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Melbourne Radiology Clinic

Mar 30th
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CT Spine

CT of the lumbar spine is an excellent method of evaluating the patient with back pain.

With a state of the art modern multi-slice CT scanner, fine slices are taken as the patient enters the scanner.  The images are then produced and can be reconstructed from any angle, without having to scan the patient again.  As such, an accurate diagnosis may be confidently made.

Further to this, the images may be rendered to produce a 3-D effect.

Common conditions include disc bulges, which compresses a nerve.  This commonly results in leg pain, a condition often referred to as “sciatica”.

If the pain does not respond to physiotherapy and medications, then a CT guided nerve root injection, delivering a small dose of cortisone may be of benefit.





Of course, an MRI may also be used to evaluate back pain, which has the advantage over CT in that it well demonstrates the nerves in the spinal canal (MRI image 7).  In this case, the patient has a developmental defect which results in forward slipping of the L5 vertebral body (“spondylolisthesis") and therefore disruption of the disc.  The condition may result in both localised back and leg pain.

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CT Arthrogram ACL Tear

A CT arthrogram may be used in place of an MRI scan, for example when a patient cannot undergo an MRI because they have a pacemaker, cochlear implant or brain aneurysm clip.

The procedure involves an injection of dye (contrast) into the knee in order to provide the soft definition and contrast to reliably diagnose the common disorders affecting the knee.  In this case, note the dye extending across the knee (image 1), consistent with an absent anterior cruciate ligament (ACL) and thus the diagnosis of an ACL tear.

The posterior cruciate ligament (PCL) is intact (image 2).

The ACL tear is associated with a vertical tear through the medial meniscus, which is highlighted by the contrast dye (image 3) as well as a Baker’s cyst (image 4) which has formed from increased fluid in the joint.

Note a normal appearing lateral meniscus, which demonstrates a triangular appearance (image 5).

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CT Urology

MEDICAL DISCLAIMER The Melbourne Radiology Clinic web site is not intended as a substitute for your own independent health professional's advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider within your country or place of residency with any questions you may have regarding a medical condition. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second medical opinion.