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Sample records for scoliosis radiographic clinical

  1. Radiographic and clinical outcomes following MIS-TLIF in patients with adult lumbar degenerative scoliosis.

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    Zhao, Yongfei; Liang, Yan; Mao, Keya

    2018-04-19

    Patients suffering from adult lumbar degenerative scoliosis (ALDS) are commonly complicated with advanced age, osteoporosis, cardiopulmonary insufficiency, and some other medical comorbidity. Therefore, the traditional open surgery can lead to high rate of postoperative complications. The purposes of this study were to introduce our experiences and explore the efficacy and feasibility of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of patients with ALDS. From January 2008 to January 2014, a retrospective study of 22 patients with ALDS treated with MIS-TLIF was followed up at least 2 years. All patients suffered from one-level lumbar stenosis, and the nerve root block was performed to make sure the exact level. The clinical and radiographic outcomes were evaluated preoperatively and at the time of 2-year follow-up. The mean visual analog scale (VAS) back pain scores decreased from 6.2 ± 1.8 preoperatively to 2.2 ± 0.7 at 2-year follow-up (P < 0.05), and the mean VAS leg pain scores decreased from 8.2 ± 0.7 preoperatively to 1.4 ± 1.4 at 2-year follow-up (P < 0.05). The Oswestry Disability Index score improved from 62.4 ± 16.1% preoperatively to 24.2 ± 9.3% at 2-year follow-up (P < 0.05). The average lumbar curve was 20.7° ± 7.0° preoperatively and 12.7° ± 7.1° at 2-year follow-up (P < 0.05). The lumbar lordosis changed from - 39.5° ± 13.6° to - 43.6° ± 10.6° at 2-year follow-up (P < 0.05). Solid fusion was achieved in all patients. The technique of MIS-TLIF can be used to treat the patients with ALDS whose symptom is mainly from one-level lumbar stenosis, achieving favorable clinical outcomes and good fusion, with less blood loss and complications.

  2. Clavicle Chest Cage Angle Difference: Is It a Radiographic and Clinical Predictor of Postoperative Shoulder Imbalance in Lenke I Adolescent Idiopathic Scoliosis?

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    Han, Xiao; Liu, Zhen; Qiu, Yong; Sha, Shifu; Yan, Huang; Jin, Mengran; Zhu, Zezhang

    2016-09-01

    A retrospective study. To evaluate the effect of preoperative clavicle chest cage angle difference (CCAD) on postoperative radiographic shoulder imbalance, cosmetic shoulder balance, patient's satisfaction, and surgeon's fulfillment in Lenke I adolescent idiopathic scoliosis (AIS). CCAD is a novel predictor of postoperative radiographic shoulder imbalance in AIS. However, radiographic shoulder balance does not always correspond to cosmetic shoulder balance. Forty-four Lenke I AIS patients treated with posterior spinal fusion with a minimum 2-year follow-up were analyzed. Shoulder height difference (SHD) and CCAD were measured on anteroposterior standing radiographs. The inner shoulder height (SHi) and the outer shoulder height (SHo) were measured using the patients' photographs. The patients' satisfaction and the surgeons' fulfillment were evaluated using a questionnaire. A receiver operative characteristic curve analysis was performed to explore the threshold values of preoperative CCAD in the prediction of the final follow-up radiographic shoulder imbalance, patients' satisfaction, and surgeons' fulfillment. At the final follow-up, the preoperative CCAD was significantly greater in patients with unbalanced shoulders (SHD ≥1 cm). For cosmetic shoulder balance at the final follow-up, there was no significant difference in preoperative CCAD between Group 1i (SHi ≥1 cm, n = 14) and Group 2i (SHi imbalance, patients' satisfaction, and surgeons' fulfillment was 5.5°. CCAD is a good radiographic predictor for postoperative radiographic shoulder imbalance in Lenke I AIS patients. Moreover, it is also associated with the patients' satisfaction and surgeons' fulfillment postoperatively. However, CCAD cannot predict postoperative cosmetic shoulder balance. 4.

  3. Reliability and accuracy analysis of a new semiautomatic radiographic measurement software in adult scoliosis.

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    Aubin, Carl-Eric; Bellefleur, Christian; Joncas, Julie; de Lanauze, Dominic; Kadoury, Samuel; Blanke, Kathy; Parent, Stefan; Labelle, Hubert

    2011-05-20

    Radiographic software measurement analysis in adult scoliosis. To assess the accuracy as well as the intra- and interobserver reliability of measuring different indices on preoperative adult scoliosis radiographs using a novel measurement software that includes a calibration procedure and semiautomatic features to facilitate the measurement process. Scoliosis requires a careful radiographic evaluation to assess the deformity. Manual and computer radiographic process measures have been studied extensively to determine the reliability and reproducibility in adolescent idiopathic scoliosis. Most studies rely on comparing given measurements, which are repeated by the same user or by an expert user. A given measure with a small intra- or interobserver error might be deemed as good repeatability, but all measurements might not be truly accurate because the ground-truth value is often unknown. Thorough accuracy assessment of radiographic measures is necessary to assess scoliotic deformities, compare these measures at different stages or to permit valid multicenter studies. Thirty-four sets of adult scoliosis digital radiographs were measured two times by three independent observers using a novel radiographic measurement software that includes semiautomatic features to facilitate the measurement process. Twenty different measures taken from the Spinal Deformity Study Group radiographic measurement manual were performed on the coronal and sagittal images. Intra- and intermeasurer reliability for each measure was assessed. The accuracy of the measurement software was also assessed using a physical spine model in six different scoliotic configurations as a true reference. The majority of the measures demonstrated good to excellent intra- and intermeasurer reliability, except for sacral obliquity. The standard variation of all the measures was very small: ≤ 4.2° for Cobb angles, ≤ 4.2° for the kyphosis, ≤ 5.7° for the lordosis, ≤ 3.9° for the pelvic angles, and

  4. Serial Casting for Infantile Idiopathic Scoliosis: Radiographic Outcomes and Factors Associated With Response to Treatment.

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    Iorio, Justin; Orlando, Giuseppe; Diefenbach, Chris; Gaughan, John P; Samdani, Amer F; Pahys, Joshua M; Betz, Randal R; Cahill, Patrick J

    Serial casting for early-onset scoliosis has been shown to improve curve deformity. Our goal was to define clinical and radiographic features that determine response to treatment. We retrospectively reviewed patients with idiopathic infantile scoliosis with a minimum of 2-year follow-up. Inclusion criteria were: progressive idiopathic infantile scoliosis and initial casting before 6 years of age. Two groups were analyzed and compared: group 1 (≥10-degree improvement in Cobb angle from baseline) and group 2 (no improvement). Twenty-one patients with an average Cobb angle of 48 degrees (range, 24 to 72 degrees) underwent initial casting at an average age of 2.1 years (range, 0.7 to 5.4 y). Average follow-up was 3.5 years (range, 2 to 6.9 y). Sex, age at initial casting, magnitude of spinal deformity, and curve flexibility (defined as change in Cobb angle from pretreatment to first in-cast radiograph) were not significantly different between groups (P>0.05). Group 1 had a significantly higher body mass index (BMI) than group 2 at the onset of treatment (17.6 vs. 14.8, Pcasted at less than 1.8 years of age had a Cobb angle casting does not confirm treatment success. Key aspects of treatment that may determine success include age of less than 1.8 years at initiation of casting and derotation of the spine to correct rib vertebral angle difference of <20 degrees. Level IV-Therapeutic.

  5. A multicenter study analyzing the relationship of a standardized radiographic scoring system of adolescent idiopathic scoliosis and the Scoliosis Research Society outcomes instrument.

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    Wilson, Philip L; Newton, Peter O; Wenger, Dennis R; Haher, Thomas; Merola, Andrew; Lenke, Larry; Lowe, Thomas; Clements, David; Betz, Randy

    2002-09-15

    A multicenter study examining the association between radiographic and outcomes measures in adolescent idiopathic scoliosis. To evaluate the association between an objective radiographic scoring system and patient quality of life measures as determined by the Scoliosis Research Society outcomes instrument. Although surgical correction of scoliosis has been reported to be positively correlated with patient outcomes, studies to date have been unable to demonstrate an association between radiographic measures of deformity and outcomes measures in patients with adolescent idiopathic scoliosis. A standardized radiographic deformity scoring system and the Scoliosis Research Society outcome tool were used prospectively in seven scoliosis centers to collect data on patients with adolescent idiopathic scoliosis. A total of 354 data points for 265 patients consisting of those with nonoperative or preoperative curves >or=10 degrees, as well as those with surgically treated curves, were analyzed. Correlation analysis was performed to identify significant relationships between any of the radiographic measures, the Harms Study Group radiographic deformity scores (total, sagittal, coronal), and the seven Scoliosis Research Society outcome domains (Total Pain, General Self-Image, General Function, Activity, Postoperative Self-Image, Postoperative Function, and Satisfaction) as well as Scoliosis Research Society outcomes instrument total scores. Radiographic measures that were identified as significantly correlated with Scoliosis Research Society outcome scores were then entered into a stepwise regression analysis. The coronal measures of thoracic curve and lumbar curve magnitude were found to be significantly correlated with the Total Pain, General Self-Image, and total Scoliosis Research Society scores (P Society domain and total scores. No radiographic measures taken after surgery were significantly correlated with the postoperative domains of the Scoliosis Research Society

  6. Scoliosis

    International Nuclear Information System (INIS)

    Rowe, L.J.; Yochum, T.R.

    1987-01-01

    The term ''scoliosis'' is usually credited to Hippocrates. Its derivation is from the Greek word ''skolios'', meaning twisted or crooked. Within the disciplines of orthopedics and radiology scoliosis describes any lateral deviation of the spine from the midsagitttal plane. A review of the past and present literature available on this subject reveals a voluminous amount of information and sophisticated research. This chapter is not an encyclopedic compilation of this data but represents a presentation of the fundamental concepts, principles, and knowledge, particularly in relation to the role, evaluation, and clinical application of the radiological examination

  7. Selection of Fusion Levels Using the Fulcrum Bending Radiograph for the Management of Adolescent Idiopathic Scoliosis Patients with Alternate Level Pedicle Screw Strategy: Clinical Decision-making and Outcomes.

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    Samartzis, Dino; Leung, Yee; Shigematsu, Hideki; Natarajan, Deepa; Stokes, Oliver; Mak, Kin-Cheung; Yao, Guanfeng; Luk, Keith D K; Cheung, Kenneth M C

    2015-01-01

    Selecting fusion levels based on the Luk et al criteria for operative management of thoracic adolescent idiopathic scoliosis (AIS) with hook and hybrid systems yields acceptable curve correction and balance parameters; however, it is unknown whether utilizing a purely pedicle screw strategy is effective. Utilizing the fulcrum bending radiographic (FBR) to assess curve flexibility to select fusion levels, the following study assessed the efficacy of pedicle screw fixation with alternate level screw strategy (ALSS) for thoracic AIS. A retrospective study with prospective radiographic data collection/analyses (preoperative, postoperative 1-week and minimum 2-year follow-up) of 28 operative thoracic AIS patients undergoing ALSS was performed. Standing coronal/sagittal and FBR Cobb angles, FBR flexibility, fulcrum bending correction index (FBCI), trunkal shift, radiographic shoulder height (RSH), and list were assessed on x-rays. Fusion level selection was based on the Luk et al criteria and compared to conventional techniques. In the primary curve, the mean preoperative and postoperative 1 week and last follow-up standing coronal Cobb angles were 59.9, 17.2 and 20.0 degrees, respectively. Eighteen patients (64.3%) had distal levels saved (mean: 1.6 levels) in comparison to conventional techniques. Mean immediate and last follow-up FBCIs were 122.6% and 115.0%, respectively. Sagittal alignment did not statistically differ between any assessment intervals (p>0.05). A decrease in trunkal shift was noted from preoperative to last follow-up (p = 0.003). No statistically significant difference from preoperative to last follow-up was noted in RSH and list (p>0.05). No "add-on" of other vertebra or decompensation was noted and all patients achieved fusion. This is the first report to note that using the FBR for decision-making in selecting fusion levels in thoracic AIS patients undergoing management with pedicle screw constructs (e.g. ALSS) is a cost-effective strategy that

  8. Role of Intraoperative Radiographs in the Surgical Treatment of Adolescent Idiopathic Scoliosis.

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    Vidal, Christophe; Ilharreborde, Brice; Queinnec, Steffen; Mazda, Keyvan

    2016-03-01

    One of the main goals of scoliosis surgery is to obtain a balanced fused spine. Although preoperative planning remains essential, intraoperative posteroanterior radiographs are the only available tool during the procedure to verify shoulder and coronal spinal balance and, if necessary, adjust the construct. The aim of this study was to quantify the direct influence of intraoperative radiographs on the surgical procedure itself during correction of adolescent idiopathic scoliosis. Retrospective analysis of prospectively collected data on a monocentric cohort of adolescent idiopathic scoliosis patients undergoing corrective surgery. A total 148 consecutive patients operated in the same department following the same validated preoperative planning method were included in this prospective radiologic study. The mean follow-up averaged 33 months. Frontal Cobb angles, T1 tilt, shoulder tilt, iliolumbar angle, and frontal balance were measured and compared on intraoperative, early postoperative, and latest follow-up radiographs. Any intraoperative modification of the correction performed after analysis of the intraoperative radiograph were recorded. The analysis of all radiologic parameters was possible in 90.5% of the cases. In 9.5% of the cases, shoulders could not be properly distinguished. Significant modifications on the upper thoracic curve to correct T1 tilt or shoulder balance were performed in 29% of the patients, and changes at the distal levels were recorded in 19%, underlining planification imperfections. On postoperative standing radiographs, the average coronal parameters were neutral, without loss of correction at follow-up. Intraoperative radiographs remain necessary to ensure compensation of the shortcomings of the modern preoperative planification method.

  9. Bluetooth wireless database for scoliosis clinics.

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    Lou, E; Fedorak, M V; Hill, D L; Raso, J V; Moreau, M J; Mahood, J K

    2003-05-01

    A database system with Bluetooth wireless connectivity has been developed so that scoliosis clinics can be run more efficiently and data can be mined for research studies without significant increases in equipment cost. The wireless database system consists of a Bluetooth-enabled laptop or PC and a Bluetooth-enabled handheld personal data assistant (PDA). Each patient has a profile in the database, which has all of his or her clinical history. Immediately prior to the examination, the orthopaedic surgeon selects a patient's profile from the database and uploads that data to the PDA over a Bluetooth wireless connection. The surgeon can view the entire clinical history of the patient while in the examination room and, at the same time, enter in any new measurements and comments from the current examination. After seeing the patient, the surgeon synchronises the newly entered information with the database wirelessly and prints a record for the chart. This combination of the database and the PDA both improves efficiency and accuracy and can save significant time, as there is less duplication of work, and no dictation is required. The equipment required to implement this solution is a Bluetooth-enabled PDA and a Bluetooth wireless transceiver for the PC or laptop.

