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Modern computed tomography is a non-invasive technique for obtaining information about the structure of the human skeleton, upper and lower limbs, as well as internal organs without violating the integrity of the skin. At the same time, the method makes it possible to obtain three-dimensional images with the exact localization of injuries or diseases. This procedure is more effective and safer than radiography, which is based on x-rays, just like computed tomography. In addition, modern tomography uses tomographs of a new generation of multispiral type, which level the radiation exposure almost completely without compromising the quality of the diagnostics.
Features of ankle injuries
When traumatizing the bone tissue of the ankle joints, specialists observe a high frequency of damage inside the joints. The course and therapy of various diseases in this area significantly aggravate the destruction of articular cartilage or subchondral plates. The ineffectiveness of traditional methods of treating such fractures reaches 28% of the total number of such cases.
The same situation is observed by doctors in the event of fractures in the foot area. The most complex and severe in this area are injuries to the talus and calcaneus. Most often, the result of traditional conservative treatment of such fractures is an unsatisfactory result. Thus, 75% of cases of calcaneal fractures are accompanied by involvement of the subtalar joint. Of these, in 80% of cases, displacement of bone fragments occurs, which leads to a violation or mismatch of the congruence of joint surfaces, early degenerative changes, delayed pain attacks and, as a result, disability. That is why, taking into account the fact that most cases of fractures in the ankle area occur in people of working age, a detailed X-ray examination of these pathologies becomes simply necessary.
Computed tomography of the ankle joint allows you to diagnose damage or pathology of this area of the human body. This is very important because ankle injuries in all seasons and in all age groups are the most common, according to orthopedists. This diagnostic allows you to perfectly distinguish even the smallest bones and joints on the feet of a person, which makes it possible to make an accurate diagnosis, as well as competent and high-quality therapy for the problem that has arisen. Computed tomography in most cases does not replace radiography, but supplements it with clarifying data for prescribing the appropriate treatment for the problem.
Preparation and procedure
In order to undergo a computed tomography of the ankle, the patient does not need to specially prepare. To conduct an examination, the specialist needs to show all the results of previous procedures, such as radiography, ultrasound, magnetic resonance imaging or a similar procedure previously performed, so that it is possible to trace the dynamic development and determine the necessary treatment regimen.
Carrying out this type of diagnosis is safe and painless, the patient does not feel any discomfort during the examination. Before starting the examination, it is mandatory to remove all items containing metal, such as jewelry, glasses, or a hearing aid, from yourself.
During the direct passage of computed tomography, the patient lies on the tomography table in a horizontal position, and his legs are located in the annular compartment of the tomograph. When scanning, the ring will rotate around the table, and the table itself will slowly move in a horizontal direction. During this procedure, there is no medical staff in the room. Specialists monitor the progress of tomography through X-ray-proof glass from another room. The patient will have a system for alerting the doctor about any problems in case they occur. The procedure is performed with the patient completely immobile. The time of computed tomography of the ankle joint is usually about 5 minutes.
Indications and contraindications for the study
The main medical indications for a CT scan of the ankle are:
- various injuries of the area – fractures, dislocations, bone fractures;
- foot tumors that occur both in the case of a primary symptom and as secondary (metastatic) consequences in oncology of other organs of the body;
- bone tuberculosis, osteomyelitis and other purulent-destructive diseases of the feet;
- any joint diseases, including arthritis or arthrosis;
- osteochondropathy;
- the need to clarify indicators after other diagnostics;
- the need for surgical intervention in the ankle region to clarify its volume;
- the need to confirm the effectiveness of the operation and the absence of complications.
Computed tomography has some contraindications. For example, it is categorically impossible to conduct a study during pregnancy, since even the minimum dose of radiation exposure can become critical for the unborn child. Among the relative contraindications, doctors call various neurotic conditions of the patient, for example, hyperkinesis, which is characterized by twitching of the limbs and involuntary movements. You should also pay attention to the fact that tomographs have restrictions on the weight of patients, so it is often not possible for overweight people to make a CT scan.
Breastfeeding women should not perform computed tomography using contrast enhancement, since the drug used in this case is able to penetrate into milk, which can adversely affect the health of the child. If a woman needs to do a computed tomography using a contrast agent, she should stop breastfeeding for a day or two after the procedure, so that the contrast agent is completely removed from her body. Also, contrast tomography is contraindicated in people with a diagnosed allergy to iodine, which forms the basis of contrast agents. In coma, shock or somatic decompensated pathologies, contrasting cannot be performed due to the possible deterioration of the patient’s condition as a result of such studies.
The kidneys play a major role in the excretion of contrast. In severe renal failure, computed tomography with contrast is also impossible.
In order to avoid complications during the procedure in the presence of chronic diseases or ligatures, metal implants or braces in the leg, it is important to inform the specialist about them in advance.
Features of diagnostics using computed tomography
Diagnostic examination of the ankle using computed tomography can be performed without health risks. Despite the presence of X-rays, the body experiences minimal amounts of radiation exposure, which cannot adversely affect it. However, it is not recommended to carry out such procedures too often, especially daily.
When diagnosing and treating problems with the ankle joints, doctors often need data not only from computed tomography, but also from magnetic resonance imaging. This is due to the fact that magnetic resonance imaging provides the results of the condition of the soft tissues of the ankle, and computed tomography – bones and joints. At the same time, it may be important for the patient that computed tomography is several times cheaper in cost than magnetic resonance imaging.
When examining children, experts do not recommend diagnosing using x-rays. Even minimal doses of such an effect on a growing organism can adversely affect its further growth and development. That is why, without special needs, computed tomography of the ankle joints for children under 14 years of age is not desirable.
As already mentioned, when conducting this diagnosis, it is sometimes necessary to use a contrast agent. This becomes necessary in cases where the affected areas are poorly visualized during the usual procedure. Most often, specialists use iodine-based contrast agents. They are safe and completely eliminated from the human body a day after administration.
Computed tomography of the ankle joint with the use of contrast agents boils down to the fact that intravenously injected contrast through the blood vessels enters the affected area and makes it visually clearer and more readable for a specialist. With household and other injuries of the ankle joint, this technique is practically not used. Its main purpose is to identify tumor processes in a given area of the body.
In case of foot or ankle injuries, it is very important to determine the damage picture in a timely and accurate manner in order to prescribe a highly effective treatment. In the near future, not a single case of the occurrence of such pathologies will do without computed tomography of the ankle joint, since it is this type of diagnosis that allows you to accurately visualize the problem, take measures to eliminate it by prescribing appropriate therapy.