CT-guided interventions in orthopedics

Abstract

Purpose: In this study we present our experience with CT-guided interventions for musculoskeletal diseases. Technical details, advantages and disadvantages and the accuracy of the method are described.

Materials and methods: Between 2002 and 2005 we performed 77 CT-guided interventions on 72 patients (42 men, mean age 43.9 +/- 24.4 years, and 30 women, mean age 54.2 +/- 20.3) with (suspected) fracture, tumor or infection.

Results: Forty-one tumors, metastases or bone cysts, 17 infections, 12 bone alterations (e.g. osteoporosis, fracture) and 4 joints were diagnosed or treated. In three patients a tumor or an infection could be excluded. The duration of the procedure was 29.1 +/- 16.8 min. We did not see any intraoperative complication. However, the intervention had to be repeated in two patients, as the collected specimen was insufficient for histopathological evaluation in one patient, and in the other the nidus of osteoid osteoma persisted. The effective accuracy was 90.5%. Two patients were diagnosed first and then treated by screw osteosynthesis or corticoid steroid infiltration. One patient with an osteoid osteoma of the tibia fell and sustained a fracture of the tibial shaft.

Conclusion: CT-guidance can substantially support diagnostic and therapeutic procedures in bone and soft tissues, especially if located in deep areas of the body, which are difficult to reach using open approaches.