  10. Effects of novel corrective spinal technique on adolescent idiopathic scoliosis as assessed by radiographic imaging.

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    Noh, Dong Koog; You, Joshua Sung-H; Koh, Jae-Hyun; Kim, Hoseong; Kim, Donghyun; Ko, Sung-Mok; Shin, Ji-Youn

    2014-01-01

    To compare the therapeutic effects of a 3-dimensional corrective spinal technique (CST) and a conventional exercise program (CE) on altered spinal curvature and health related quality-of-life in patients with adolescent idiopathic scoliosis (AIS). Adolescents with idiopathic scoliosis (N=32, 6 males and 26 females) between 10 and 19 years of age (14.34 ± 2.60 years) were recruited and underwent the CST or CE for 60 minutes/day, 2-3 times a week, and an average of total 30 sessions. Diagnostic X-ray imaging technique was used to determine intervention-related changes in the Cobb angle, thoracic kyphosis angle, lumbar lordosis angle, sacral slope, pelvic tilt, pelvic incidence, and vertebral rotation (Nash-Moe method). The Scoliosis Research Society-22 (SRS-22) health related quality-of-life questionnaire was used. Data were analysed using independent t-test, paired t-test, and non-parametric Mann-Whitney U-test at p self-image and treatment satisfaction subscale scores and total score, p=0.026, p=0.039, and p=0.041, respectively) as compared to the controls. There were no significant changes in the other measures between the two groups. This is the first clinical trial to investigate the effects of the 3-dimensional CST on spinal curvatures and health related quality-of-life in AIS, providing the important clinical rationale and compelling evidence for the effective management of AIS.

  11. Patient evaluation in idiopathic scoliosis: Radiographic assessment, trunk deformity and back asymmetry.

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    Rigo, Manuel

    2011-01-01

    Progressive adolescent idiopathic scoliosis (AIS) produces specific signs and symptoms, including trunk and spinal deformity and imbalance, impairment of breathing function, pain, progression during adult life, and psychological problems, as a whole resulting in an alteration of the health-related quality of life. A scoliosis-specific rehabilitation program attempts to prevent, improve, or minimize these signs and symptoms by using exercises and braces as the main tools in the rehabilitation treatment. Patient evaluation is an essential point in the decision-making process and determines the selection of the specific exercises and the specifications of the brace design. However, this article is not addressed to scoliosis management. In this present article, a complete definition and discussion of radiological aspects, such as the Cobb angle, axial rotation, curve pattern classifications, and sagittal configuration, follow a short description of the three-dimensional nature of AIS. The relationship between AIS and growth is also discussed. There is also a section dedicated to the assessment of trunk deformity and back asymmetry. Other important clinical aspects, such as pain and disability, changes in other regions of the body, muscular balance, breathing function, and health-related quality of life, are not discussed in this present article.

  12. Reliability analysis for radiographic measures of lumbar lordosis in adult scoliosis: a case–control study comparing 6 methods

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    Hong, Jae Young; Modi, Hitesh N.; Hur, Chang Yong; Song, Hae Ryong; Park, Jong Hoon

    2010-01-01

    Several methods are used to measure lumbar lordosis. In adult scoliosis patients, the measurement is difficult due to degenerative changes in the vertebral endplate as well as the coronal and sagittal deformity. We did the observational study with three examiners to determine the reliability of six methods for measuring the global lumbar lordosis in adult scoliosis patients. Ninety lateral lumbar radiographs were collected for the study. The radiographs were divided into normal (Cobb lordosis measurement decreased with increasing severity of scoliosis. In Cobb L1–S1, centroid and posterior tangent L1–S1 methods, the ICCs were relatively lower in the high-grade scoliosis group (≥0.60). And, the mean absolute difference (MAD) in these methods was high in the high-grade scoliosis group (≤7.17°). However, in the Cobb L1–L5 and posterior tangent L1–L5 method, the ICCs were ≥0.86 in all groups. And, in the TRALL method, the ICCs were ≥0.76 in all groups. In addition, in the Cobb L1–L5 and posterior tangent L1–L5 method, the MAD was ≤3.63°. And, in the TRALL method, the MAD was ≤3.84° in all groups. We concluded that the Cobb L1–L5 and the posterior tangent L1–L5 methods are reliable methods for measuring the global lumbar lordosis in adult scoliosis. And the TRALL method is more reliable method than other methods which include the L5–S1 joint in lordosis measurement. PMID:20437183

  13. Assessment of Coronal Radiographic Parameters of the Spine in the Treatment of Adolescent Idiopathic Scoliosis.

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    Karami, Mohsen; Maleki, Arash; Mazda, Keyvan

    2016-10-01

    To determine the most important preoperative factors that affect postoperative coronal parameters of scoliotic curves. All Adolescent Idiopathic Scoliosis (AIS) patients included in the study were classified according to Lenke and King Classification. The fusion levels were selected according to the rigidity of the existing curves (correction less than 50%), tilt of T1 and shoulders, sagittal angle of the curves and with considering stable and neutral end vertebra. The radiographic coronal parameters: shoulders tilt angle, iliolumbar angle and coronal balance were measured in all patients before, after, and in the last follow-up visit. One hundred twenty patients after mean of 25 months follow-up (18-40 months) were included in the study. Before operation, abnormal coronal balance (more than 2 cm shift) was noticed in 46 patents (38%) and in the last visit, was noted in 22 patients (18%). Multivariate regression analysis revealed a significant predictive value of the preoperative coronal balance on the last visit coronal balance ( P value=0.01). Preoperative coronal balance is very important to make a balanced spine after surgery. Other parameters like Lenke classification or main thoracic overcorrection did not affect postoperative coronal decompensation.

  14. A new brace treatment similar for adolescent scoliosis and kyphosis based on restoration of thoracolumbar lordosis. Radiological and subjective clinical results after at least one year of treatment

    Directory of Open Access Journals (Sweden)

    van Loon Piet JM

    2012-10-01

    Full Text Available Abstract Study design A prospective treatment study with a new brace was conducted Objective. To evaluate radiological and subjective clinical results after one year conservative brace treatment with pressure onto lordosis at the thoracolumbar joint in children with scoliosis and kyphosis. Summary of background data Conservative brace treatment of adolescent scoliosis is not proven to be effective in terms of lasting correction. Conservative treatment in kyphotic deformities may lead to satisfactory correction. None of the brace or casting techniques is based on sagittal forces only applied at the thoracolumbar spine (TLI= thoracolumbar lordotic intervention. Previously we showed in patients with scoliosis after forced lordosis at the thoracolumbar spine a radiological instantaneous reduction in both coronal curves of double major scoliosis. Methods A consecutive series of 91 children with adolescent scoliosis and kyphosis were treated with a modified symmetric 30 degrees Boston brace to ensure only forced lordosis at the thoracolumbar spine. Scoliosis was defined with a Cobb angle of at least one of the curves [greater than or equal to] 25 degrees and kyphosis with or without a curve Results Before treatment start ‘in brace’ radiographs showed a strong reduction of the Cobb angles in different curves in kyphosis and scoliosis groups (sagittal n = 5 all p Conclusion Conservative treatment using thoracolumbar lordotic intervention in scoliotic and kyphotic deformities in adolescence demonstrates a marked improvement after one year also in clinical and postural criteria. An effect not obtained with current brace techniques.

  15. Resultados clínicos e radiográficos do tratamento cirúrgico da escoliose paralítica na mielomeningocele Resultados clínicos y radiográficos del tratamiento quirúrgico de la escoliosis paralítica en la mielomeningocele Clinical and radiographic results of surgical treatment of paralytic scoliosis in myelomeningocele

    Directory of Open Access Journals (Sweden)

    Marcos Gassen Martins

    2012-12-01

    inmediato para 10º, y en el periodo postoperatorio tardío para 13º. El promedio de la descompensación del tronco fue de 117 mm, inicialmente ajustado en 67 mm y en el seguimiento final se deterioró hasta 98 mm. CONCLUSIONES: Los pacientes en los que se extendió la instrumentación hasta la pelvis, obtuvieron mejores resultados para todos los cambios relacionados con el tiempo, o sea, escoliosis, oblicuidad pélvica y descompensación del tronco, excepto por la pérdida de corrección de la escoliosis, que fue menor en pacientes que no tenían la fijación de la pelvis.OBJECTIVE: To evaluate the clinical and radiographic results of surgical treatment for paralytic scoliosis in myelomeningocele. METHODS: A retrospective study by reviewing medical records and radiographs of patients with myelomeningocele, surgically treated between the years 1999 and 2009. RESULTS: We analyzed the medical records and radiographs of 29 patients. The mean age at surgery was 12.2 years, with a mean follow-up of 3.8 years. The mean preoperative angle of scoliosis was 77º, initially adjusted to 29º that, at the end of follow-up, deteriorated to 34º. The average of the pelvic obliquity was 16º, corrected in the immediate postoperative period to 10º, and in the late postoperative period to 13º. The trunk decompensation average was 117 mm, initially adjusted to 67 mm and, at final follow-up, deteriorated to 98 mm. CONCLUSIONS: Patients in which the instrumentation was extended to the pelvis, obtained better results for all related changes over time, namely, scoliosis, pelvic obliquity and decompensation of the trunk, except for the loss of scoliosis correction that was lower in patients not undergoing pelvic fixation.

  16. Radiographic characteristics in congenital scoliosis associated with split cord malformation: a retrospective study of 266 surgical cases.

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    Feng, Fan; Tan, Haining; Li, Xingye; Chen, Chong; Li, Zheng; Zhang, Jianguo; Shen, Jianxiong

    2017-10-23

    Vertebrae, ribs, and spinal cord are anatomically adjacent structures, and their close relationships are clinically important for planning better corrective surgical approach. The objective is to identify the radiographic characteristics in surgical patients with congenital scoliosis (CS) and coexisting split cord malformation (SCM). A total of 266 patients with CS and SCM underwent surgical treatment at our hospital between May 2000 and December 2015 was retrospectively identified. The demographic distribution and radiographic data were collected to investigate the characteristics of spine curve, vertebral, rib, and intraspinal anomalies. According to Pang's classification, all patients were divided into two groups: type I group is defined as two hemicords, each within a separate dural tube separated by a bony or cartilaginous medial spur, while type II group is defined as two hemicords within a single dural tube separated by a nonrigid fibrous septum. There were 104 patients (39.1%) in Type I group and 162 patients (60.9%) in Type II group. SCM was most commonly found in the lower thoracic and lumbar regions. The mean length of the septum in Type I SCM was significantly shorter than Type II SCM (2.7 vs. 5.2 segments). Patients in Type I group had a higher proportion of kyphotic deformity (22.1%). The vertebral deformities were simple in only 16.5% and multiple in 83.5% of 266 cases. Patients in Type I group presented higher prevalence of multiple (90.4%) and extensive (5.1 segments) malformation of vertebrae. In addition, hypertrophic lamina and bulbous spinous processes were more frequent in Type I group (29.7%), even developing into the "volcano-shape" deformities. Rib anomalies occurred in 62.8% of all patients and 46.1% of them were complex anomalies. The overall prevalence of other intraspinal anomalies was 42.9%. The most common coexisting intraspinal anomalies was syringomyelia (30.5%). The current study, with the largest cohort to date, demonstrated that

  17. Clinically orientated classification incorporating shoulder balance for the surgical treatment of adolescent idiopathic scoliosis.

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    Elsebaie, H B; Dannawi, Z; Altaf, F; Zaidan, A; Al Mukhtar, M; Shaw, M J; Gibson, A; Noordeen, H

    2016-02-01

    The achievement of shoulder balance is an important measure of successful scoliosis surgery. No previously described classification system has taken shoulder balance into account. We propose a simple classification system for AIS based on two components which include the curve type and shoulder level. Altogether, three curve types have been defined according to the size and location of the curves, each curve pattern is subdivided into type A or B depending on the shoulder level. This classification was tested for interobserver reproducibility and intraobserver reliability. A retrospective analysis of the radiographs of 232 consecutive cases of AIS patients treated surgically between 2005 and 2009 was also performed. Three major types and six subtypes were identified. Type I accounted for 30 %, type II 28 % and type III 42 %. The retrospective analysis showed three patients developed a decompensation that required extension of the fusion. One case developed worsening of shoulder balance requiring further surgery. This classification was tested for interobserver and intraobserver reliability. The mean kappa coefficients for interobserver reproducibility ranged from 0.89 to 0.952, while the mean kappa value for intraobserver reliability was 0.964 indicating a good-to-excellent reliability. The treatment algorithm guides the spinal surgeon to achieve optimal curve correction and postoperative shoulder balance whilst fusing the smallest number of spinal segments. The high interobserver reproducibility and intraobserver reliability makes it an invaluable tool to describe scoliosis curves in everyday clinical practice.

  18. The Clinical Effectiveness of School Screening Programme for Idiopathic Scoliosis in Malaysia.

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    Deepak, A S; Ong, J Y; Choon, Dsk; Lee, C K; Chiu, C K; Chan, Cyw; Kwan, M K

    2017-03-01

    There is no large population size study on school screening for scoliosis in Malaysia. This study is aimed to determine the prevalence rate and positive predictive value (PPV) of screening programme for adolescent idiopathic scoliosis. A total of 8966 voluntary school students aged 13-15 years old were recruited for scoliosis screening. Screening was done by measuring the angle of trunk rotation (ATR) on forward bending test (FBT) using a scoliometer. ATR of 5 degrees or more was considered positive. Positively screened students had standard radiographs done for measurement of the Cobb angle. Cobb angle of >10° was used to diagnose scoliosis. The percentage of radiological assessment referral, prevalence rate and PPV of scoliosis were then calculated. Percentage of radiological assessment referral (ATR >5°) was 4.2% (182/4381) for male and 5.0% (228/4585) for female. Only 38.0% of those with ATR >5° presented for further radiological assessment. The adjusted prevalence rate was 2.55% for Cobb angle >10°, 0.59% for >20° and 0.12% for >40°. The PPV is 55.8% for Cobb angle >10°, 12.8% for >20° and 2.6% for > 40°. This is the largest study of school scoliosis screening in Malaysia. The prevalence rate of scoliosis was 2.55%. The positive predictive value was 55.8%, which is adequate to suggest that the school scoliosis screening programme did play a role in early detection of scoliosis. However, a cost effectiveness analysis will be needed to firmly determine its efficacy.

  19. The Clinical Effectiveness of School Screening Programme for Idiopathic Scoliosis in Malaysia

    Directory of Open Access Journals (Sweden)

    Deepak AS

    2017-03-01

    Full Text Available INTRODUCTION: There is no large population size study on school screening for scoliosis in Malaysia. This study is aimed to determine the prevalence rate and positive predictive value (PPV of screening programme for adolescent idiopathic scoliosis. MATERIALS AND METHODS: A total of 8966 voluntary school students aged 13-15 years old were recruited for scoliosis screening. Screening was done by measuring the angle of trunk rotation (ATR on forward bending test (FBT using a scoliometer. ATR of 5 degrees or more was considered positive. Positively screened students had standard radiographs done for measurement of the Cobb angle. Cobb angle of >10° was used to diagnose scoliosis. The percentage of radiological assessment referral, prevalence rate and PPV of scoliosis were then calculated. RESULTS: Percentage of radiological assessment referral (ATR >5° was 4.2% (182/4381 for male and 5.0% (228/4585 for female. Only 38.0% of those with ATR >5° presented for further radiological assessment. The adjusted prevalence rate was 2.55% for Cobb angle >10°, 0.59% for >20° and 0.12% for >40°. The PPV is 55.8% for Cobb angle >10°, 12.8% for >20° and 2.6% for > 40°. CONCLUSIONS: This is the largest study of school scoliosis screening in Malaysia. The prevalence rate of scoliosis was 2.55%. The positive predictive value was 55.8%, which is adequate to suggest that the school scoliosis screening programme did play a role in early detection of scoliosis. However, a cost effectiveness analysis will be needed to firmly determine its efficacy.

