What is the role of CT scanning in septic arthritis (SA) imaging?

Updated: Sep 19, 2019
  • Author: Lourdes Nunez-Atahualpa, MD; Chief Editor: Felix S Chew, MD, MBA, MEd  more...
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Although not commonly used for the evaluation of joint infections, CT scanning can be accurate in the evaluation of septic arthritis. [40, 41]  It is very helpful when evaluating the sternoclavicular joint and the sacroiliac joint, which may be difficult to evaluate using plain films. CT scanning can depict early findings in septic arthritis, such as synovial thickening or joint effusion. Periarticular abscesses or fluid collections can also be identified. [40]

CT findings are otherwise similar to those on plain radiographs and include joint effusion, joint-space narrowing, bone and cartilage erosions, gas within the joint, and soft tissue swelling.

Moreover, real-time CT scanning can be used to guide joint aspirations in uncommon or difficult sites such as the sacroiliac or sternoclavicular joints.

Some authors have reported that the sensitivity of CT is similar to that of MRI. However, joint aspiration should be performed in all cases of suspected septic arthritis, and it is the primary means of diagnosis.

Although associated findings of osteomyelitis or soft tissue abscess increase the specificity of CT, distinguishing septic arthritis from other diseases in the differential diagnosis may be difficult.

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