AHI PedCAT CASE STUDIES

CASE 1 -- TARSAL COALITION

Clinical History

25-year-old female who sustained an MVA 14 months ago injuring the right ankle, status post ORIF for bimalleolar fractures, complaining of persistent right ankle pain and reduced range of motion.

Plain Films

Case 1 Lateral XRay
Case 1 AP and Oblique XRays

Lateral, AP and Oblique views of the right ankle show orthopedic hardware and healed bimalleolar fractures. No tarsal coalition is demonstrated. The posteroinferior aspect of the sustentaculum tali appears somewhat prominent (arrows).

PedCAT Scan

Case 1 Lateral XRay
Case 1 AP and Oblique XRays

Sagittal and coronal sections from the PedCAT scan clearly demonstrate non-osseous talocalcaneal coalition involving the posterior subtalar joint, with irregularity of the articular surfaces, narrowing of the joint space, and subchondral sclerosis (arrows).

PedCAT Impact

The PedCAT scan quickly and easily estblished the diagnosis of talocalcaneal coalition, and outlined the type, size, location and extent of the coalition.

CASE 2 -- SUBTALAR ARTHRODESIS

Clinical History

65-year-old male status post subtalar arthrodesis one year ago, complaining of persistent right ankle pain.

Plain Films

Case 1 Lateral XRay
Case 1 AP and Oblique XRays

Lateral, Oblique and DP views of the right foot show a fracture in the more posterior screw through the posterior subtalar joint (arrow). The other screws appear intact. No bony fusion can be seen.

PedCAT Scan

Case 1 Lateral XRay
Case 1 AP and Oblique XRays

Sagittal and coronal sections from the PedCAT scan demonstrate additional fractures in the more anterior screw through the posterior subtalar joint (arrow), and in a calcaneal screw connected to a small lateral plate (double arrow). Bony fusion is also demonstrated in the lateral aspect of the subtalar arthrodesis (open arrow).

PedCAT Impact

The PedCAT scan quickly and easily estblished the lack of integrity of several harware components, and the presence and extent of bony fusion in the arthrodesis. The PedCAT scan can also assess for loosenin of the hardware.

CASE 3 -- MIDFOOT FRACTURES

Clinical History

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Plain Films

Case 1 Lateral XRay
Case 1 AP and Oblique XRays

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PedCAT Scan

Case 1 Lateral XRay
Case 1 AP and Oblique XRays

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PedCAT Impact

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CASE 4 -- SUBTALAR ARTHRODESIS

Clinical History

70-year-old male status post subtalar arthrodesis in the right foot one year ago, complaining of ongoing right foot pain.

Plain Films

Case 1 Lateral XRay
Case 1 AP and Oblique XRays

Lateral and Axial views of the right hindfoot show a fracture of one orthopedic screws. The plain films are indeterminate for bony fusion.

PedCAT Scan

Case 1 Lateral XRay
Case 1 AP and Oblique XRays

Sagittal and coronal sections from the PedCAT scan again show the fractured screw. The PedCAT scan demonstrates that there is no bony fusion of the arthrodesis.

PedCAT Impact

The PedCAT scan quickly and easily estblished the absence of bony fusion across the arthrodesis. The scan also accurately assessed the integrity of the hardware components.