Postoperative imaging of the musculoskeletal system : Clinical aspects

Abstract

Postoperative imaging in trauma surgery is an essential part of documenting optimal osteosynthetic care. Aprecise and goal-oriented analysis with ajustifiable indication is essential. The clinical information has agreat impact on the quality of imaging. An objective evaluation and structured reporting complete the postoperative imaging procedure. Conventional x‑rays in two planes is the standard of postoperative imaging in musculoskeletal surgery. In specific anatomic structures, additional images may be necessary. The postoperative x‑ray is the simplest way to visualize asuccessful osteosynthesis and combines the most important points of postoperative management. Computed tomography (CT) is mostly used in emergencies, but also in the postoperative management of some elective procedures, including patients with surgery of the spine, hip or to the proximal long bones of the extremities. Furthermore, CT is useful in postoperative imaging of complicated ankle fractures. Magnetic resonance imaging (MRI) plays amodest role in postoperative imaging and is mostly used in musculoskeletal cancer surgery. Ultrasound rather plays asubordinated role in postoperative management, but it is increasingly becoming established as atool for postoperative quality control. The great advantage is dynamic visualization in real time. Postoperative imaging remains challenging, but can detect most issues regarding osteosynthesis, which can be then be treated or monitored. Various imaging modalities are available to make reliable statements on osteosynthetic material, bone and soft tissue.