Musculoskeletal imaging with computed tomography and magnetic resonance imaging: when is computed tomography the study of choice?

Indications for computed tomography (CT) of the musculoskeletal system, especially with the advent of 16-slice multidetector CT (MDCT), are numerous. In addition to the evaluation of the trauma patient where CT is essential when imaging complex skeletal injuries, MDCT is particularly useful in patients who have had prior surgery. In postoperative cases, metal artifact typically prohibits magnetic resonance imaging evaluation, but volume-rendering of a MDCT axial database virtually eliminates streak artifact associated with hardware. For the evaluation of masses, CT provides the ability to detect and characterize calcification, cortical disruption, and periosteal reaction. In this article, these and other indications for performance of CT of the musculoskeletal system will be discussed.