Objective To study diagnosis value contrast of Spiral CT two-dimensional reconstruction and three-dimensional reconstruction for the bone joint disease. Methods Retrospective analysis from August 2013 to April 2015, 98 cases of bone joint disease patients admitted in our department. Inspection on patients was first with X-ray plain film (control group), then with the spiral CT two-dimensional reconstruction and threedimensional reconstruction (observation group), compared with the diagnosis value. Results The observation group of femoral head necrosis 41.84%, meniscus tear24.49%, osteoarthritis 32.65%, joint disease 18.37% detection rate was significantly higher than the control group of 25.51%, 13.27%, 18.37%, 7.14%, had statistically significant differences (all P<0.05). Observation group for joint disease's rate of leakage diagnosis 2.04%, misdiagnosis 0.00%, was significantly lower than the control group were 9.18%, 5.10%, which were statistically significant differences (all P<0.05). Observation group check especially the sensitivity of 86.73% and specificity 89.80% was significantly higher than the control group 68.37%, and 68.37%, which were statistically significant differences (all P<0.05). Observation group's single lesion detection rate 45.92%, lesion detection rate 52.04% was significantly higher than the control group of 30.61% and 30.61%, which were statistically significant differences (all P<0.05). Conclusion Spiral CT two-dimensional reconstruction and three-dimensional reconstruction technique has the characteristics of sense of high sensitivity, specificity, applied to joint pathological changes can be obviously improved lesion detection rate, provide accurate diagnostic information for clinical. It has high security, is worth to recommend.