From the Research
For a patient who underwent ORIF for a femur fracture with large incisions on both lateral and medial sides of the knee, I would recommend ordering a CT scan of the knee rather than the upper leg to assess poor wound healing. The knee is the most appropriate anatomical region to specify since the incisions are located on the lateral and medial aspects of the knee joint. While the femur is technically part of the upper leg, the surgical approach for distal femur ORIF typically involves knee incisions, and the healing concerns are focused at the knee joint area. Specifying a knee CT will ensure proper imaging coverage of both incisions and the surrounding soft tissues where poor healing is occurring. This will allow for better assessment of potential complications such as infection, hematoma, or dehiscence that may be affecting wound healing. The radiologist will be able to better focus on the relevant anatomy with this more precise designation, as studies have shown that CT scans can provide more accurate and clinically relevant data compared to plain radiographs 1. Additionally, CT scans have been found to be beneficial in evaluating knee arthritis and arthroplasty, and can help identify complications such as infection or hematoma 1. It is worth noting that other imaging modalities, such as ultrasound, may also be useful in evaluating certain pathologic conditions of the knee, but CT scans are generally more suitable for assessing bone and soft tissue anatomy 2. Overall, ordering a CT scan of the knee is the most appropriate choice for assessing poor wound healing in this patient. Key points to consider when ordering the CT scan include:
- Specifying the knee as the anatomical region of interest
- Ensuring proper imaging coverage of both incisions and surrounding soft tissues
- Allowing the radiologist to focus on the relevant anatomy
- Considering the potential benefits of CT scans in evaluating knee complications, as supported by studies such as 1 and 3.