  20. Radiographic and Clinical Analysis of Lateral Epicondylitis.

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    Shillito, Matthew; Soong, Maximillian; Martin, Nicholas

    2017-06-01

    The literature suggests that radiographs may be unnecessary in the initial evaluation of lateral epicondylitis because treatment is rarely altered as a result of the radiographic findings. The most commonly reported radiographic finding is calcification at the lateral epicondyle. Our goal was to perform a quantitative and qualitative analysis of this finding to determine its importance and possible relationship with various clinical factors and patient-reported measures. All patients diagnosed with lateral epicondylitis by a single surgeon during a 5-year period were retrospectively reviewed. Age, sex, laterality, hand dominance, pain visual analog scale, duration of symptoms, Quick-Disability of the Arm, Shoulder, and Hand questionnaire score, and history of steroid injection were recorded. Calcifications on standard elbow radiographs, acquired digitally and viewed at 200% magnification on a 24-inch monitor, were characterized by size and relationship with the lateral epicondyle. We reviewed 245 patients diagnosed with lateral epicondylitis. A total of 115 elbows (47%) demonstrated lateral epicondyle calcifications. Patients with and without calcifications were similar with regard to clinical factors, as were patients with larger or smaller lesions. Eighty-five elbows (35%) had additional radiographic findings. Treatment was not altered by the radiographic findings in any case. Lateral epicondyle calcifications are much more common in lateral epicondylitis than previously reported, possibly owing to modern digital radiography and magnification, although they do not appear to be related to clinical factors including patient-reported measures. Thus, patients and surgeons should be careful to avoid overinterpretation of such findings. Although radiographs may be helpful in ruling out additional pathology, we did not find other clinically important contributions to the initial evaluation and management of this condition, and thus we do not recommend their routine use

  1. Dose, image quality and spine modeling assessment of biplanar EOS micro-dose radiographs for the follow-up of in-brace adolescent idiopathic scoliosis patients.

    Science.gov (United States)

    Morel, Baptiste; Moueddeb, Sonia; Blondiaux, Eleonore; Richard, Stephen; Bachy, Manon; Vialle, Raphael; Ducou Le Pointe, Hubert

    2018-05-01

    The aim of this study was to compare the radiation dose, image quality and 3D spine parameter measurements of EOS low-dose and micro-dose protocols for in-brace adolescent idiopathic scoliosis (AIS) patients. We prospectively included 25 consecutive patients (20 females, 5 males) followed for AIS and undergoing brace treatment. The mean age was 12 years (SD 2 years, range 8-15 years). For each patient, in-brace biplanar EOS radiographs were acquired in a standing position using both the conventional low-dose and micro-dose protocols. Dose area product (DAP) was systematically recorded. Diagnostic image quality was qualitatively assessed by two radiologists for visibility of anatomical structures. The reliability of 3D spine modeling between two operators was quantitatively evaluated for the most clinically relevant 3D radiological parameters using intraclass correlation coefficient (ICC). The mean DAP for the posteroanterior and lateral acquisitions was 300 ± 134 and 433 ± 181 mGy cm 2 for the low-dose radiographs, and 41 ± 19 and 81 ± 39 mGy cm 2 for micro-dose radiographs. Image quality was lower with the micro-dose protocol. The agreement was "good" to "very good" for all measured clinical parameters when comparing the low-dose and micro-dose protocols (ICC > 0.73). The micro-dose protocol substantially reduced the delivered dose (by a factor of 5-7 compared to the low-dose protocol) in braced children with AIS. Although image quality was reduced, the micro-dose protocol proved to be adapted to radiological follow-up, with adequate image quality and reliable clinical measurements. These slides can be retrieved under Electronic Supplementary Material.

  2. Clinical balance tests, proprioceptive system and adolescent idiopathic scoliosis.

    Science.gov (United States)

    Le Berre, Morgane; Guyot, Marc-Alexandre; Agnani, Olivier; Bourdeauducq, Isabelle; Versyp, Marie-Christine; Donze, Cécile; Thévenon, André; Catanzariti, Jean-Francois

    2017-06-01

    Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spinal column of unknown etiology. Multiple factors could be involved, including neurosensory pathways and, potentially, an elective disorder of dynamic proprioception. The purpose of this study was to determine whether routine balance tests could be used to demonstrate an elective alteration of dynamic proprioception in AIS. This was a multicentre case-control study based on prospectively collected clinical data, in three hospitals pediatric, with spine consultation, from January 2013 through April 2015. From an original population of 547 adolescents, inclusion and non-inclusion criteria indentified 114 adolescents with right thoracic AIS (mean age 14.5 ± 1.9 years, Cobb angle 35.7 ± 15.3°) and 81 matched adolescents without scoliosis (mean age 14.1 ± 1.9 years). Participants performed three routine clinical balance tests to assess the static and dynamic proprioception: the Fukuda-Utenberger stepping test (angle of rotation in degrees and distance of displacement in cm) to assess dynamic balance; the sharpened Romberg test and the unipedal stance test (eyes closed) to assess static balance. There was no significant difference between AIS subjects and controls for the static tests, but there was a significant difference for the dynamic test for both measures: distance of displacement (p tests can be performed in routine practice. Their validity as a biomarker for screening and monitoring purposes should be assessed.

  3. Idiopathic Scoliosis

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    Jens Ivar Brox

    2014-07-01

    Full Text Available Idiopathic scoliosis (IS is a lifetime condition and is defined as a structural, lateral rotated curvature of the spine of >10° on standing coronal plane radiographs. It should be distinguished from other causes of scoliosis. It can be classified as infantile, juvenile, and adolescent according to age. As a rule of thumb, about 80% of all curves are idiopathic, right convex thoracic, and present in otherwise healthy girls at the beginning of puberty. A family member most commonly detects scoliosis. The structural asymmetry of the spine is best observed by asking the patient to bend forward. IS is often seen in more than one member of a family, but the aetiology remains unknown. Multiple genes are likely to be involved with incomplete penetrance and variable expressivity. Early detection by screening allows for monitoring curve progression and timely initiation of bracing, but school screening is controversial and practises vary worldwide. Most patients have minor scoliosis and treatment is generally not recommended for patients with curves 45°. Scoliosis surgery was not successful until the introduction of Harrington’s instrumentation in the 1960s. Modern instrumentation has evolved from the Cotrel-Dubousset system in the 1980s, and a variety of methods are available today. Although scoliosis may be a burden, long-term studies suggest that a good quality of life is maintained in most patients.

  4. Nosocomial Legionnaires’ Disease: Clinical and Radiographic Patterns

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    Thomas J Marrie

    1992-01-01

    Full Text Available From 1981 to 1991, 55 patients (33 males, 22 females, mean age 58.6 years with nosocomial Legionnaires’ disease were studied. The mortality rate was 64%. One-half of the patients developed nosocomial Legionnaires’ disease within three weeks of admission. A surprising clinical feature was the low rate of findings of consolidation on physical examination, despite the fact that 52% of patients had this finding on chest radiograph. More than one-half of patients had pre-existing lung disease, rendering a radiographic diagnosis of pneumonia due to Legionella pneumophila impossible in 16% of cases despite microbiological confirmation. Nineteen per cent of patients who had blood cultures done had a pathogen other than L pneumophila isolated, suggesting dual infection in at least some of the patients. When the clinical and radiographic findings were combined it was noted that 40% of patients had one of three patterns suggestive of nosocomial Legionnaires’ disease: rapidly progressive pneumonia, lobar opacity and multiple peripheral opacities. However, in 60% of patients there were no distinctive features.

  5. Adolescent Idiopathic Scoliosis

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    Safak Ekinci

    2014-06-01

    Full Text Available Scoliosis is called idiopathic when no other underlying disease can be identified. The etiology of adolescent idiopathic scoliosis (AIS is still unknown despite many years of research effort. Theories on AIS's etiology have included mechanical, hormonal, metabolic, neuromuscular, growth, and genetic abnormalities. Skeletally immature patients with adolescent idiopathic scoliosis are at risk of curve progression. The adolescent onset of severe idiopathic scoliosis has traditionally been evaluated using standing posteroanterior radiographs of the full spine to assess lateral curvature with the Cobb method. Scoliosis in children of school age and above primarily occurs in girls. The therapeutic goal in children is to prevent progression. In children, scoliosis of 20 and deg; or more should be treated with a brace, and scoliosis of 45 and deg; or more with surgery. [Arch Clin Exp Surg 2014; 3(3.000: 174-182

  6. Reliability analysis for manual radiographic measures of rotatory subluxation or lateral listhesis in adult scoliosis.

    Science.gov (United States)

    Freedman, Brett A; Horton, William C; Rhee, John M; Edwards, Charles C; Kuklo, Timothy R

    2009-03-15

    Retrospective observational study. To define the inter- and intraobserver reliability of 3 measures of rotatory subluxation (RS) in adult scoliosis (AS). RS is a hallmark of AS. To accurately track this measure, one must know its reliability. Reliability testing has not been performed. PA 36" films of 29 AS patients were collected from one surgeon's practice. Three observers on 2 separate occasions measured all levels with >or=3-mm RS (60 levels, 360 measurements) on the convexity of the involved segment using 3 different techniques-midbody (MB), endplate (EP), and centroid (C). These data were then analyzed to determine the intraclass correlation coefficient (ICC) for inter- and intraobserver reliability. The thoracolumbar/lumbar curve (average 58 degrees ) was the major curve for the majority (62%) of patients. RS at L3/4 was most common (35%). The overall inter- and intraobserver reliability was good-excellent for all methods, but the centroid method consistently had the highest ICC. ICC correlated with observer experience. Moderate-severe arthritic change (present in 55%) and poor image quality (52%) decreased ICC, but it still remained good-excellent for each measure. The reproducibility coefficient for each measure was 4 mm for MB and 2.8 mm for C and EP. MB, EP, and C are reliable techniques to measure RS even in elderly arthritic spines, but the methods inherently produce different values for a given level. The centroid method is most reliable and least influenced by experience. The EP method is easy to perform and very reliable. Spine surgeons should pick their preferred method and apply it consistently. Changes >3 mm suggest RS progression. RS may be a useful measure in addition to Cobb angle in AS. Having defined measurement reliability, the role of RS progression in surgical indications and patient outcomes can be evaluated.

  7. Adolescent Idiopathic Scoliosis – case report of a patient with clinical deterioration after surgery

    Directory of Open Access Journals (Sweden)

    Weiss Hans-Rudolf

    2007-12-01

    Full Text Available Abstract Background Although there is no evidence that the long-term effects of scoliosis surgery are superior to the long-term effects of Adolescent Idiopathic Scoliosis (AIS itself, patients can fear the consequences of not under going this surgery due to incorrect or insufficient information. The main indication for surgical treatment in patients with AIS, is cosmetic. However spinal surgery may, along with other negative side effects, actually cause postoperative clinical deterioration. This complication of surgery has not yet been described in international literature. Case presentation A 15-year old female patient originally presenting with a well-compensated double curve pattern scoliosis. The patient was advised to undergo surgery due to the long-term negative impact of signs and symptoms of scoliosis upon her health. The patient agreed to surgery, which was performed in one of Germanys leading centres for spinal surgery. The thoracolumbar curve was corrected and fused, while the thoracic curve, clearly showing wedged vertebrae, defined as structural scoliosis, remained untreated. This operation left the patient with an unbalanced appearance, with radiological and clinical imbalance to the right. The clinical appearance of the patient though clearly deteriorated post-surgery. Furthermore, the wedged disc space below the fusion area indicates future problems with possible destabilisation accompanied probably by low back pain. Conclusion Scoliosis surgery for patients with AIS is mainly indicated for cosmetic or psychological reasons. Therefore the treatment leading to the best possible clinical appearance and balance has to be chosen. Patients should be informed that surgery will not necessarily improve their health status. Clinical deterioration after surgery may occur, and such information is crucial for an adequate informed consent.

  8. Do postoperative radiographically verified technical success, improved cosmesis, and trunk shift corroborate with patient-reported outcomes in Lenke 1C adolescent idiopathic scoliosis?

    Science.gov (United States)

    Sharma, Shallu; Bünger, Cody Eric; Andersen, Thomas; Sun, Haolin; Wu, Chunsen; Hansen, Ebbe Stender

    2015-07-01

    To examine correlation between postoperative radiographic and cosmetic improvements in Lenke 1C adolescent idiopathic scoliosis (AIS) with patients' self-rated outcomes of health and disability at follow-up as determined by the Scoliosis Research Society questionnaire (SRS-30), Oswestry Disability Index score (ODI) and measure of overall health quality Euroqol-5d (EQ-5D). 24 Lenke 1C scoliosis patients, mean age 16.5 (12.8-38.1) years, treated with posterior pedicle screw-only construct, were included. The coronal profile indices (radiographic and cosmetic) regarding magnitude of spinal deformity and truncal balance were measured preoperatively, postoperatively and at final follow-up. A comprehensive index of overall back symmetry was also measured by means of the Posterior Trunk Symmetry Index (POTSI). Pearson's correlation analysis determined the association between the radiographic-cosmetic indices and patient-rated outcomes. Mean follow-up for the cohort was 4.4 (±1.86) years. The thoracic apical vertebra-first thoracic vertebra horizontal distance (AV-TI) correction had significant correlation with function, self-image, and mental health SRS-30 scores (0.55, 0.54, 0.66). Similarly, thoracic apical vertebra horizontal translation from central sacral vertical line (AV-CSVL) correction at follow-up had significant correlation with self-image and management domains (0.57, 0.50). Follow-up POTSI correlated well with SRS-30 and EQ-5D scores (r = -0.64, -0.54). Postoperative leftward trunk shift/spinal imbalance did not influence overall cosmesis and outcomes; significant spinal realignment was evident in follow-up resulting in physiological balance and acceptable cosmesis and outcomes. Significant, but less than "perfect" correlations were observed between the radiographic, cosmetic measures and patient-rated outcomes. Thoracic AV-CSVL, AV-T1 correction and POTSI associated significantly with SRS-30 scores. Whereas, thoracic Cobb angle, Cobb correction, and

  9. Clinical Outcomes of Extreme Lateral Interbody Fusion in the Treatment of Adult Degenerative Scoliosis

    Directory of Open Access Journals (Sweden)

    Adam M. Caputo

    2012-01-01

    Full Text Available Introduction. The use of extreme lateral interbody fusion (XLIF and other lateral access surgery is rapidly increasing in popularity. However, limited data is available regarding its use in scoliosis surgery. The objective of this study was to evaluate the clinical outcomes of adults with degenerative lumbar scoliosis treated with XLIF. Methods. Thirty consecutive patients with adult degenerative scoliosis treated by a single surgeon at a major academic institution were followed for an average of 14.3 months. Interbody fusion was completed using the XLIF technique with supplemental posterior instrumentation. Validated clinical outcome scores were obtained on patients preoperatively and at most recent follow-up. Complications were recorded. Results. The study group demonstrated improvement in multiple clinical outcome scores. Oswestry Disability Index scores improved from 24.8 to 19.0 (P < 0.001. Short Form-12 scores improved, although the change was not significant. Visual analog scores for back pain decreased from 6.8 to 4.6 (P < 0.001 while scores for leg pain decreased from 5.4 to 2.8 (P < 0.001. A total of six minor complications (20% were recorded, and two patients (6.7% required additional surgery. Conclusions. Based on the significant improvement in validated clinical outcome scores, XLIF is effective in the treatment of adult degenerative scoliosis.

