Musculoskeletal Computed Tomography Imaging: A 30-Year Perspective.

ABSTRACT: Computed tomography remains essential in musculoskeletal imaging, offering superior spatial resolution and contrast for detailed assessment of bone anatomy and fractures, as well as for evaluation in the pre- and postoperative settings. Decades of technological progress-from helical to advanced high-resolution, dose-efficient systems-have reinforced the central role of computed tomography in bone imaging.

ABSTRACT: Expanding beyond static skeletal assessment, spectral computed tomography enables characterization of crystal deposits, marrow edema, and metal artifact reduction; weight-bearing cone-beam computed tomography assesses joint alignment; computed tomography arthrography offers a radiation-based alternative to magnetic resonance imaging to assess internal joint disorders; and dynamic computed tomography provides insight into joint motion.

ABSTRACT: Emerging technologies such as photon-counting computed tomography promise unprecedented spatial and spectral performance with reduced dose. Synthetic computed tomography derived from magnetic resonance imaging data integrates osseous detail without radiation exposure.

ABSTRACT: This 30-year perspective reviews major technological advances, highlights current clinical applications, and explores future directions shaping the role of computed tomography in musculoskeletal imaging.