Although MR imaging has become the dominant modality for cross-sectional musculoskeletal imaging, the widespread availability, speed, and versatility of CT continue to make it a mainstay of emergency room (ER) diagnostic imaging. When plain films are unable to provide sufficient information regarding cases of skeletal trauma or musculoskeletal infection, CT can often delineate additional findings that lead to correct patient diagnosis and triage.
When musculoskeletal CT is indicated in the ER setting, the use of spiral acquisition provides several specific advantages, including extremely rapid data acquisition; optimization of contrast delivery (when appropriate); and minimization of respiratory misregistration. This article reviews the applications of musculoskeletal spiral CT most often encountered in the ER setting, including skeletal trauma and musculoskeletal infection or inflammatory disease. The role of multiplanar (MPR) reconstruction and three-dimensional imaging are discussed.