  10. Scoliosis Associated With Syringomyelia

    Directory of Open Access Journals (Sweden)

    Gh Fathi

    2007-01-01

    Full Text Available Introduction: The differential diagnosis of idiopathic and syringomyelia associated scoliosis is important because corrective surgery for scoliosis associated with syringomyelia prior to management of syringomyelia can be dangerous. There are important imaging indicators for diagnosis of syringomyelia associated with scoliosis. A few of these indicators have been assessed in our study. Methods: A retrospective descriptive study including 38 patients with both scoliosis and syringomyelia was performed at the Shafa Yahyaeian center. Standard scoliosis series radiographs and MRI of all patients were studied. The type of scoliosis, location and magnitude of deformity, kyphosis or lordosis in the sagittal plane, location and size of syrinx were assessed. Results: Thoracic kyphosis was present in 94.7% of patients. 37% of patients had scoliosis with convexity to left. Arnold –chiari malformation was present in 36% and cord tethering in 21% of patients. The locations of syrinx were as follows: 47.4%cervical, 44.6 thoracic, 2.7% lumbar and 5.3% were holocord. Conclusion: Kyphosis, abscence of lordosis in sagittal plane, progressive scoliosis and scoliosis with convexity to left are atypical findings and could be indicators of the presence of syringomyelia. If these indicators are present, a diagnosis of idiopathic scoliosis should be made with caution.

  11. Tratamento cirúrgico da escoliose idiopática do adolescente utilizando parafusos pediculares: análise dos resultados clínicos e radiográficos Tratamiento quirúrgico de la escoliosis idiopática del adolescente utilizando tornillos pediculares: análisis de los resultados clínicos y radiográficos Surgical treatment of adolescent idiopathic scoliosis using pedicle screws: analysis of clinical and radiographic results

    Directory of Open Access Journals (Sweden)

    Alberto Ofenhejm Gotfryd

    2011-01-01

    artrodesis por vía posterior, utilizando solamente tornillos pediculares, y correlacionar el resultado radiográfico con los valores obtenidos a través del cuestionario SRS-24. Métodos: Fueron evaluados 25 pacientes portadores de escoliosis idiopáticas del adolescente, sometidos a artrodesis de la columna por vía posterior. El seguimiento promedio fue de 23,7 meses, con variación entre 12 y 35. Analizamos criterios radiográficos referentes a la corrección de las deformidades y aplicamos el cuestionario SRS-24, específico para la patología en cuestión, estandarizada por la Scoliosis Research Society. Resultados: La muestra fue compuesta por 92% de pacientes del sexo femenino y el promedio de edad fue 14,2 años. El promedio del índice de Cobb en la radiografía anteroposterior preoperatoria fue de 24,4 grados para la curva torácica proximal, 54,9 grados para torácica principal y 38,5 grados para la curva lumbar. Los valores angulares promedio en el postoperatorio fueron 11 grados, 16,7 grados y 12,2 grados respectivamente, con un porcentaje de corrección promedio de la curva torácica principal de 69,9%. El valor promedio final del cuestionario SRS-24 fue de 98,1 puntos. Dos de los pacientes presentaron complicaciones en el postoperatorio, sin embargo ninguna del tipo neurológico. Conclusión: La técnica se mostró eficaz para el tratamiento quirúrgico de la EIA, proporcionando un alto porcentual de corrección de las deformidades, con un bajo riesgo de complicaciones y resultado clínico satisfactorio. No hubo asociación estadísticamente significativa entre el porcentaje de corrección de la curva (torácica o lumbar principal o su valor postoperatorio para el valor final del cuestionario SRS-24 ni con los dominios "satisfacción" y "autoimagen postoperatoria".Objective: To evaluate clinically and radiographically patients with adolescent idiopathic scoliosis (AIS submitted to posterior arthrodesis using pedicle screws-only constructs and correlate image

  12. Internet use by parents of children attending a dedicated scoliosis outpatient clinic.

    Science.gov (United States)

    Baker, Joseph F; Devitt, Brian M; Lynch, Sam; Green, Connor J; Byrne, Damien P; Kiely, Patrick J

    2012-10-01

    No information exists on the level of internet use among parents of pediatric patients with scoliosis. The internet may represent a medium through which to provide information to augment the outpatient consultation. The aim of this research was to establish the prevalence of internet use amongst a cohort of parents attending a pediatric scoliosis outpatient clinic. A previously used questionnaire (Baker et al., Eur Spine J, 19:1776-1779, 2010) was distributed to parents attending a dedicated scoliosis outpatient clinic with their children. Demographic data and details about use of the internet were collected. Fifty-eight percent of respondents had used the internet to search for information on scoliosis, and 94 % were interested in a local internet provided information provision. A positive history of corrective surgery and possession of health insurance were independent positive predictors of internet use. As surgeons we need to be aware of our patients' use of the internet, and there is the opportunity to use this medium to provide additional education.

  13. Radiographic demonstration of small intestinal villi on routine clinical studies

    International Nuclear Information System (INIS)

    Gelfand, D.W.; Ott, D.J.

    1981-01-01

    The radiographic demonstration of the small intestinal villi is reported. The villi were demonstrable with both single- and double-contrast methods on routine clinical studies. The primary requirement for their delineation appears to be employment of a high-resolution radiographic system. (orig.) [de

  14. The influence of elastic orthotic belt on sagittal profile in adolescent idiopathic thoracic scoliosis: a comparative radiographic study with Milwaukee brace

    Directory of Open Access Journals (Sweden)

    Qian Bangping

    2010-09-01

    Full Text Available Abstract Background The effectiveness of bracing on preventing curve progression in coronal plane for mild and moderate adolescent idiopathic scoliosis (AIS patients has been confirmed by previous radiographic researches. However, a hypokyphotic effect on the sagittal plane has been reported by a few studies. A relatively increasing number of AIS patients were noticed to wear a new kind of elastic orthotic belt for the treatments of scoliosis without doctors' instructions. We postulate the correcting mechanism of this new appliance may cause flattening of the spine. To our knowledge, no study has investigated the effects of this new orthosis on the sagittal profile of AIS patients. The aim of this study was to evaluate and compare the effects of elastic orthotic belt and Milwaukee brace on the sagittal alignment in AIS patients. Methods Twenty-eight female AIS patients with mild or moderate thoracic curves were included in this study. Standing full-length lateral radiographs were obtained in three conditions: natural standing posture without any treatment, with elastic orthotic belt and with Milwaukee brace. Thoracic kyphosis (TK, lumber lordosis (LL and pelvic incidence (PI were measured and compared between the above three conditions. Results Both elastic orthotic belt and Milwaukee brace can lead to significant decrease of TK, however, the decrease of TK after wearing elastic orthotic belt is significantly larger than that after wearing Milwaukee brace. Compared with no treatment, LL was found to be significantly smaller after wearing Milwaukee brace, however, such significant decrease was not noted after wearing elastic orthotic belt. No significant changes were observed for the PI between 3 conditions. Conclusions The elastic orthotic belt could lead to more severe thoracic hypokyphosis when compared with Milwaukee brace. This belt may not be a suitable conservative method for the treatment of mild and moderate AIS patients.

  15. Radiation dose reduction in the evaluation of scoliosis: an application of digital radiography

    International Nuclear Information System (INIS)

    Kushner, D.C.; Cleveland, R.H.; Herman, T.E.; Zaleske, D.J.; Ehrlich, M.G.; Correia, J.A.

    1986-01-01

    This report documents the clinical testing of scanning beam digital radiography as an imaging method in patients with scoliosis. This type of digital imaging requires a skin exposure of only 2.4 mR (0.619 microC/kg) per image, compared with the lowest possible posteroanterior screen-film exposure of 10 mR (2.58 microC/kg) at the chest and 60 mR (15.48 microC/kg) at the lumbar spine. Digital radiographic and screen-film images were obtained on multiple test objects and 273 patients. Scoliosis measurements using screen-film radiographs and digital radiographs were comparable to within a mean difference of 1 degrees at many different degrees of severity. The low-dose digital images were found to be useful and accurate for the detection and measurement of scoliosis after the first screen-film radiographs have excluded tumors and structural abnormalities

  16. Scoliosis in Steinert syndrome: a case report.

    Science.gov (United States)

    Themistocleous, George S; Sapkas, George S; Papagelopoulos, Panayiotis J; Stilianessi, Eugenia V; Papadopoulos, Elias Ch; Apostolou, Constantinos D

    2005-01-01

    Steinert syndrome is described as an autosomal dominant condition characterized by progressive muscular wasting, myotonia, musculoskeletal manifestations and rare spinal defects. Little is reported about spinal deformity associated with this syndrome. We present a patient with Steinert syndrome complicated by scoliosis. In the literature on muscular dystrophy, other than Duchenne, little mention is given to the problem of scoliosis in general and its treatment in particular. A case report of a patient with Steinert syndrome associated with thoracic scoliosis and hypokyphosis is presented. A 17-year-old boy presented with King type II right thoracic scoliosis (T5-T11, Cobb angle of 40 degrees) and hypokyphosis--10 degrees. He was treated with posterior stabilization and instrumentation at level T3-L2 with a postoperative correction of the scoliotic curve to 20 degrees. Histopathologic examination of the muscles confirmed the diagnosis of Steinert myotonic dystrophy. At 30-month follow-up, the patient was clinically pain free and well balanced. Plain radiographs showed solid spine fusion with no loss of deformity correction. Scoliosis in Steinert syndrome shares the characteristic of an arthrogrypotic neuromuscular curve and demands the extensive soft tissue release for optimal surgical correction. Intraoperative observations included profound tissue bleeding, abnormally tough soft tissues and a difficult recovery from anaesthesia.

  17. Clinical history and physical examination skills - A requirement for radiographers?

    International Nuclear Information System (INIS)

    Snaith, Beverly A.; Lancaster, Anne

    2008-01-01

    Radiographer's roles have evolved with their scope broadening over the last 20 years culminating in the development of advanced and consultant posts. Yet one development has not been embraced, despite being inherent in medicine and a common extension of nurse and other allied health professionals' roles, is that of clinical assessment. This article explores the evolving role of the radiographer and discusses whether this should include skills in clinical history taking and physical examination. Issues for education and development will be addressed together with examples of current and potential roles

  18. Discrepancy in clinical versus radiological parameters describing deformity due to brace treatment for moderate idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Szulc Andrzej

    2007-12-01

    Full Text Available Abstract Background The shape of the torso in patients with idiopathic scoliosis is considered to reflect the shape of the vertebral column, however the direct correlation between parameters describing clinical deformity and those characterizing radiological curvature was reported to be weak. It is not clear if the management proposed for scoliosis (physiotherapy, brace, surgery affects equally the shape of the axial skeleton and the surface of the body. The aim of the study was to compare clinical deformity of (1 idiopathic scoliosis girls being under brace treatment for radiological curves of 25 to 40 degrees and (2 non treated scoliotic girls matched for age and Cobb angle. Methods Cross-sectional study of 24 girls wearing the brace versus 26 girls without brace treatment, matched for age and Cobb angle. Hypothesis: Patients wearing the brace for more than 6 months, when comparing to patients without brace, may present different external morphology of the trunk, in spite of having similar Cobb angle. Material. Inclusion criteria: girls, idiopathic scoliosis, growing age (10–16 years, Cobb angle minimum 25°, maximum 40°. The braced group consisted of girls wearing a TLSO brace (Cheneau for more than 6 months with minimum of 16 hours per day. The non-braced group consisted of girls first seen for their spinal deformity, previously not treated. The groups presented similar curve pattern. Methods. Scoliometer exam: angle of trunk rotation at three levels of the spine: upper thoracic, main thoracic, lumbar or thoracolumbar. The maximal angle was noted at each level and the sum of three levels was calculated. Posterior trunk symmetry index (POTSI and Hump Sum were measured using surface topography. Results Cobb angle was 34.9° ± 4.8° in braced and 32.7° ± 4.9° in un-braced patients (difference not significant. The age was 14.1 ± 1.6 years in braced patients and 13.1 ± 1.9 years in un-braced group (p = 0.046. The value of angle of trunk

  19. Clinical and radiographic findings of focally infected polycystic kidneys

    International Nuclear Information System (INIS)

    Rothermel, F.J.; Miller, F.J. Jr.; Sanford, E.; Drago, J.; Rohner, T.J.

    1977-01-01

    Three patients with localized polycystic kidney infections are presented with the pertinent clinical, laboratory, and radiographic findings. Gallium-67 citrate and angiography play an important role in evaluation of these patients. Angiography in particular is valuable in the diagnosis and the exact localization of the inflammatory disease. Localization is extremely important in planning surgical treatment should conservative therapy fail

  20. The lungs in rheumatoid arthritis - a clinical, radiographic and ...

    African Journals Online (AJOL)

    The lungs in rheumatoid arthritis - a clinical, radiographic and pulmonary function study. Stephen C. Morrison, Girish M. Mody, Sally R. Benatar, Orlando L Meyers. Abstract. Objective. To detennine the prevalence and spectrum of pulmonary abnormalities in patients with rheumatoid arthritis (RA) in a developing country.

  1. Adolescent Idiopathic Scoliosis Treatment by a Korean Neurosurgeon: The Changing Role for Neurosurgeons

    OpenAIRE

    Hyun, Seung-Jae; Kim, Woong-Beom; Park, Young-Seop; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Yongjung J.

    2015-01-01

    Objective The purpose of this study was to evaluate radiographic/clinical outcomes of adolescent idiopathic scoliosis (AIS) patients treated by a Korean neurosurgeon. Methods Ten AIS patients were treated by a single neurosurgeon between January 2011 and September 2013 utilizing segmental instrumentation with pedicle screws. Basic demographic information, curve pattern by Lenke classification, number of levels treated, amount of correction achieved, radiographic/clinical outcomes [by Scolisis...

  2. [Scoliosis: the bent spine].

    Science.gov (United States)

    Radl, R; Maafe, M; Ziegler, S

    2011-05-01

    Scoliosis, a permanent abnormal curvature of the spine to the side, is divided into four forms: idiopathic (infantile, juvenile and adolescent, accounting for 80% of cases), neurogenic, congenital and adult scoliosis. Most patients with adolescent idiopathic scoliosis initially have mainly cosmetic problems. However, neurogenic, congenital and adult scoliosis can lead to severe clinical symptoms. The leading symptom is back pain caused by secondary changes. In recent years the Lenke classification has been proven to be a reliable tool for disease classification. Non-progressive scoliosis is usually treated conservatively. In the case of Cobb angles of greater than 50°, surgical therapy is recommended in patients presenting before adulthood. Technical improvements in implants and the optimisation of surgical methods have set a trend in the direction of surgical therapy.

