Healthcare News & Insights

Differentiators to prioritize when evaluating extremity imaging systems

In today’s ever-changing healthcare landscape, technology is at the crux of clinician success and patient satisfaction. In this guest post, Jeremy Cook, DPM, MPH, assistant professor of surgery at Harvard Medical School and the director of quality and safety, division of podiatric surgery at Mount Auburn Hospital, offers technological innovations and breakthroughs that have enhanced the effectiveness and performance of orthopedic procedures, and have helped to improve patient outcomes, satisfaction and most importantly, safety.


In musculoskeletal surgery, extremity imaging equipment has become essential. As a result, purchasing decisions, and system features and functionality can greatly impact both the clinician and patient experience. As a foot and ankle surgeon, I’ve dealt with a wide variety of patient cases and have had the opportunity to utilize a range of extremity imaging systems, from CT and MRI to C-arm systems large and small. With new technological advancements being introduced more rapidly than ever, it can be daunting for decision makers to understand which system features to prioritize when researching and selecting equipment. There are several differentiators they should focus on to ensure they’re making the right decision for their providers, facility and patients.

Various imaging systems have become indispensable to professionals in the musculoskeletal field. Regarding foot and ankle cases, C-arm systems have become the de facto standard for these procedures, providing crucial fluoroscopic intraoperative imaging, delivering real-time, high-quality X-ray images and helping surgeons evaluate and make necessary adjustments immediately.

Not created equal

While this technology has numerous benefits, not all C-arm systems are created equal. Larger C-arm systems are designed for cases requiring a large field of view. However, due to the size of these systems, they can take up valuable real estate in the operating room. Large C-arms can also suffer from a restricted range of motion and arc angulation, forcing surgeons to awkwardly move and position the patient. In recent years, surgeons have turned to more compact and fluid mini C-arm systems, which allow them to seamlessly orient imaging around a patient, delivering varied imaging angles while ensuring accurate imaging.

Some mini C-arm systems feature a large field of view and rotating flat detector, which help improve workflow and ultimately, patient outcomes. When evaluating C-arm systems, clinicians and decision makers should prioritize field of view, flexibility and range of motion to ensure efficiency and procedural success.

For CT and MRI equipment, resolution has exponentially improved recently and high-quality imaging has essentially become the norm throughout the industry. As a result, medical providers and decision makers should focus on other factors that can help differentiate between systems. For MRI procedures, more and more patients prefer an apparatus that doesn’t enclose their entire body. In order to maximize patient satisfaction, target MRI equipment that can operate without surrounding a patient, thereby improving comfort and, potentially, reducing patient-related artifacts caused by anxious movements or adjustments.

One essential aspect

When it comes to CT systems, manufacturers increasingly offer devices that can perform standing scans and convert images into plain radiographs with a simple digital command. This technology allows surgeons to see how various extremities respond while bearing weight, setting it apart from traditional horizontal CT equipment. This optimizes the pre-operative planning process for complex deformities.

Although there are various differentiators that factor into extremity imaging equipment decisions, they’re all connected to one essential aspect: safety.

In musculoskeletal surgery, and the medical field, procedural safety is undoubtedly intertwined with clinician capability and patient experience. While factors such as dosage can impact safety, it’s also a product of efficiency and workflow. A unit that’s difficult to maneuver and position, or one that clutters the operating room or prolongs surgical time, can affect all parties involved. When evaluating equipment and making purchasing choices, surgeons and decision makers will always be on the right path when prioritizing safety while maintaining efficiency and quality.

Jeremy Cook, DPM, MPH, is an assistant professor of surgery at Harvard Medical School and the director of quality and safety, division of podiatric surgery at Mount Auburn Hospital.

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