Leg CT Scan (without contrast, both legs)

Before a surgeon fixes a badly broken heel, ankle, or shin, they need to know how many pieces there are and how the joint surface has been driven apart — which an x-ray cannot show. This CT of the leg, done without injected dye, is the study that produces that map. The listing here covers the scan performed on both legs.

This explanation has not been reviewed by a person yet.

What it is

Some fractures are a line; others are a demolition. When someone lands from a height on their heels, the heel bone does not simply crack — it is compressed, widened, and split into fragments, with the joint surface above it pushed out of shape. A plain x-ray shows that something bad has happened without showing what. CT scans the region in thin cross-sections which can be reassembled into any plane and into a three-dimensional model, so the number of fragments, the step in the joint surface, and the direction each piece has moved can all be measured. That is the information a surgical plan is built on. No contrast is needed, because bone is naturally dense enough to stand out against everything around it.

Why it is done

  • To plan the surgical repair of a complex fracture of the heel, ankle, shin, or knee region, where the shape of the joint surface decides the approach
  • To detect a fracture that an x-ray suggested but did not prove
  • To assess whether a break has united, particularly where healing has been slow
  • To check the position of plates, screws, or a joint replacement, and the bone holding them
  • To evaluate a suspected bone infection or a lesion seen on another study

What to expect

You lie on the table and go into the scanner feet first, with the legs positioned and often strapped or padded to keep them still. Scanning takes seconds to a few minutes. There is no preparation for a study without contrast — no fasting, no IV, no sedation — and nothing afterward beyond getting up. A recently injured leg may be uncomfortable to position, and splints or casts generally stay on, since they do not block the scan the way they would block an x-ray view. The radiologist's report usually describes the fragments and the joint surface in the terms the surgeon needs.

Questions worth asking

  • Three-dimensional reconstructions are sometimes billed as an additional charge on top of the scan. Will they be, and were they requested?
  • If both legs are scanned, does the bill show one study or two?
  • Was this ordered by the surgeon for planning? If so, ask whether it is covered by the surgical global fee or invoiced separately.
  • A hospital radiology department and a freestanding imaging center often price the identical scan very differently. Is there a choice here, and will the surgeon accept images from either?
  • If I am transferred between hospitals for the surgery, will the second hospital rescan, and can that be avoided by sending the images?

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