ISO 13485 Certified | ISO9001 Certified Request more information or an in-office demo (267) 483-8081

Weight Bearing CT Helps Monroeville Orthopedic Surgeon Assess Ballet Dancers Standing En Pointe

As a soloist for the Pittsburgh Ballet Theater, dancer Diana Yohe, 25, has sprained her ankle several times – enough times that she had to have a ligament reconstruction surgery on her left ankle.

Throughout her recovery, her surgeon ordered X-Ray exams to track the progress of her healing. Yet Yohe worried she might not be ready for her upcoming lead role in Giselle.

Shortly before opening night, Dr. Victor Prisk, MD, ordered a state-of-the-art standing CT exam. Yohe stood en pointe during the scan.

“I could literally see the bones, the ligaments and even the skin,” Yohe said. “Prior to surgery my ankle was badly skewed. But on the CT scan, I could see it was back to perfect alignment.”

image_DKaQfnpDr. Prisk specializes in foot & ankle sports and dance medicine. He recently added weight bearing CT technology to Prisk Orthopedics and Wellness, PC, his private practice in Monroeville, PA. During a weight bearing CT scan, a patient stands naturally while the X-Ray tube and detector rotates 360-degrees around their feet & ankles. The X-Rays are then processed to produce a three-dimensional image of the patient’s foot.

CT imaging is more sensitive than 2D X-Rays in detecting fractures, fracture healing, and other conditions. However, traditional CT technology typically requires much more infrastructure than the average orthopedic clinic can accommodate and exposes the patient to a higher radiation dose than 2D X-Ray. In addition, foot & ankle specialists require a standing or “weight bearing” view of the foot and ankle for most conditions. In traditional CT imaging, the patient is lying down.

Dr. Prisk’s weight bearing CT scanner fits in his clinic’s X-ray room, and peer reviewed research demonstrates the scanner’s radiation dose is comparable to an X-Ray exam.

“I invested in this technology because I knew it would be a game changer in how I look at the foot & ankle from a 3D perspective; it literally adds another dimension,” Dr. Prisk said. “It allows me to critically assess deformities like never before.”

Dr. Prisk offers a pedCAT exam for every patient during their initial visit.

“The pedCAT allows me to get all X-Ray views for a new patient in less than 45 seconds, and is higher quality than standard X-Ray imaging,” Dr. Prisk said.

Several of Prisk’s patients are ballet dancers. With the pedCAT, he can get a 3D X-Ray while the dancer is standing en pointe.

“Scanning a foot en pointe allows to me see mal-alignments that could be resulting from an intrinsic foot problem or even from ballet technique,” Prisk said. He added there have been cases where he was able to determine the ballet dancer was wearing ill-fitting pointe shoes, as the toe box was either too large or too small.

Dr. Prisk, a former professional dancer himself, sprained his ankle during a gymnastics practice when he was 15 years old. The injury inspired him to become an orthopedic surgeon.

“My dance career taught me how prevalent foot & ankle injuries were for these athletes, and I wanted to help this particular population,” Dr. Prisk said. “Perhaps back then, if pedCAT technology were available, I would have known if my own ankle was displaced.”

Yohe is back to dancing five days a week. She said her first performance of Giselle went really well.

International WBCT Society Announces Book Release

The first textbook on weight bearing CT imaging, written by the board of the International WBCT Society, will be released in February 2020. The textbook is a scientific, technical and clinical guide to Weight Bearing Cone Beam Computed Tomography (WBCT), presenting all of the relevant content to date on the development, implementation, interpretation and clinical application of WBCT for the foot and ankle.

Pre-order the hardcover text from Springer here.

978-3-030-31948-9_Cover_PrintPDF indd

“At the beginning of 2019, the board of the society discussed how to further spread the knowledge of WBCT,” said Prof. Dr. Martinus Richter, past president of the International WBCT Society. “In contrast to standard textbooks, the scientific content is emphasized and placed at the beginning to reflect the initial scientific approach of WBCT ISG and International WBCT Society.

“We wish that this book serves all current and upcoming users of WBCT in foot and ankle to answer all scientific and technical questions, to educate and instruct the clinical use including measurements.”

Weight Bearing Cone Beam Computed Tomography (WBCT) in the Foot and Ankle: A Scientific, Technical and Clinical Guide is separated into three informative sections.

  • Part One describes the history of, development of, and need for WBCT as an imaging option, and features a scientific overview of the procedure.
  • Part Two is an exhaustive scientific background comprised of 16 landmark studies, describing its advantages for selected foot and ankle injuries and deformities (both congenital and acquired).
  • Part Three uses this science as context, and includes chapters that:
    • Explain the technical aspects and necessary background for WBCT
    • Introduce the different devices used for WBCT
    • Provide insight into the actual measurement possibilities, including the initial software solutions for automatic measurements
    • Feature current clinical applications via case material illustrated in an atlas-like fashion
    • Explore future developments and further applications of WBCT, such as dynamic scans and measurements or hologram-like visualization

“In the early stages of the scientific work-up in different institutions, different methodologies, especially for angle measurements, were inaugurated. No standard for the methodology for the image acquisition and measurement was defined, and different methods have been published,” Dr. Richter explained.

“Since then, the society is further growing and the member number as well as the number of Pubmed-listed publications by members will both reach 100 by the end of 2019.  The International WBCT Society can be considered as one of the most scientifically active societies,” Dr. Richter said.

Weight Bearing Cone Beam Computed Tomography (WBCT) in the Foot and Ankle will be available online and in stores beginning February 2020, providing an excellent resource for orthopedic and foot and ankle surgeons, radiologists, and allied medical professionals working in this clinical area.