Preoperative nerve imaging using computed tomography in patients with heterotopic ossification of the elbow

Journal of Shoulder and Elbow Surgery
Daniel R BachmanShawn W O'Driscoll

Abstract

This study evaluated the usefulness of computed tomography (CT) imaging for preoperative planning of heterotopic ossification (HO) excision, specifically the spatial relationship between HO and radial and median nerves. Our hypotheses were that CT imaging of the elbow can be used (1) to trace the paths of the radial and median nerves, (2) to distinguish the nerves from the heterotopic bone, and (3) to precisely measure distances from the respective nerve to the most clinically relevant HO. Patients who had HO removed from the elbow were reviewed retrospectively. On the basis of preoperative CT scans, 22 were identified as likely having HO along the pathway of the radial or median nerve. These cases were independently evaluated by 4 observers, who answered these questions: (1) Can the location of the nerve be adequately seen on sequential images to permit tracing of its path for surgical planning? (2) Can the nerve be distinguished from the HO accurately enough to permit measurement of its distance from the bone? Each observer also measured the shortest distance between nerves and the HO. Overall utility of the CT images for visualizing the nerves was high. The radial nerve was more readily distinguished from the HO (21 of 22 ca...Continue Reading

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Citations

Sep 1, 2016·The British Journal of Radiology·Nawaraj SubediSyed I Ali
Nov 21, 2020·Bone & Joint Open·Ziyang SunCunyi Fan

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