Arm CT Scan (without contrast, both arms)

This is a CT scan of the arm — shoulder to fingertips, depending on what is being looked at — with no injected dye. It is usually ordered because a plain x-ray left a question open, most often whether a small bone is broken or how the pieces of a known fracture are actually sitting. The listing here is for the study performed on both arms.

This explanation has not been reviewed by a person yet.

What it is

An x-ray of the arm is a shadow: everything the beam passed through is stacked into one flat image, and small bones that overlap hide each other. A CT takes the same kind of beam and rotates it, producing cross-sections that can be stacked, resliced in any plane, and rendered in three dimensions. The practical consequence is that fractures a plain film cannot settle become plain. The scaphoid, a small bone at the base of the thumb, is the standard example — it can be broken and look nearly normal on an x-ray, and a CT is one of the ways that question gets answered. Without contrast means no dye was injected; bone shows up perfectly well on its own, and contrast is added only when blood vessels or soft-tissue inflammation are the question.

Why it is done

  • To confirm or exclude a fracture that an x-ray could not settle, in bones that overlap or are shielded by others
  • To map a complex break before surgery — how many fragments there are, where the joint surface is broken, and how far things have moved
  • To check whether a fracture has actually healed across, when x-rays are ambiguous
  • To look at metalwork already in place, and the bone around it
  • To characterize a lesion in the bone found on another test

What to expect

You lie on a table that slides through the ring of the scanner, with the arm positioned either above the head or alongside the body depending on what is being imaged. The scan itself takes seconds to a couple of minutes; holding still is the only requirement. With no contrast there is no preparation, no IV, nothing to fast for, and nothing to recover from — people drive themselves home. A radiologist reads the cross-sections and the reconstructed views and issues a report, usually within a day.

Questions worth asking

  • This code is the version without contrast. If dye ends up being given, the study becomes a different, more expensive code — will I be told before that decision is made?
  • If both arms are scanned in one session, is that one charge or two?
  • If this is being done before or after surgery by the same surgeon, does it fall inside a global surgical package or is it billed on its own?
  • An MRI can answer some of the same questions at a very different price. Was there a reason CT was chosen, and has the cost of each been compared?
  • If I already have outside images on a disc, will they be accepted, or is the plan to rescan?

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