Multi-detector computed tomography (MDCT) using high-quality 2D formatting is highly recommended as the primary imaging technique for the evaluation of bone healing, according to a study done by radiologists at the Medical University of Vienna in Vienna, Austria.
Forty-three patients with histories of fractures, arthrodesis (joint fusion) or spinal fusions who'd undergone MDCT and conventional radiography for the evaluation of bone healing were included in this study. Mutiplanar reconstructions and radiographs were analyzed by two musculoskeletal radiologists in consensus interpretation to determine bone healing.
According to the results, no evidence of bone bridging was shown in 14 patients, 23 patients showed evidence of partial fusion, and six patients showed complete fusion. In 27 patients (63%), MDCT and digital radiography were concordant with regard to the extent of bone healing, while in 16 patients (37%) the results were not concordant. In eight patients digital radiographs underestimated the extent of bone healing, while in another eight patients they overestimated the degree of fusion. "Most cases were dealing with bonehealing after spondylodiscitis, fractures or arthrodesis," said Christian R. Krestan, MD, lead author of the study. "However no scientific data were available concerning the value of MDCT in bone healing compared to radiographs, which had been used for decades in this indication," said Krestan.
"The results of this study have a considerable impact on orthopedic patients and lead to a substantial improvement in patient care," said Krestan. "The exact diagnosis or exclusion of bone healing provides a basis for decisions like mobilization or immobilization and even repeated surgery in these patients," he said.
The study appears in the June issue of the American Journal of Roentgenology.
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