  3. Iphone app use to Cobb angle in adolescent idiopathic scoliosis: Does this apply?

    Directory of Open Access Journals (Sweden)

    Antenor Rafael de Oliveira Mazzuia

    2015-06-01

    Full Text Available OBJECTIVE: To validate a new method of measuring the Cobb angle for scoliosis from the mobile app CobbMeter to facilitate the evaluation and measurement in clinical practice.METHODS: Five observers with minimum experience of two years in the field performed radiographic measurements of Cobb angle in 24 radiographs of patients with adolescent idiopathic scoliosis through the CobbMeter. Observers performed serial measures on the images with the application, which were repeated after one month. The most experienced appraiser of the group, after measurements were made through the application, determined the Cobb angle in each radiography by the traditional method.RESULTS: The mean standard deviation by comparing the angles electronically and manually measured had no clinical significance. Although 40% of electronic measurements are outside the confidence interval when compared to manual measurements, this difference was insignificant in clinical practice.CONCLUSIONS: The CobbMeter is another alternative for measuring Cobb angle in scoliosis.

  4. Adult Scoliosis

    Science.gov (United States)

    ... For Parents For Adolescents For Adults Scoliosis Kyphosis Spondylolysis Other Spine Deformities & Conditions Conditions of the Aging ... For Parents For Adolescents For Adults Scoliosis Kyphosis Spondylolysis Other Spine Deformities & Conditions Conditions of the Aging ...

  5. Selection of fusion levels in idiopathic adolescent scoliosis treated by Harrington-DDT instrumentation

    DEFF Research Database (Denmark)

    Andersen, G R; Andersen, M O; Christensen, S B

    1995-01-01

    Clinical records and radiographs of 106 patients treated by Harrington-dorsal transverse traction (DDT) instrumentation for idiopathic adolescent thoracolumbar scoliosis were reviewed. Our strategy was to fuse from one vertebra above the measured curve to two vertebrae below the curve, but to avoid...

  6. Radiografias em inclinação lateral como fator preditivo da correção cirúrgica na escoliose idiopática do adolescente Bending radiographs as a predictive factor in surgical correction of adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Alberto Ofenhejm Gotfryd

    2011-10-01

    Full Text Available OBJETIVO: Avaliar a utilização de radiografias com inclinação lateral ativa em decúbito dorsal como fator preditivo da correção cirúrgica da curva torácica principal em pacientes com escoliose idiopática do adolescente (EIA. MÉTODOS: Foram avaliados, clínica e radiograficamente, 20 pacientes portadores de EIA tipo Lenke 1A e 1B operados por via posterior, utilizando nas montagens apenas parafusos pediculares. A flexibilidade das curvas foi calculada através de radiografias em inclinação lateral supina ativa. Os valores obtidos no pré-operatório para a curva torácica principal foram incluídos em uma equação matemática proposta por Cheung et al com a finalidade de predizer o resultado angular esperado após a correção cirúrgica. Após isto, foi realizado estudo estatístico de significância entre o valor predito e o real pós-operatório. RESULTADOS: Houve significância estatística para todos os casos estudados em relação ao valor predito pré-operatoriamente e os achados radiográficos do pós-operatório imediato (p OBJECTIVE: To evaluate the use of x-rays in dorsal decubitus, as a predictive factor for surgical correction of the main thoracic curve using pedicle screws, on patients with idiopathic adolescent scoliosis. METHOD: Twenty patients with idiopathic adolescent scoliosis of Lenke types 1A and 1B who were operated using a technique only involving pedicle screws by means of the posterior route were evaluated clinically and radiographically. The curve flexibility was calculated by means of active supine lateral oblique radiographs. The postoperative values for the main thoracic curve were included in a mathematical equation proposed by Cheung et al., with the aim of predicting the expected angular result from the surgical correction. The difference between the expected and actual postoperative results was then investigated regarding its statistical significance. RESULTS: There was statistical significance for

  7. Clinical and radiographic evaluation of modular knee replacement

    International Nuclear Information System (INIS)

    Cartier, P.; Mammeri, M.; Villers, P.

    1982-01-01

    Ninety-five modular total knee replacements, 54 of them unicompartmental, have been reviewed. The average follow-up was three years. The major indication for operation was pain. A precise preoperative radiographic evaluation and a technique for a positioning the components are described. This had led to a significant improvement in the clinical and radiographic results in 67 out of 95 knees which were operated on. The modifications concern the orientation of the tibial cut, the placing of the femoral components and the correction of axial deviation. The main causes of the 13% of failures in our series were either errors in positioning the components or a preoperative diagnosis of rheumatoid arthritis. Unicompartmental replacement gave similar results in both valgus and varus knees, and the morbidity was lower than in the bicompartmental replacements. The best results were obtained in osteoarthristic knees in elderly patients and in posttraumatic osteoarthritis. (orig.)

  8. Clinical and radiographic characteristics of ureteral polyps in children

    International Nuclear Information System (INIS)

    Niu Zhibing; Wang Changlin; Yang Qi; Hou Ying

    2007-01-01

    Objective: To analyze the clinical and radiographic characterstics of ureteral polyps with hydronephrosis in children. Methods: Thirteen patients with ureteral polyps and hydronephrosis were studied retrospectively. All patients underwent abdominal plain film, intravenous pyelogram (IVP) and ultrasound (US) examinations,contrast-enhanced CT scan was performed in 10 cases. Results: Intermittent or recurrent abdominal pain with painless hematuria was presented in most cases. Hydronephrosis was demonstrated in radiographic images. IVP delineated the dilatation of the ureter and filling defects within the ureteral lumen in 5 cases. Computed tomography (CT) showed all abnormal changes of ureter and irregular intraluminal soft tissue masses in 6 cases. Moderate and low echoic structures were showed in ureters by US in 2 cases. Conclusion: US and CT, as an important imaging modalities, can improve the diagnostic accuracy for ureteral polyps. (authors)

  9. A clinical and radiographic study of dentigerous cysts

    International Nuclear Information System (INIS)

    Lee, Kang Sook; Choi, Karp Shik

    1995-01-01

    The purpose of this study was to obtain information on the clinical and radiographic features of the dentigerous cysts in the jaws. For this study, the authors examined and analysed the clinical records and radiographs of 233 patients who had lesions of dentigerous cyst diagnosed by clinical and radiographic or histopathological examination. The following results were obtained: 1. Dentigerous cysts occurred the most frequently in the 2nd decade (38.2%) and occurred more frequently in males (67.4%) than in females (32.6%).2. The most common clinical symptom was swelling of the jaw (33.9%), and the lesions were treated by the method of surgical removal. 3. The type of lesions was mainly observed as central type (72.5%), and size of the lesion was most frequently observed 2-2.9 cm in the widest length. 4. The lesions were most frequently observed well-defined outline with hyperostotic border (49.8%), and smooth margin (73.4%), and homogeneous lesional radiolucency (79.4%). 5. Cortical thinning and expansion of the lesions (82.0%) were observed, and their direction were most frequently observed toward buccal side (64.0%). 6. The effect on the causative tooth were observed as tooth displacement (41.2%) and delayed root development (19.3%), and the distance between cemento-enamel junction and lesional wall attachment of the causative tooth was mainly observed as below 2 mm (79.6%). 7. The effect on the adjacent tooth were observed as loss of lamina dura (66.8%), root resorption (33.9%). and tooth displacement (31.5%). 8. The effect on the adjacent anatomic structure were observed as displacement of the mandibular canal (46.5%) and maxillary sinus or nasal cavity (72.2%).

  10. The effectiveness of core stabilization exercise in adolescent idiopathic scoliosis: A randomized controlled trial.

    Science.gov (United States)

    Gür, Gözde; Ayhan, Cigdem; Yakut, Yavuz

    2017-06-01

    Core stabilization training is used to improve postural balance in musculoskeletal problems. The purpose of this study was to investigate the effectiveness of stabilization training in adolescent idiopathic scoliosis. A randomized controlled trial, pretest-posttest design. In total, 25 subjects with adolescent idiopathic scoliosis were randomly divided into two groups: stabilization group ( n = 12) and control group ( n = 13). The stabilization group received core stabilization in addition to traditional rehabilitation, and the control group received traditional rehabilitation for 10 weeks. Assessment included Cobb's angle on radiograph, apical vertebral rotation in Adam's test, trunk asymmetry (Posterior Trunk Symmetry Index), cosmetic trunk deformity (Trunk Appearance Perception Scale), and quality of life (Scoliosis Research Society-22 questionnaire). Inter-group comparisons showed significantly greater improvements in the mean change in lumbar apical vertebral rotation degree and the pain domain of Scoliosis Research Society-22 in the stabilization group than those in the control group ( p adolescent idiopathic scoliosis. Clinical relevance Stabilization exercises are more effective in reducing rotation deformity and pain than traditional exercises in the conservative rehabilitation of adolescent idiopathic scoliosis. These improvements suggest that stabilization training should be added to rehabilitation programs in adolescent idiopathic scoliosis.

  11. Features of clinical and radiographic appearances of SARS in children

    International Nuclear Information System (INIS)

    Zeng Jinjin; Sun Guoqiang; Shen Kunling; Yang Yonghong; Wei Xinmiao; Lei Gang

    2003-01-01

    Objective: To evaluate the features of clinical and radiographic appearances of SARS in children. Methods: The chest films obtained at clinical presentation and during treatment in 18 children with confirmed SARS were retrospectively evaluated. Results: The main X-ray manifestations included: (1) air-space opacity in 13/18; (2) round lesion with clear margin in 3/18; (3) ground-glass lesions in 2/18; (4) unilateral and single focal involvement was more common in children than in adults (5) no reticular shadow, lymphanopathy or pleural effusion was demonstrated; (6) radiographic changes of foci was not as rapid in children as in adults. The lesions migrated in 1 case. The average absorption time of the lesions was 19 days, and most of them had no remnant. Conclusion: Compare with that in adults , the clinical manifestation was not so severe in children with SARS, and most of the infected children had clear contact history. Chest X-ray appearance in affected children mainly showed unilateral involvement of the lungs with chiefly air-space infiltrates. Remnant lesion of lung is rare in children. Differential diagnosis of SARS in children includes mycoplasma pneumonia or adenovirus pneumonia

  12. Adolescent idiopathic scoliosis screening for school, community, and clinical health promotion practice utilizing the PRECEDE-PROCEED model

    Directory of Open Access Journals (Sweden)

    Wyatt Lawrence A

    2005-11-01

    Full Text Available Abstract Background Screening for adolescent idiopathic scoliosis (AIS is a commonly performed procedure for school children during the high risk years. The PRECEDE-PROCEDE (PP model is a health promotion planning model that has not been utilized for the clinical diagnosis of AIS. The purpose of this research is to study AIS in the school age population using the PP model and its relevance for community, school, and clinical health promotion. Methods MEDLINE was utilized to locate AIS data. Studies were screened for relevance and applicability under the auspices of the PP model. Where data was unavailable, expert opinion was utilized based on consensus. Results The social assessment of quality of life is limited with few studies approaching the long-term effects of AIS. Epidemiologically, AIS is the most common form of scoliosis and leading orthopedic problem in children. Behavioral/environmental studies focus on discovering etiologic relationships yet this data is confounded because AIS is not a behavioral. Illness and parenting health behaviors can be appreciated. The educational diagnosis is confounded because AIS is an orthopedic disorder and not behavioral. The administration/policy diagnosis is hindered in that scoliosis screening programs are not considered cost-effective. Policies are determined in some schools because 26 states mandate school scoliosis screening. There exists potential error with the Adam's test. The most widely used measure in the PP model, the Health Belief Model, has not been utilized in any AIS research. Conclusion The PP model is a useful tool for a comprehensive study of a particular health concern. This research showed where gaps in AIS research exist suggesting that there may be problems to the implementation of school screening. Until research disparities are filled, implementation of AIS screening by school, community, and clinical health promotion will be compromised. Lack of data and perceived importance by

  13. Esophageal Lichen Planus: Clinical and Radiographic Findings in Eight Patients.

    Science.gov (United States)

    Rauschecker, Andreas M; Levine, Marc S; Whitson, Matthew J; Tondon, Rashmi; Rubesin, Stephen E; Furth, Emma E; Metz, David C

    2017-01-01

    The purpose of this study is to present the clinical and radiographic findings of esophageal lichen planus. A search of computerized medical records identified 15 patients with pathologic findings of esophageal lichen planus on endoscopic biopsy specimens. Three other patients had presumed esophageal lichen planus, although no biopsy specimens were obtained. Twelve of these 18 patients (67%) had double-contrast esophagography performed at our institution; for eight of the 12 patients (67%), the studies revealed abnormalities in the esophagus. These eight patients constituted our study group. The barium esophagrams and medical records of these eight patients were reviewed to determine the clinical, radiographic, and endoscopic findings of esophageal lichen planus as well as the treatment and patient outcome. All eight patients were women (median age, 66.5 years), and all eight presented with dysphagia (mean duration, 3.2 years). Four patients had previous lichen planus that involved the skin (n = 1), the oral cavity (n = 2), or both (n = 1), and one patient later had lichen planus that involved the vagina. Five patients had a small-caliber esophagus with diffuse esophageal narrowing. The remaining three patients had segmental strictures in the cervical (n = 1), upper thoracic (n = 1), and distal thoracic (n = 1) esophagus. Esophageal lichen planus typically occurs in older women with longstanding dysphagia and often develops in the absence of extraesophageal disease. Barium esophagrams may reveal a small-caliber esophagus or, less commonly, segmental esophageal strictures. Greater awareness of the radiographic findings of esophageal lichen planus hopefully will lead to earlier diagnosis and better management of this condition.

  14. Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short term radiological and clinical results based on SOSORT and SRS criteria

    Science.gov (United States)

    2011-01-01

    Background Conservative scoliosis therapy according to the FITS Concept is applied as a unique treatment or in combination with corrective bracing. The aim of the study was to present author's method of diagnosis and therapy for idiopathic scoliosis FITS-Functional Individual Therapy of Scoliosis and to analyze the early results of FITS therapy in a series of consecutive patients. Methods The analysis comprised separately: (1) single structural thoracic, thoracolumbar or lumbar curves and (2) double structural scoliosis-thoracic and thoracolumbar or lumbar curves. The Cobb angle and Risser sign were analyzed at the initial stage and at the 2.8-year follow-up. The percentage of patients improved (defined as decrease of Cobb angle of more than 5 degrees), stable (+/- 5 degrees), and progressed (increase of Cobb angle of more than 5 degrees) was calculated. The clinical assessment comprised: the Angle of Trunk Rotation (ATR) initial and follow-up value, the plumb line imbalance, the scapulae level and the distance from the apical spinous process of the primary curve to the plumb line. Results In the Group A: (1) in single structural scoliosis 50,0% of patients improved, 46,2% were stable and 3,8% progressed, while (2) in double scoliosis 50,0% of patients improved, 30,8% were stable and 19,2% progressed. In the Group B: (1) in single scoliosis 20,0% of patients improved, 80,0% were stable, no patient progressed, while (2) in double scoliosis 28,1% of patients improved, 46,9% were stable and 25,0% progressed. Conclusion Best results were obtained in 10-25 degrees scoliosis which is a good indication to start therapy before more structural changes within the spine establish. PMID:22122964

  15. Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short term radiological and clinical results based on SOSORT and SRS criteria

    Directory of Open Access Journals (Sweden)

    Białek Marianna

    2011-11-01

    Full Text Available Abstract Background Conservative scoliosis therapy according to the FITS Concept is applied as a unique treatment or in combination with corrective bracing. The aim of the study was to present author's method of diagnosis and therapy for idiopathic scoliosis FITS-Functional Individual Therapy of Scoliosis and to analyze the early results of FITS therapy in a series of consecutive patients. Methods The analysis comprised separately: (1 single structural thoracic, thoracolumbar or lumbar curves and (2 double structural scoliosis-thoracic and thoracolumbar or lumbar curves. The Cobb angle and Risser sign were analyzed at the initial stage and at the 2.8-year follow-up. The percentage of patients improved (defined as decrease of Cobb angle of more than 5 degrees, stable (+/- 5 degrees, and progressed (increase of Cobb angle of more than 5 degrees was calculated. The clinical assessment comprised: the Angle of Trunk Rotation (ATR initial and follow-up value, the plumb line imbalance, the scapulae level and the distance from the apical spinous process of the primary curve to the plumb line. Results In the Group A: (1 in single structural scoliosis 50,0% of patients improved, 46,2% were stable and 3,8% progressed, while (2 in double scoliosis 50,0% of patients improved, 30,8% were stable and 19,2% progressed. In the Group B: (1 in single scoliosis 20,0% of patients improved, 80,0% were stable, no patient progressed, while (2 in double scoliosis 28,1% of patients improved, 46,9% were stable and 25,0% progressed. Conclusion Best results were obtained in 10-25 degrees scoliosis which is a good indication to start therapy before more structural changes within the spine establish.

