title: Titanium plate artefact mimicking popliteal artery dissection on digital subtraction CT angiography.
abstract: Titanium plates used for the internal fixation of long bone fractures cause significant artefact on CT scans but have not been reported to affect digital subtraction CT angiography. We present a patient with clinical suspicion of popliteal artery injury following a high tibial osteotomy. The osteotomy was stabilised with a titanium locking plate. During the digital subtraction process used to produce reconstruction CT angiography, removal of artefact caused by the titanium plate produced CT images mimicking the appearance of a popliteal artery dissection. The imaging inaccuracy was realised prior to the patient undergoing further intervention. We highlight the potential error caused by titanium plates on digital subtraction CT angiography and recommend careful analysis of such images prior to further treatment.
authors.affiliation: Department of Trauma and Orthopaedics, Royal Devon and Exeter Hospital, Exeter, Devon, UK. timwoodacre@yahoo.co.uk
authors.forename: Timothy
authors.initials: T
authors.lastname: Woodacre
authors.forename: Sophie
authors.initials: S
authors.lastname: Wienand-Barnett
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging; D015901:Angiography, Digital Subtraction; D016477:Artifacts; D001860:Bone Plates; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D020370:Osteoarthritis, Knee / Q000601:surgery; D010027:Osteotomy; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery; D014025:Titanium; D014057:Tomography, X-Ray Computed
chemical_list: D014025:Titanium
references.citation: AJNR Am J Neuroradiol. 2006 Jan;27(1):60-6
references.pmid: 16418357
references.citation: Radiology. 2012 Feb;262(2):605-12
references.pmid: 22143927
references.citation: Eur Radiol. 2012 Jun;22(6):1331-40
references.pmid: 22307814
references.citation: Int Orthop. 2010 Feb;34(2):255-61
references.pmid: 19547973
references.citation: J Bone Joint Surg Br. 1995 May;77(3):384-6
references.pmid: 7744920
references.citation: J Bone Joint Surg Br. 1986 May;68(3):471-5
references.pmid: 3733817
references.citation: Br J Anaesth. 2009 Jan;102(1):3-11
references.pmid: 19022795
references.citation: Rofo. 1997 Nov;167(5):448-52
references.pmid: 9440888