General Guideline Principles for Computerized
Tomography for workers compensation patients
The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Computerised Tomography.
These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.
The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.
While MRI is superior for soft tissue anomalies, computerised tomography is still a crucial imaging technique, especially for bone anatomy. When sophisticated bone imaging is necessary for elbow joint problems, CT may be helpful.
After severe dislocations or recurring dislocations linked to arthroplasty, CT may be useful for evaluating AVN. Patients who cannot undergo MRI due to contraindications (usually an implanted metallic-ferrous equipment) may also benefit from a CT scan.
Routine CT for Evaluating Acute, Subacute, Chronic Elbow Pain
Routine CT for Evaluating Acute, Subacute, Chronic Elbow Pain are not recommended to determine whether elbow discomfort is acute, subacute, or persistent.
CT for Evaluating Patients with Osteonecrosis (AVN)
CT for Evaluating Patients with Osteonecrosis (AVN) are recommended – to assess patients with osteonecrosis, after severe dislocations or repeated dislocations brought on by arthroplasty, or for patients who require advanced imaging but cannot undergo MRI.
Indications – Patients with elbow osteonecrosis who have elevated polyostotic bone metabolism and a suspicion of subchondral fracture(s). Patients should have a contraindication for MRI because it is typically preferred.
Patients with traumatic elbow dislocations, especially those with fragments of capitular or trochlear fractures.
Helical CT for Select Acute, Subacute, or Chronic Elbow Pain
Helical CT for Select Acute, Subacute, or Chronic Elbow Pain are recommended for specific individuals with acute, subacute, or chronic elbow pain in whom enhanced imaging of bone structures is believed to be potentially beneficial, and for patients who require advanced imaging but have medical conditions that preclude MRI.
Indications – Patients who require advanced bony structure imaging and have acute, subacute, or chronic elbow discomfort. Candidates can include patients who require sophisticated imaging but cannot undergo MRI due to, for example, implanted hardware.
Rationale for Recommendations – The use of computerised tomography preferred to MRI for imaging the majority of abnormalities in the elbow when calcified structures demand sophisticated imaging.
CT helical is considered to be more effective than MRI for assessing subchondral fractures, but no conclusive research has been recorded.
What our office can do if you have workers compensation injury
We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.
We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.
We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.