  16. Horizontal fissure on neonatal plain chest radiographs: clinical implications

    International Nuclear Information System (INIS)

    Konarzewska, J.; Zawadzka-Kepczynska, A.; Bianek-Bodzak, A.; Kawinska-Kilianczyk, A.; Domzalska-Popadiuk, I.

    2005-01-01

    Regardless of etiology, pleural fluid, even in small amounts, can be visualized on the neonatal chest x-ray picture within pulmonary fissures. It remains unclear whether a marked horizontal fissure unaccompanied by any other radiological symptoms is of diagnostic value or not. Ninety-one consecutive neonatal chest radiographs with marked horizontal fissure were retrospectively analyzed. The images were made between 1999 and 2005 on 69 newborns admitted to the Neonatology Department, Institute of Obstetrics and Gynecology, Medical University of Gdansk. Analysis of the radiographs was conducted independently by three radiologists based on the following criteria: fissure thickness (marked or thickened), bronchovascular markings (increased or normal), size and shape of the heart (normal or abnormal), presence or absence of pulmonary infiltration, atelectasis, and changes related to wet lung syndrome. Due to divergent interpretations, the ultimate interpretation was established by consensus in 25 cases. The radiological findings were compared with clinical data. The compatibility of the three independent interpreters was statistically significant (p<0.0001). Marked transverse fissure was the only radiological finding on 66 x-rays. In 63 cases (69.2%) the children were asymptomatic as well. In 3 cases (3.3%) clinical symptoms of respiratory tract infection occurred. On the other 25 images, horizontal fissure was accompanied by other radiological symptoms. Chest x-ray results corresponded with clinical symptoms in 24 cases (26.4%). One child (1.1%) with radiological evidence of wet lung syndrome did not present any typical clinical symptoms of it. Horizontal fissure noted on a neonatal chest x-ray seems to be of minor diagnostic value if not accompanied by any other radiological symptoms. (author)

  17. Radiographic findings of gastrointestinal anisakiasis: clinical and pathologic correlation

    International Nuclear Information System (INIS)

    Chung, Tae Woong; Kang, Heoung Keun; Jeong, Yong Yeon; And Others

    2000-01-01

    To evaluate the radiographic findings of gastrointestinal anisakiasis with clinical and pathologic correlation. In ten patients, findings were retrospectively analysed. There were two cases of the gastric variety of gastrointestinal anisakiasis and eight of the intestinal, and they were diagnosed during gastroscopy, by resection during surgery, and on the basis of typical clinical findings. All ten patients underwent both plain radiography and CT scanning of the abdomen. US was performed in five patients and an upper gastrointestinal series in one. Clinical data were evaluated with regard to a history of raw fish ingestion, time from ingestion of raw fish to onset of symptoms, location of abdominal pain, and laboratory data. Radiologic findings were analysed in terms of wall thickening and appearance, mesenteric infiltration, bowel dilatation proximal to lesion, and ascites. All patients had a history of recent ingestion of raw fish and complained of severe abdominal pain that occurred approximately 7-48 hours later. Pain occurred in the lower abdomen in five patients, the epigastrium in four, and the right lower abdomen in two. Laboratory test disclosed the leukocytosis in eight patients and eosinophilia in three. In all cases of intestinal anisakiasis, ileus was demonstrated on plain radiographs of the abdomen, while the upper gastrointestinal series showed mucosal thickening and multiple filling defects. US findings were bowel thickening and dilation, and on CT images, wall thickening revealed a target sign. Mesenteric infiltration and ascites were seen in seven patients. In four who underwent surgery, a cross-section through the lesion revealed submucosal eosinophilic granuloma with anisakis larva. Although the CT findings are non-specific, taken in conjunction with characteristic clinical findings, they may be helpful in the diagnosis of gastrointestinal anisakiasis. (author)

  18. Radiographic findings of gastrointestinal anisakiasis: clinical and pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Tae Woong; Kang, Heoung Keun; Jeong, Yong Yeon [Medical School, Chonnam University, Kwangju (Korea, Republic of); And Others

    2000-08-01

    To evaluate the radiographic findings of gastrointestinal anisakiasis with clinical and pathologic correlation. In ten patients, findings were retrospectively analysed. There were two cases of the gastric variety of gastrointestinal anisakiasis and eight of the intestinal, and they were diagnosed during gastroscopy, by resection during surgery, and on the basis of typical clinical findings. All ten patients underwent both plain radiography and CT scanning of the abdomen. US was performed in five patients and an upper gastrointestinal series in one. Clinical data were evaluated with regard to a history of raw fish ingestion, time from ingestion of raw fish to onset of symptoms, location of abdominal pain, and laboratory data. Radiologic findings were analysed in terms of wall thickening and appearance, mesenteric infiltration, bowel dilatation proximal to lesion, and ascites. All patients had a history of recent ingestion of raw fish and complained of severe abdominal pain that occurred approximately 7-48 hours later. Pain occurred in the lower abdomen in five patients, the epigastrium in four, and the right lower abdomen in two. Laboratory test disclosed the leukocytosis in eight patients and eosinophilia in three. In all cases of intestinal anisakiasis, ileus was demonstrated on plain radiographs of the abdomen, while the upper gastrointestinal series showed mucosal thickening and multiple filling defects. US findings were bowel thickening and dilation, and on CT images, wall thickening revealed a target sign. Mesenteric infiltration and ascites were seen in seven patients. In four who underwent surgery, a cross-section through the lesion revealed submucosal eosinophilic granuloma with anisakis larva. Although the CT findings are non-specific, taken in conjunction with characteristic clinical findings, they may be helpful in the diagnosis of gastrointestinal anisakiasis. (author)

  19. An online clinical governance learning package for student radiographers

    International Nuclear Information System (INIS)

    Messer, Simon; Griffiths, Marc

    2007-01-01

    Purpose: Clinical governance is a key element of the Government's plan for reform in the National Health Service. As such, it is an essential element for final year undergraduate radiography studies. With Ciris becoming a standard web-based solution for clinical governance within the NHS, a need has been identified for it to be introduced at university to undergraduate radiographers. Methods: A distance learning package for Ciris has therefore been developed that was trialed by third year radiography students whilst on their final clinical placement. The package includes a specifically designed online virtual hospital which the students engaged with interactively using a workbook. The students undertook detailed individual and group exercises aimed at delivering practical experience of the Ciris program and its role in clinical governance. Results: The package was evaluated by the students in terms of their experiential learning and their perceived learning needs for clinical governance. Technical and support issues associated with the delivery of this package online were identified. Conclusion: The combination of a distance online learning environment, supported by a workbook, is an effective method of engaging students and is beneficial in terms of helping achieve learning outcomes in clinical governance for final year radiography studies

  20. Automatic Cobb Angle Determination From Radiographic Images

    NARCIS (Netherlands)

    Sardjono, Tri Arief; Wilkinson, Michael H. F.; Veldhuizen, Albert G.; van Ooijen, Peter M. A.; Purnama, Ketut E.; Verkerke, Gijsbertus J.

    2013-01-01

    Study Design. Automatic measurement of Cobb angle in patients with scoliosis. Objective. To test the accuracy of an automatic Cobb angle determination method from frontal radiographical images. Summary of Background Data. Thirty-six frontal radiographical images of patients with scoliosis. Methods.

  1. Radiographer's impact on improving clinical decision-making, patient care and patient diagnosis: a pilot study

    International Nuclear Information System (INIS)

    Lam, Daniel; Egan, Ingrid; Baird, Marilyn

    2004-01-01

    This pilot study attempts to quantify the benefits of a documented radiographic clinical history through the use of the clinical history template form designed by Egan and Baird. Six radiographers completed the clinical history template for 40 patients and four radiologists included the recorded information as part of their reporting process. A focus discussion group was held between the radiographers to ascertain the level of satisfaction and benefits encountered with the use of the template form. A questionnaire was designed for the radiologists to complete regarding the usefulness of the template form with respect to the radiological reporting process. Results/Discussion: 15 cases for which the form was used demonstrated a direct benefit in respect to improved radiographic clinical decision-making. Radiographers agreed the template form aided the establishment of a stronger radiographer-patient relationship during the radiographic examination. Two radiologists agreed the form aided in establishing a radiological diagnosis and suggested the form be implemented as part of the standard departmental protocol. Despite the small sample size, there is evidence the form aided radiographic decision-making and assisted in the establishment of an accurate radiological diagnosis. The overall consensus amongst radiographers was that it enhanced radiographer-patient communication and improved the level of patient care. Copyright (2004) Australian Institute of Radiography

  2. Variability amongst radiographers in the categorization of clinical acceptability for digital trauma radiography

    Science.gov (United States)

    Decoster, Robin; Toomey, Rachel; Smits, Dirk; Mol, Harrie; Verhelle, Filip; Butler, Marie-Louise

    2016-03-01

    Introduction: Radiographers evaluate anatomical structures to judge clinical acceptability of a radiograph. Whether a radiograph is deemed acceptable for diagnosis or not depends on the individual decision of the radiographer. Individual decisions cause variation in the accepted image quality. To minimise these variations definitions of acceptability, such as in RadLex, were developed. On which criteria radiographers attribute a RadLex categories to radiographs is unknown. Insight into these criteria helps to further optimise definitions and reduce variability in acceptance between radiographers. Therefore, this work aims the evaluation of the correlation between the RadLex classification and the evaluation of anatomical structures, using a Visual Grading Analysis (VGA) Methods: Four radiographers evaluated the visibility of five anatomical structures of 25 lateral cervical spine radiographs on a secondary class display with a VGA. They judged clinical acceptability of each radiograph using RadLex. Relations between VGAS and RadLex category were analysed with Kendall's Tau correlation and Nagelkerke pseudo-R². Results: The overall VGA score (VGAS) and the RadLex score correlate (rτ= 0.62, pscore. The reproduction of spinous processes (rτ=0.67, pscore. Conclusion: RadLex scores and VGAS correlate positively, strongly and significantly. The predictive value of bony structures may support the use of these in the judgement of clinical acceptability. Considerable inter-observer variations in the VGAS within a certain RadLex category, suggest that observers use of observer specific cut-off values.

  3. Clinical and Plain Radiograph Pattern of Joint Dislocations and ...

    African Journals Online (AJOL)

    Plain radiograph is an integral part of early assessment of patients' evaluation, though newer imaging modalities such as magnetic resonance imaging (MRI), ... Conclusion: The shoulder joint is the most frequently dislocated and a conventional plain radiograph is still valuable as a first line investigative modality in ...

  4. Clinical and radiographic assessment of approximal carious lesions

    International Nuclear Information System (INIS)

    Espelid, I.; Tveit, A.B.

    1986-01-01

    The aim of the study was to compare the radiographic diagnosis of approximal carious lesions with visual observations of the approximal surfaces and within drilled Class II cavities (made into the pulp). Sound (n=28) and carious (n=123) approximal surfaces of extracted premolars and molars were radiographed. The radiographs were studied by seven observers to diagnose caries. Lesions without cavitation were most often classified as sound (61.3%). When lesions had cavities, the rate of detection increased to 89.1%. Sound surfaces were erroneously classified as carious in 15.7% of cases. Statistically, about 6 our of every 10 qualitative assessments of lesion depth on the basis of radiographs, correctly recorded lesions as being in enamel or extending into dentin. The interexaminer variation in radiographic caries diagnosis were mostly due to difference in diagnostic criteria, whereas differences in diagnostic capability were less important

  5. Radiographic and Functional Outcome in Adolescent Idiopathic Scoliosis Operated With Hook/Hybrid Versus All-Pedicle Screw Instrumentation-A Retrospective Study in 149 Patients

    DEFF Research Database (Denmark)

    Ohrt-Nissen, Søren; Hallager, Dennis W; Karbo, Ture

    2017-01-01

    largely replaced H/H in the surgical treatment of AIS but whether a normalized sagittal profile can be obtained with the PS construct is still debated. Additionally, comparative studies assessing HRQL and surgical complications are needed. METHODS: Two consecutive series of surgically treated AIS patients...... were included. Surgical treatment consisted of H/H or low-profile all-PS instrumentation. Radiographic and clinical follow-up, including SRS-22r questionnaires, was performed a minimum of two years postoperatively. RESULTS: There were 85 and 64 patients in the H/H and PS group, respectively. The groups...... 4° (p kyphosis was significantly higher in the H/H group (27° ± 11° vs. 22° ± 11° in the PS group) with a mean change in kyphosis of 3° ± 9° versus -3° ± 12...

  6. Exploratory analyses of the association of MRI with clinical, laboratory and radiographic findings in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Emery, Paul; van der Heijde, Désirée; Østergaard, Mikkel

    2011-01-01

    Evaluate relationships between MRI and clinical/laboratory/radiographic findings in rheumatoid arthritis (RA).......Evaluate relationships between MRI and clinical/laboratory/radiographic findings in rheumatoid arthritis (RA)....

  7. Clinical cavitation and radiographic lesion depth in proximal surfaces in an Indian population

    DEFF Research Database (Denmark)

    Sansare, Kaustubh; Raghav, Mamta; Sontakke, Subodeh

    2014-01-01

    the developing world. Materials and methods. Relationship between clinical cavitation and radiographic caries lesion depth in proximal surfaces in an Indian population was assessed. Proximal surfaces (n = 126) without restorations were examined on bitewing radiographs in patients with suspected caries and lesion......Abstract Objectives. To assess the relationship between clinical cavitation and radiographic caries lesion depth in proximal surfaces of permanent posterior teeth in an Indian population. This study also assessed the clinical feasibility of applying 'western guidelines' to this population from...... to the radiographic findings of lesion depth, 80-100% of the lesions observed in outer dentine would lead to a false (non-operative) treatment decision. Conclusions. Radiographic shallow carious lesions were often cavitated in this population. The threshold for cavitation in this study population is suggested...

  8. Root form and clinical radiographic estimation of the number of root ...

    African Journals Online (AJOL)

    The root form of 100 extracted maxillary premolars, the pre-operative radiographic estimation and clinical radiographic determination of the number of root canals in 340 maxillary premolars of Nigerian patients attending the dental hospital for endodontic treatment were studied. The maxillary second premolars had one root ...

