm thick x 1.0 mm interval 1.0 mm thick x 1.0 mm interval 3D reconstruction For scaphoid /carpal fracture : (No need) For distal radius fracture : Rotation of the wrist bone (figure2)/and wrist with tendons (figure3) to see relationship of fracture and tendon : En face view of the radius (figure4) For scaphoid or carpal fracture : (No need) For distal radius fracture : Rotation of the wrist bone (figure2)/and wrist with tendons (figure3) to see relationship of fracture and tendon : En face view of the radius (figure4) 4
Position scaphoid fracture with metal Coverage 3D Bone & tendons 5
En face view of radius 6
Pelvis Position: Supine, toes together Indications: Pelvic fracture, sacral fracture, acetabular fracture, lumbrosacral junction injury, complication of arthroplasty No instrumentation With metal or cast KV/ Effective mas/rotation time 120/300/1.0 140/400/1.0 (sec) Detector collimation (mm) 0.6 (x 64) 0.6 (x 64) Slice thickness (mm) 0.75 0.75 Pitch 0.9 0.9 Extended CT scale box off optional Kernel Bone (B=70) Soft tissue(b=30) B=45 Reconstruction Increment (mm) 0.5 0.5 Start position Iliac crest (Figure1) Iliac crest (Figure1) Finish position Below lesser trochanter Below lesser trochanter Reconstruction Plane/Window Axial (soft, bone) Coronal (bone) Sagittal (bone) (affected side from outside to inside) Axial (soft, bone) Coronal (bone) Sagittal (bone) (affected side from outside to inside) Reconstruction interval 2.0 mm thick x 2.0 mm interval 2.0 mm thick x 2.0 mm interval 3D reconstruction 1. Pelvic inlet view (figure2) 2. Pelvic outlet view ( figure3) 3. Profile of affected acetabulum (figure4) 4. Inside of the affected ilium(figure5) 1. Pelvic inlet view (figure2) 2. Pelvic outlet view (figure3) 3. Profile of affected acetabulum (figure4) 4. Inside of the affected ilium(figure5) 7
Coverage (Figure1) Pelvic inlet view (figure2) Pelvic outlet view ( figure3) 8
Profile of affected acetabulum (figure 4) Inside of the affected ilium(figure5) 9
Knee Position: Supine. Keep knee AP Indications: Tibial plateau fracture, condylar fracture No instrumentation With metal or cast KV/ Effective mas/rotation time 120/300/1.0 140/300/1.0 (sec) Detector collimation (mm) 0.6 0.6 Slice thickness (mm) 0.75 0.75 Pitch 0.9 0.9 Extended CT scale box off optional Kernel Bone (B=70) Soft tissue(b=30) B=30 Reconstruction Increment (mm) 0.5 0.5 Start position Above femoral epicondyle Above femoral epicondyle Finish position Below the fracture Below the fracture Reconstruction Plane/Window Axial (soft, bone) Coronal (bone) Sagittal (bone) (soft) Axial (soft, bone) Coronal (bone) Sagittal (bone) (soft) Reconstruction interval 2.0 mm thick x 2.0 mm interval 2.0 mm thick x 2.0 mm interval 3D reconstruction 1. Rotation of the knee 2. En face view of the articular surface (remove femur) 1. Rotation of the knee 2. En face view of the articular surface (remove femur) 10
Coverage 3D en face view of the tibial plateau 11
Ankle and foot Position: Supine, foot in neutral position Indications: Calcaneal fracture, distal tibia fracture No instrumentation With metal or cast KV/ Effective mas/rotation time 120/300/1.0 120/300/1.0 (sec) Detector collimation (mm) 0.6 (x64) 0.6(x64) Slice thickness (mm) Bone/Soft tissue 0.6/0.75 Bone/Soft tissue 0.6/0.75 Pitch 0.9 0.9 Extended CT scale box off optional Kernel Bone (B=70) Soft tissue(b=30) B=45 Reconstruction Increment (mm) 0.5 0.5 Start position Above distal tibia Above distal tibia Finish position Through calcaneus Through calcaneus Reconstruction Plane/Window Axial (soft, bone) Coronal (soft,bone)(figure 1) Sagittal (soft, bone) (figure 2) For calcaneal fracture Coronal oblique (bone) (fig 3) Axial oblique (bone) (fig 4) Axial (soft, bone) Coronal (soft,bone)(figure1) Sagittal (soft,bone) (figure 2) For calcaneal fracture Coronal oblique (bone) (figure 3) Axial oblique (bone) (figure 4) Reconstruction interval 2.0 mm thick x 2.0 mm interval 2.0 mm thick x 2.0 mm interval 3D reconstruction 1. Rotation of the ankle with tendon ( to see the relationship of fracture and tendon) 1. Rotation of the ankle with tendon ( to see the relationship of fracture and tendon) 12
Coronal reconstruction Sagittal reconstruction Coronal oblique calcaneus (perpendicular to the subtalar joint) 13
Coronal oblique calcaneus (perpendicular to the subtalar joint) 3D view of the tendon 14