You know the situation - the patient is supposed to have an elbow CT but is seriously limited in movement, has severe pain and/or cannot extend the arm as usual. Lying on the stomach with the arm forward, like Superman, is just not possible. So what can be done to be able to perform the examination with a high image quality despite these challenging circumstances?
One possible alternative looks as follows:
The patient is placed on his back slightly raising the side which is to be examined and the elbow resting on the abdomen.
It is important here that a cushion is positioned between the arm and the upper body/abdomen, as otherwise strong artifacts will occur during the acquisition. Afterwards, it is advisable to fix the arm to prevent any possible slipping or unwanted movement of the arm during the examination and to achieve a desirable image quality.
In this positioning example (Fig. 1 and 2), different PearlFit Cushions and the ProBelt System are used to position the patient stably and comfortably at the same time. For the vast majority of patients, this alternative in the supine position is tolerable and the exam can be performed with little or no pain.
protocol Optimization
Depending on the patient's size and weight, it may be necessary to move the table down to adjust the elbow to the center of the scan. It is also recommended to move the elbow slightly to the center of the table, otherwise it will be outside the field of view and may not be displayed correctly.
The standard CT shoulder protocol can be used for the examination. Here, a larger field of view and a higher voltage are usually applied. In addition, it is recommended to perform the examination in respiratory arrest to avoid motion artifacts. This setting often has to be activated in the scan protocol additionally. Radiation protection can and should be applied to this method without any problems, for example with a wrap-around apron (Fig. 2).
Subsequently, reconstructions of the elbow must be made. These should definitely include coronary reconstructions of the upper arm and forearm.
With this alternative positioning approach considering some simple measures, elbow examinations can be performed without problems even in patients with limited mobility.
Credits to: Dorina Petersen for providing this content https://www.dorina-petersen.de
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About PEARL TECHNOLOGY
Pearl Technology AG, based in Schlieren, offers innovative solutions for the placement, positioning and immobilization of patients in radiology and radiotherapy. The products are manufactured in Switzerland according to ISO norm 13485 and are characterized by simple handling, high patient comfort and excellent hygiene which guarantees smooth and safe examination processes.
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