CME OnDemand: Novel Imaging and MIS Techniques in Foot and Ankle Care (2026)-Module 1: Weightbearing CT

Video Transcription

Video Summary

Cesar De Saturnetto (Duke University) reviews weight-bearing CT (WBCT) using cone-beam technology for foot and ankle surgery. He contrasts it with conventional radiographs, emphasizing that 2D x-rays poorly capture the complex 3D anatomy and that weight-bearing is essential for alignment and mechanics. Cone-beam CT acquires hundreds of projections in a single rapid rotation to reconstruct 3D datasets, enabling true standing imaging with minimal motion artifact. Key advantages versus conventional CT include markedly lower radiation (even bilateral WBCT can be far less than unilateral conventional CT), high spatial resolution for bone, compact clinic-friendly scanners, and fast acquisition. Limitations include weak soft-tissue contrast, metal artifact susceptibility, smaller field of view, less standardized quantitative density measures, and longer reconstruction time. Importantly, WBCT indications mirror weight-bearing x-rays (alignment/deformity), not conventional CT (fracture characterization). WBCT has most influenced understanding and planning for progressive collapsing foot deformity—especially coronal-plane peritalar subluxation—and hallux valgus by improving assessment of first metatarsal rotation, sesamoid position, and metatarsal-sesamoid arthritis, including 3D mapping tools for surgical evaluation.

Asset Subtitle

In this lesson, Cesar deCesar Netto, MD discusses the history and development of Weightbearing CT. He reviews how WBCT has influenced our understanding and treatment of progressive collapsing foot deformity—especially coronal-plane peritalar subluxation—and hallux valgus by improving assessment of first metatarsal rotation, sesamoid position, and metatarsal-sesamoid arthritis, including 3D mapping tools for surgical evaluation.

Keywords

weight-bearing CT

cone-beam CT

foot and ankle surgery imaging

progressive collapsing foot deformity

peritalar subluxation

hallux valgus 3D assessment