Use of CT-arthrography and ultrasound in ACL surgery during Operation Enduring Freedom in Afghanistan: a case report and practice recommendations.
The availability of magnetic resonance imaging is severely limited in a deployed environment. However, advanced imaging for diagnosis and treatment of musculoskeletal soft-tissue injuries in theater does exist. Computed tomography (CT), arthrography, and ultrasound are readily available at Role 2 and 3 Medical Treatment Facilities in Afghanistan in support of Operation Enduring Freedom. In this report, we describe a case using CT arthrogram and ultrasound to assist with the diagnosis, treatment, and follow-up of an anterior cruciate ligament reconstruction surgery performed at a Role 2E hospital at Camp Arena, Herat, Afghanistan on a coalition soldier. All physicians who treat musculoskeletal injuries in theater should be familiar with the musculoskeletal applications of ultrasound and CT arthrography. Finally, treatment of the local population and coalition soldiers who do not have access to magnetic resonance imaging will be improved with the knowledge and use of existing advanced imaging in a deployed and austere setting.
Task Force 14th Combat Support Hospital Regional Command-West, Spanish Military Hospital (Role IIE), Camp Arena, Herat, Afghanistan APO AE 09382.
Patrick
P
Davis
Task Force 14th Combat Support Hospital Regional Command-West, Spanish Military Hospital (Role IIE), Camp Arena, Herat, Afghanistan APO AE 09382.
Justin J
JJ
Stewart
Task Force 14th Combat Support Hospital Regional Command-West, Spanish Military Hospital (Role IIE), Camp Arena, Herat, Afghanistan APO AE 09382.
Nancy G
NG
Hoover
Task Force 14th Combat Support Hospital Regional Command-West, Spanish Military Hospital (Role IIE), Camp Arena, Herat, Afghanistan APO AE 09382.
Billie J
BJ
Matthews
Hughston Sports Medicine Clinic, 6262 Veterans Pkwy, Columbus, GA 31909.
Douglas W
DW
Pahl
Task Force 14th Combat Support Hospital Regional Command-West, Spanish Military Hospital (Role IIE), Camp Arena, Herat, Afghanistan APO AE 09382.
John A
JA
Bojescul
D000328:Adult; D055826:Afghan Campaign 2001-; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D001175:Arthrography; D006772:Hospitals, Military; D006801:Humans; D008297:Male; D008889:Military Personnel; D014056:Tomography, X-Ray; D014463:Ultrasonography; D014481:United States