  9. Analysis and evaluation of the radiological aspects of scoliosis

    International Nuclear Information System (INIS)

    Vargas Gonzalez, Paula

    2012-01-01

    The theme of scoliosis is proposed from the radiological perspective. An extensive literature review is realized, extracting the most relevant information for research. The initiation and evolution of scoliosis has been silent, therefore, to meet this condition has been important to detect it early and opportunely, before that curvatures have progressed and become structured, forcing the surgical treatment. The timely correction of curvatures in the spine has generated significant conditions in the patient's life. The early diagnosis has been fundamental to realize an opportune treatment of orthopedic type. A great variety of congenital and developmental disorders have been evident in the spine. The causes and patterns of the abnormal curvature of the spine have been varied. Precise diagnosis of these alterations is supported on a careful clinical assessment and is aided by imaging explorations, such as conventional radiography, computed tomography, ultrasound and magnetic resonance. Imaging methods to detect scoliosis are mentioned. The measurement procedures of the angle of spine curve are determined. The classification of scoliosis according to King-Lenke are cited to facilitate objective assessment of a disease for examiners, making that the results are presented in shape uniform and comparable possible. The types of scoliosis are explained. The characterization of the deformities of the axis of the spine, quantification and estimation of the degree of skeletal maturity has been the principal objective of the spine radiography. In an radiography has been important to be included all the thoracolumbar spine from C7. The Cobb and Ferguson measurements are used to measure angles, Risser for skeletal maturation, Nas and Moe for vertical rotation. Congenital deformities should be taken into account in radiographs of spine. Each vertebra is examined minutely in search of malformations of fusion, etc., that explain scoliosis. In neurological disorders, to take

  10. Correlation between clinical and radiographic findings on the occurrence of furcation involvement in patients with periodontitis

    Directory of Open Access Journals (Sweden)

    Estela Santos Gusmão

    2014-01-01

    Conclusion: Taking into consideration the method employed and the results obtained, it may be concluded that the clinical and radiographic examinations performed are effective tools for diagnosing furcation involvement in teeth affected with periodontal disease.

  11. Clinical outcome and radiographic results after operative treatment of Scheuermann's disease

    NARCIS (Netherlands)

    Poolman, R. W.; Been, H. D.; Ubags, L. H.

    2002-01-01

    The aim of this prospective study was to evaluate radiographic findings, patient satisfaction and clinical outcome, and to report complications and instrumentation failure after operative treatment of Scheuermann's disease using a combined anterior and posterior spondylodesis. The loss of sagittal

  12. Clinical and radiographic evaluation of Portland cement added to radiopacifying agents in primary molar pulpotomies.

    Science.gov (United States)

    Lourenço Neto, N; Marques, N C T; Fernandes, A P; Hungaro Duarte, M A; Abdo, R C C; Machado, M A A M; Oliveira, T M

    2015-10-01

    This was to evaluate the clinical and radiographic outcomes of Portland cement (PC) added to radiopacifying agents in primary molar pulpotomies. Thirty primary mandibular molars of children aged between 5 and 9 years were randomly assigned to the following groups: PC; PC with iodoform (PC + CHI(3)); PC with zirconium oxide (PC + ZrO(2)) and treated by pulpotomy technique. Clinical and radiographic follow-up assessments were performed at 6, 12 and 24 months. Statistical analysis was performed by Fisher's exact test (P < 0.05). The clinical and radiographic evaluations showed 100 % success rates, and the results showed no statistically significant difference between groups. According to this study, PC added to radiopacifying agents exhibited satisfactory clinical and radiographic results in primary molar pulpotomies.

  13. Spinal Cord Injury without Radiographic Abnormality (SCIWORA) – Clinical and Radiological Aspects

    OpenAIRE

    Szwedowski, Dawid; Walecki, Jerzy

    2014-01-01

    Summary The acronym SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) was first developed and introduced by Pang and Wilberger who used it to define “clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability”. SCIWORA is a clinical-radiological condition that mostly affects children. SCIWORA lesions are found mainly in the cervical spine but can also be seen, although much less frequently, in the thoracic or l...

  14. [Optimization of radiological scoliosis assessment].

    Science.gov (United States)

    Enríquez, Goya; Piqueras, Joaquim; Catalá, Ana; Oliva, Glòria; Ruiz, Agustí; Ribas, Montserrat; Duran, Carmina; Rodrigo, Carlos; Rodríguez, Eugenia; Garriga, Victoria; Maristany, Teresa; García-Fontecha, César; Baños, Joan; Muchart, Jordi; Alava, Fernando

    2014-07-01

    Most scoliosis are idiopathic (80%) and occur more frequently in adolescent girls. Plain radiography is the imaging method of choice, both for the initial study and follow-up studies but has the disadvantage of using ionizing radiation. The breasts are exposed to x-ray along these repeated examinations. The authors present a range of recommendations in order to optimize radiographic exam technique for both conventional and digital x-ray settings to prevent unnecessary patients' radiation exposure and to reduce the risk of breast cancer in patients with scoliosis. With analogue systems, leaded breast protectors should always be used, and with any radiographic equipment, analog or digital radiography, the examination should be performed in postero-anterior projection and optimized low-dose techniques. The ALARA (as low as reasonable achievable) rule should always be followed to achieve diagnostic quality images with the lowest feasible dose. Copyright © 2014. Published by Elsevier Espana.

  15. [Peculiarities of clinical manifestations and physiotherapy of discogenic scoliosis in young subjects].

    Science.gov (United States)

    Miriutinova, N F; Suleĭmanov, R R

    2011-01-01

    The present study has demonstrated that pulsed magnetotherapy in combination with the traction of the vertebral column in young subjects with discogenic scoliosis makes it possible to reduce the flow of vertebral painful pulsation, has beneficial effect on the spinal muscular corset (reduced asymmetry of the muscular tone on the intact and affected sides), decreases the degree of vertebral deformation, broadens the scope of spinal movements due to the enhanced activity of vertebral muscles, and helps to sustain and maintain the results thus obtained for a longer period.

  16. Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    ... Radiation Exposure in Scoliosis Kyphosis Adolescent Back Pain Spondylolysis For Adolescents For Adults Common Questions & Glossary Resources ... Radiation Exposure in Scoliosis Kyphosis Adolescent Back Pain Spondylolysis For Adolescents For Adults Juvenile Idiopathic Scoliosis Diagnosed ...

  17. [Characteristics of neuromuscular scoliosis].

    Science.gov (United States)

    Putzier, M; Groß, C; Zahn, R K; Pumberger, M; Strube, P

    2016-06-01

    Usually, neuromuscular scolioses become clinically symptomatic relatively early and are rapidly progressive even after the end of growth. Without sufficient treatment they lead to a severe reduction of quality of life, to a loss of the ability of walking, standing or sitting as well as to an impairment of the cardiopulmonary system resulting in an increased mortality. Therefore, an intensive interdisciplinary treatment by physio- and ergotherapists, internists, pediatricians, orthotists, and orthopedists is indispensable. In contrast to idiopathic scoliosis the treatment of patients with neuromuscular scoliosis with orthosis is controversially discussed, whereas physiotherapy is established and essential to prevent contractures and to maintain the residual sensorimotor function.Frequently, the surgical treatment of the scoliosis is indicated. It should be noted that only long-segment posterior correction and fusion of the whole deformity leads to a significant improvement of the quality of life as well as to a prevention of a progression of the scoliosis and the development of junctional problems. The surgical intervention is usually performed before the end of growth. A prolonged delay of surgical intervention does not result in an increased height but only in a deformity progression and is therefore not justifiable. In early onset neuromuscular scolioses guided-growth implants are used to guarantee the adequat development. Because of the high complication rates, further optimization of these implant systems with regard to efficiency and safety have to be addressed in future research.

  18. Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis

    Directory of Open Access Journals (Sweden)

    Sébastien Pesenti

    2016-01-01

    Full Text Available The objective of this investigation was to determine the outcome of spine fusion for neuromuscular (NM scoliosis, using Unit Rod technique, with emphasis on complications related to preoperative general health. Between 1997 and 2007, 96 consecutive patients with neuromuscular scoliosis operated on with Unit Rod instrumentation were retrospectively reviewed. The inclusion criteria were diagnosis of NM scoliosis due to cerebral palsy (CP and muscular dystrophy (DMD. Patient’s preoperative general health, weight, and nutrition were collected. Different radiographic and clinical parameters were evaluated. There were 66 CP patients (59 nonwalking and 30 DMD patients (24 nonwalking. Mean age at surgery was 16.5 years and 13.9 years, respectively. All radiographic measurements improved significantly. Wound infection rate was 16.7% (11% of reoperation rate in CP; 10% in DMD; 3 hardware removal cases. No pelvic fracture due to rod irritation was observed. Unit Rod technique provides good radiographic and clinical outcomes even if this surgery is associated with a high complication rate. It is a quick, simple, and reliable technique. Perioperative management strategy should decrease postoperative complications and increases outcome. A standardized preoperative patient evaluation and preparation including respiratory capacity and nutritional, digestive, and musculoskeletal status are mandatory prior to surgery.

  19. A study on findings from simple chest radiographs without any clinical symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham Gyum [Ansan College, Ansan (Korea, Republic of)

    2007-06-15

    In this study, the analysis on findings from simple chest radiography (CXR) test with total 1,669 subjects without any special clinical symptom came to the following conclusions: In terms of the general characteristics of subjects hereof, male and female group accounted for 55.2% and 44.8% respectively out of all 1,669 people. Pulmonary disease cases amounted to 249 persons (14.9%) out of all subjects. In the analysis on prevalence rate by age distribution, it was noted that the older age led to the more number of diseases, which was demonstrated by age 34 or younger (6.1%), age 35 {approx} 39 (9.7%), age 40 {approx} 49 (13.3%), and age 50 or older (30.8%). In regard of pulmonary disease alone, the region of onset was represented primarily by right upper lobe, which was followed by both upper lobe and left upper lobe, respectively. In terms of disease types, it was found that most cases were represented by pulmonary nodule (55.0%), which was followed by cardiomegaly (24.5%), CP angle blunting (4.8%), scoliosis (4.6%) tortuous aorta (2.8%), bronchial luminal dilatation(2.4%), and pleural thickening (2.0%). However, dextrocardia, cystic dilation of bronchus, cavitary lesion, and lung collapse accounted for relatively low rate (0.4% respectively). In terms of disease types by sex, it was found that male group accounted for higher percentage of having cardiomegaly, tortuous aorta and scoliosis than the former. In terms of disease types by age distribution, it was noted that age 34 or younger group accounted for higher percentage of scoliosis than any other age groups, while age 40 {approx} 49 group, age 35 {approx} 39 group, and age 50 or older group represented the case of CP angle blunting, pulmonary nodule, and cardiomegaly/tortuous aorta, respectively.

  20. A study on findings from simple chest radiographs without any clinical symptoms

    International Nuclear Information System (INIS)

    Kim, Ham Gyum

    2007-01-01

    In this study, the analysis on findings from simple chest radiography (CXR) test with total 1,669 subjects without any special clinical symptom came to the following conclusions: In terms of the general characteristics of subjects hereof, male and female group accounted for 55.2% and 44.8% respectively out of all 1,669 people. Pulmonary disease cases amounted to 249 persons (14.9%) out of all subjects. In the analysis on prevalence rate by age distribution, it was noted that the older age led to the more number of diseases, which was demonstrated by age 34 or younger (6.1%), age 35 ∼ 39 (9.7%), age 40 ∼ 49 (13.3%), and age 50 or older (30.8%). In regard of pulmonary disease alone, the region of onset was represented primarily by right upper lobe, which was followed by both upper lobe and left upper lobe, respectively. In terms of disease types, it was found that most cases were represented by pulmonary nodule (55.0%), which was followed by cardiomegaly (24.5%), CP angle blunting (4.8%), scoliosis (4.6%) tortuous aorta (2.8%), bronchial luminal dilatation(2.4%), and pleural thickening (2.0%). However, dextrocardia, cystic dilation of bronchus, cavitary lesion, and lung collapse accounted for relatively low rate (0.4% respectively). In terms of disease types by sex, it was found that male group accounted for higher percentage of having cardiomegaly, tortuous aorta and scoliosis than the former. In terms of disease types by age distribution, it was noted that age 34 or younger group accounted for higher percentage of scoliosis than any other age groups, while age 40 ∼ 49 group, age 35 ∼ 39 group, and age 50 or older group represented the case of CP angle blunting, pulmonary nodule, and cardiomegaly/tortuous aorta, respectively

  1. A clinical and radiographic study of coir workers.

    Science.gov (United States)

    Uragoda, C G

    1975-02-01

    Processing of coir, which is the fibre obtained from the husk of the coconut, is a dusty procedure; 779 workers in two coir processing factories in Sri Lanka were examined clincally and radiographically for evidence of respiratory disease. Respiratory symptoms were present in 20 (2-6%) of them, which is no higher than in the general population. Respiratory disease such as asthma, chronic bronchitis, byssinosis, and pulmonary tuberculosis which may occur from occupational exposures were considered, but there was no evidence to suggest a definite association between these conditions and coir dust. Twenty-two workers had abnormal chest radiographs, but when compared with a control group of 591 workers from an engineering firm where lesions were found in 20 cases, there was no significant difference. In the opinion of the medical officer, management and workers of the large factory investigated, coir dust does not produce any respiratory disability. The chemical composition of coir dust is similar to that of sisal which is also relatively inert.

  2. Formative feedback in the clinical practice setting: What are the perceptions of student radiographers?

    International Nuclear Information System (INIS)

    Fowler, P.; Wilford, B.

    2016-01-01

    The role of feedback to a learner's development has been well established. There is an absence of studies relating to student radiographers experience of gaining and applying formative feedback. This study investigated processes involved in gaining written formative feedback in the clinical practice setting as well as the impact feedback had on student radiographers learning. The data was collected from radiography students at two higher education institutions by electronic questionnaire comprising scaled and open questions. There was a response rate of 37% (n = 103/279). Scaled data was analysed using inferential statistics and the qualitative data helped explain the findings. The majority of students recognised radiographers were frequently busy; resulting in feedback that is generic and not always timely. There is strength of opinion 82.6% (n = 85/103) that student radiographers do not work with any one radiographer consistently enough to enable the provision of constructive and meaningful feedback. There appears to be difficulty in obtaining the comments but the evidence shows they are valued. The majority of students seek feedback that is specific and will clearly identify areas for development. They reflect on feedback as well as use self-criticism of their practice performance indicating the development of autonomous skills. The challenge of enabling consistent one to one working with radiographers, the need to maximise a learning culture within practice environments and ensuring full engagement by radiographers and students could be addressed by modification of the feedback system, a working group being formed from students, supervising radiographers and academic tutors. - Highlights: • Students value constructive criticism and on-going verbal feedback. • Written feedback is not always easy to obtain because of pressures on staff time. • Student radiographers are rarely able to work consistently with the same person. • Student and mentor

  3. Spinal decompensation in degenerative lumbar scoliosis

    NARCIS (Netherlands)

    de Vries, A.A.; Mullender, M.G.; Pluymakers, W.J.; Castelein, R.M.; van Royen, B.J.

