Brown Protocol

Patient supine on the table.  Scan 3 x 3 slice thickness and index.  Scan the entire pelvis from above the crest to below the symphsis. Be sure to include the entire bony structure of the pelvis.  This will probably be around 100 slices.  No tube angle and use a pitch 1.5.

The field view needs to be larger than the length of the pelvis.  For example, 90 slices are completed.  Multiply the number of slices by the slice thickness (3 mm).  This equals 270 mm, therefore use a field larger than 270 mm or 27 cm.  So for this scan, use a field 280 mm or larger.  Use a full field and standard algorithm.

After exam is complete, move the image to the voxel workstation so images can be performed.  It is possible to be asked to perform 3D reconstructions and tag the femoral heads off the pelvis.

Miller Protocol

The patient is placed feet first on the CT scanner.  The foot can be in the head holder or positioned flat on the table.  The knee of the patient is bent at a 45-degree angle.  If the patient can bend the uneffected leg, position this leg across the table and behind the foot that will be scanned.  Obtain a pilot in both the AP and lateral plane.  Use the lateral pilot to program the scanner for the axial images which should be obtained using a spiral Acq.  The radiologist will provide the starting and ending locations when the protocol for the procedure is done.  Use a spiral joint protocol and perform multiple acquisitions.  As many as seven acquisitions may be necessary depending on the area of interest.  Scan using 2 x 2 collimation and index and a bone algorithm.  For better detail, process the spiral data in 1 mm increments. However, 2 mm slices are the normal index and thickness of the x-ray beam.  Upon completion, film the images in a bone window and send the data to the voxel workstation to do the MPR reformations.

The tube should be angled perpendicular to the sole of the foot.  Be careful not to angle to the point where the patient's knee is running into the gantry cover or the back pressure plate, shutting down the Gantry.

Tibial Plateau Fracture CT Protocol

The routine CT examination for evaluation of tibial plateau fractures should be performed as follows:

Spiral images should be performed from a level just proximal to the articular surface of the tibia and completely through any depression in the articular surface.  Additional images with a collimation of 5 mm may be necessary to completely image plateau fractures that extend longitudinally into the tibial metaphysis or shaft.