WBCT and its evolving role in OA research and clinical practice

Abstract

ObjectiveAlthough radiography has traditionally been the most common means of imaging knee and ankle osteoarthritis (OA), the technology is limited in its abilities to accurately detect features of OA and provide accurate, sensitive, and responsive imaging biomarkers. More advanced modalities such as non-weight-bearing CT and MRI reveal additional details not well visualized on weight-bearing radiographs, such as 3D bone shape, subchondral cysts, and presence of meniscal extrusions. However, the clinical value of these imaging modalities is limited by the non-functional position during image acquisition. This mini-review examines the value added by WBCT and its evolving role in lower limb OA research and clinical practice. DesignNarrative mini-review. ResultsWeight-bearing computed tomography (WBCT) recently has been found to detect signs of OA that are commonly not as well visualized by other imaging modalities. Studies have shown that WBCT detects osteophytes, subchondral cysts and joint space narrowing more accurately than radiographs. The structural changes associated with assessment of functionally loaded knees and the 3D models provided by WBCT offer compelling insight into disease processes not easily discernable on other imaging modalities. Emerging evidence suggests that WBCT reveals meniscal extrusion not detected by MRI and that contrast enhancement—WBCT arthrography (WBCTa)— visualizes meniscal tears not seen on MRI. ConclusionsClinicians specializing in foot and ankle disorders have adopted WBCT as an imaging modality of choice and its value is becoming recognized for evaluation of other lower limb joints as well.