    2010-01-01

    Due to the aging population, degenerative scoliosis is a growing clinical problem. It is associated with back pain and radicular symptoms. The pathogenesis of degenerative scoliosis lies in degenerative changes of the spinal structures, such as the intervertebral disc, the facet joints and the

  4. Dental caries, restorations and extractions by dental caries in first permanent molars. Clinical and radiographic study

    International Nuclear Information System (INIS)

    Aguiar, Sandra Maria H.C. Avila de; Santos Pinto, Ruy dos

    1996-01-01

    This research analyse by clinical and radiographic study, dental caries, restorations and extractions in 1.600 first permanent molars, from 400 children, both sexes, aged 5 to 13 years old, assisted in the Children's Clinic, Faculdade de Odontologia de Aracatuba, UNESP, in 1994. (author)

  5. Correlation between clinical and radiographic findings on the occurrence of furcation involvement in patients with periodontitis.

    Science.gov (United States)

    Gusmão, Estela Santos; Picarte, Ana Carolina Lessa Cavalcanti; Ben Barbosa, Maria Bernadete Cavalcanti; Rösing, Cassiano Kuchenbecker; Cimoes, Renata

    2014-01-01

    Aim : The aim of the present study was to determine the occurrence of furcation involvement in the molars of patients with chronic periodontitis and correlate clinical and radiographic findings. Seventy subjects aged 35-69 years enrolled for treatment at a periodontics specialization program in Pernambuco, Brazil (EAP-SCDP-ABO/PE) participated in the study, comprising a total of 350 molars examined. The clinical diagnosis of furcation involvement was performed with a horizontal Nabers probe, whereas the radiographic examination was performed with periapical and bite-wing radiographs. The images were analyzed with an X-ray viewer at 3× magnification. The Chi-square test was used, with the level of significance set at 5%. A total of 64.5% individuals presented with furcation involvement, 43.1% of whom had degree II furcation. A significant association (P = 0.0060) was found between tooth type and frequency of furcation involvement. The first lower and upper molars were affected in 64.5 and 58.5% of cases, respectively. Adequate agreement (0.65) was observed between the clinical and radiographic findings. Taking into consideration the method employed and the results obtained, it may be concluded that the clinical and radiographic examinations performed are effective tools for diagnosing furcation involvement in teeth affected with periodontal disease.

  6. Painful rib hump: a new clinical sign for detecting intraspinal rib displacement in scoliosis due to neurofibromatosis

    Directory of Open Access Journals (Sweden)

    Katsalouli Marina

    2006-06-01

    Full Text Available Abstract Background Spinal cord compression and associate neurological impairment is rare in patients with scoliosis and neurofibromatosis. Common reasons are vertebral subluxation, dislocation, angulation and tumorous lesions around the spinal canal. Only twelve cases of intraspinal rib dislocation have been reported in the literature. The aim of this report is to present a case of rib penetration through neural foramen at the apex of a scoliotic curve in neurofibromatosis and to introduce a new clinical sign for its detection. Methods A 13-year-old girl was evaluated for progressive left thoracic kyphoscoliotic curve due to a type I neurofibromatosis. Clinical examination revealed multiple large thoracic and abdominal "cafe-au-lait" spots, neurological impairment of the lower limbs and the presence of a thoracic gibbous that was painful to pressure at the level of the left eighth rib (Painful Rib Hump. CT-scan showed detachment and translocation of the cephalic end of the left eighth rib into the adjacent enlarged neural foramen. The M.R.I. examination of the spine showed neither cord abnormality nor neurogenic tumor. Results The patient underwent resection of the intraspinal mobile eighth rib head and posterior spinal instrumentation and was neurologically fully recovered six months postoperatively. Conclusion Spine surgeons should be aware of intraspinal rib displacement in scoliotic curves in neurofibromatosis. Painful rib hump is a valuable diagnostic tool for this rare clinical entity.

  7. Clinical validity of panoramic radiographs with Digora PCT

    International Nuclear Information System (INIS)

    Matsuda, Yukiko; Araki, Kazuyuki; Hanazawa, Tomomi; Seki, Kenji; Okano, Tomohiro

    2006-01-01

    The quality of panoramic radiographs with a digital imaging system, Digora PCT, was compared with that of a Fuji Computed Radiography (FCR) system. The exposure settings that would produce the appropriate density for observation of the images were determined. The images of the Digora PCT and the FCR system were observed on a 17-inch CRT monitor and printed films respectively. Thirty images of patients were obtained with each system. Six oral radiologists observed the images and evaluated the visibility of pathologic conditions based on outline of mandible, mandibular canal and bone trabecula, shape of the tooth and periodontal hard tissue of the mandible, shape of the tooth and periodontal hard tissue of the maxilla, and outline of the bony structure of the maxillary sinus, using the following three categories: good, fair, and unacceptable. The images of each system were evaluated separately at an interval of 3 months. Mann-Whitney test with p=0.05 was used to analyze differences between the two systems. There were no images of either system rated as ''unacceptable''. The visibility of the shape of the tooth, periodontal hard tissue, and the outline of the bony structure of the maxillary sinus with the Digora PCT was inferior to that with the FCR system. However, it can be concluded that the image quality of the Digora PCT is adequate for dental purposes because there were no unacceptable images. (author)

  8. Redundant nerve roots of cauda equina in clinically neurologically asymptomatic patients. A clinical and radiographic study

    International Nuclear Information System (INIS)

    Otoshi, Ken-ichi; Kikuchi, Shin-ichi; Konno, Shin-ichi; Arai, Itaru

    2005-01-01

    A radiographic study was conducted to determine the incidence of redundant nerve roots of the cauda equina (RNR) in neurologically asymptomatic patients, and to clarify whether RNR has an impact on the clinical symptom. 50 patients who had spine disease such as spondylosis and compression fracture were examined by MRI. They didn't have neurological symptom such as sciatica, leg numbness, and motor weakness of lower extremities. There were 18 men and 32 women, and their mean age was 72.4 years (range: 32-87 years). RNR was found in 18 of the 50 patients (36.0%) and in a higher percentage of the patients who had lumber spinal canal stenosis. We concluded that RNR was only a morphological change of the cauda equine and had little effect on the neurological symptom. (author)

  9. A correlative study of the clinical and radiographic signs of periodontal disease in dogs

    International Nuclear Information System (INIS)

    Smith, M.M.; Zontine, W.J.; Willits, N.H.

    1985-01-01

    Twenty-four dogs admitted for routine teeth cleaning were selected arbitrarily to undergo a periodontal examination and a dental radiographic examination before the dental procedure. Data pertaining to the physical and radiographic manifestations of periodontal disease of 783 teeth were collected. All dogs had lesions consistent with periodontal disease, ranging from mild gingivitis and minimal plaque accumulation to severely inflamed gingiva, exuberant calculus formation, and root exposure. Of the 783 teeth examined, 153 (20%) had a pocket depth greater than or equal to 4 mm and less than or equal to 9 mm. Data regarding these teeth were subjected to statistical analysis. The clinical signs of plaque, calculus, mobility, pocket depth, and furcation were positively associated with radiographic signs of periodonta disease. The association between grossly evident gingivitis and radiographic signs of periodontal disease was not significant. Conditional probability analysis was applied to determine confidence intervals for the probability of a radiographic sign of periodontal disease occurring given that a clinical sign of periodontal disease occurs. (author)

  10. Acute chest syndrome of sickle cell disease: radiographic and clinical analysis of 70 cases

    International Nuclear Information System (INIS)

    Martin, L.; Buonomo, C.

    1997-01-01

    Background. Acute chest syndrome (ACS) is a pulmonary illness with fever, chest pain, leukocytosis and new pulmonary opacity in a patient with sickle cell disease. It is a common reason for hospitalization in sickle cell patients, and a significant cause of mortality. The etiology of ACS is unclear. Lung or bone infarction and infection, among other possible causes, have been proposed. Objective. We reviewed the chest radiographs and medical records of 41 patients with 70 episodes of ACS and correlated the clinical and radiographic courses in an attempt to better characterize and understand the syndrome. Results. In 87 % of episodes, no identifiable etiology of ACS was found. This group of patients had a median age of 14 years and showed dramatic clinical and radiographic improvement within 24 h of therapy. In the remainder of episodes (13 %), an identifiable etiology was found, usually bacterial pneumonia. These patients were younger than the group without an identifiable etiology (median age 2 years) and had a prolonged radiographic course of illness. Conclusion. The chest radiographs of children with ACS without an identifiable etiology have an extremely typical appearance and evolution. Only in cases which do not have this typical pattern should infection be suspected as the underlying cause. (orig.). With 3 figs

  11. The prevalence, clinical and radiographic characteristics of cemento-osseous dysplasia in Korea

    International Nuclear Information System (INIS)

    Cho, Bong Hae; Jung, Yun Hoa; Nah, Kyung Soo

    2007-01-01

    This study was intended to estimate the prevalence of cemento-osseous dysplasia (COD) in the Korean population and to assess the clinical and radiographic characteristics of this condition. Panoramic radiographs from 10,646 patients (4.982 males and 5.664 females, age range from 6 to 91 years) were reviewed for evidence of COD. Their demographics, clinical characteristics, and radiographic features were retrospectively assessed. Of 10,646 panoramic radiographs, 33 radiographs (0.31%) exhibited evidence of COD. The prevalence of COD increased to over 1% in women over 40-years old. Of these 33 patients, 16 had florid cemento-osseous dysplasia (FCOD) and 17 had focal COD. Due tp the multiplicity of FOCD, a total of 63 COD lesions were assessed. These lesions were most common in the mandibular molar area. Most of the COD lesion examined (61.9%) were less than 10 mm and the majority (82.5%) showed radiopacity. COD has a predilection for the mandibular molar area of middle-aged and older women

  12. The prevalence, clinical and radiographic characteristics of cemento-osseous dysplasia in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae; Jung, Yun Hoa; Nah, Kyung Soo [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)

    2007-12-15

    This study was intended to estimate the prevalence of cemento-osseous dysplasia (COD) in the Korean population and to assess the clinical and radiographic characteristics of this condition. Panoramic radiographs from 10,646 patients (4.982 males and 5.664 females, age range from 6 to 91 years) were reviewed for evidence of COD. Their demographics, clinical characteristics, and radiographic features were retrospectively assessed. Of 10,646 panoramic radiographs, 33 radiographs (0.31%) exhibited evidence of COD. The prevalence of COD increased to over 1% in women over 40-years old. Of these 33 patients, 16 had florid cemento-osseous dysplasia (FCOD) and 17 had focal COD. Due tp the multiplicity of FOCD, a total of 63 COD lesions were assessed. These lesions were most common in the mandibular molar area. Most of the COD lesion examined (61.9%) were less than 10 mm and the majority (82.5%) showed radiopacity. COD has a predilection for the mandibular molar area of middle-aged and older women.

  13. Spontaneous esophageal rupture - Boerhaave's syndrome: Clinical symptoms and radiographic findings

    International Nuclear Information System (INIS)

    Gaa, J.; Deininger, H.K.

    1989-01-01

    Spontaneous transmural rupture of the esophagus (Boerhaave's syndrome) is a life-threatening emergency. Prompt diagnosis is essential to a better prognosis, successful operative outcome and patient survival. The chest roentgenogram and the contrast esophagograms to follow are the most helpful diagnostic tests. The clinical manifestations are variable and may be misleading and thus delay accurate recognition. In our case report the major clinical features and radiological signs of Boerhaave's syndrome are described. The pathogenesis, characteristic clinical symptoms and the signs and radiological evaluation are reviewed. (orig.) [de

  14. Physiotherapeutic scoliosis-specific exercises for adolescents with idiopathic scoliosis.

    Science.gov (United States)

    Bettany-Saltikov, J; Parent, E; Romano, M; Villagrasa, M; Negrini, S

    2014-02-01

    The use of exercises for the treatment of Adolescents with Idiopathic Scoliosis is controversial. Whilst exercises are routinely used in a number of central and southern European countries, most centres in the rest of the world (mainly in Anglo-Saxon countries), do not advocate its use. One of the reasons for this is that many health care professionals are usually not conversant with the differences between generalised physiotherapy exercises and physiotherapeutic scoliosis-specific exercises (PSSE): while the former are generic exercises usually consisting of low-impact stretching and strengthening activities like yoga, Pilates and the Alexander technique, PSSE consist of a program of curve-specific exercise protocols which are individually adapted to a patients' curve site, magnitude and clinical characteristics. PSSEs are performed with the therapeutic aim of reducing the deformity and preventing its progression. It also aims to stabilise the improvements achieved with the ultimate goal of limiting the need for corrective braces or the necessity of surgery. This paper introduces the different 'Schools' and approaches of PSSE currently practiced (Scientific Exercise Approach to Scoliosis - SEAS, Schroth, Barcelona Scoliosis Physical Therapy School - BSPTS, Dobomed, Side Shift, Functional Individual Therapy of Scoliosis - FITS and Lyon) and discusses their commonalities and differences.

  15. Comparison of conventional full spine radiographs and fluoroscopic scanning method in young patients with idiopathic scoliosis; Vergleich von konventioneller Wirbelsaeulenganzaufnahme und fluoroskopischer Scan-Methode bei jungen Patienten mit idiopathischer Skoliose

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, J.; Kottke, R.; Claussen, C. [Abt. fuer Radiologische Diagnostik, Universitaetsklinikum Tuebingen (Germany); Kluba, T.; Niemeyer, T.; Hahnfeldt, T. [Klinik und Poliklinik fuer Orthopaedie, Universitaetsklinikum Tuebingen (Germany); Vonthein, R. [Inst. fuer Medizinische Biometrie, Universitaetsklinikum Tuebingen (Germany); Kamm, K.F. [Philips Medizin Systeme GmbH, Hamburg (Germany)

    2005-08-01

    Purpose: evaluation of low-dose full spine radiographs using fluoroscopic images for the assessment of the Cobb angle measurement in patients with scoliosis. Material and methods: twenty-one consecutive patients (aged 10-27 years, mean age 14 years) with a conventional full spine examination (film speed class 800) underwent a follow-up exam using digital pulsed fluoroscopy (Multi Diagnost 4, Philips Medical Systems, Eindhoven, The Netherlands). The mean follow-up was 9 months. During a synchronized scan with a C-arm speed of 4 cm/sec fluoroscopic images were stored with a pulsed frequency of 3 images per second. The single images were merged and reconstructed to one image with the software easy spine (Philips medical Systems, Eindhoven, The Netherlands). The corresponding dose-area product values (DAP) of both methods were compared. Three independent observers assessed Cobb angles and image quality for each technique. Results: the mean DAP values for conventional imaging was 94.9 cGy x cm{sup 2} and for fluoroscopy 7.8 cGy x cm{sup 2}, respectively. A significant dose reduction of 91.8% (CI 91% to 95%) was calculated. The average absolute angle difference between the observers was found to be 2.7 for conventional imaging and 2.4 for the fluoroscopic method. Interobserver standard deviation of 2.9 was lower than the 5.3 for conventional images. Image quality was better in the conventional images. Conclusion: using the scanning method, we could achieve a mean reduction of the radiation dose of 92%, while the accuracy of the Cobb angle measurements was comparable for both techniques despite of reduced image quality of digital fluoroscopy. (orig.)

  16. Imaging in scoliosis: What, why and how?

    International Nuclear Information System (INIS)

    Cassar-Pullicino, V.N.; Eisenstein, S.M.

    2002-01-01

    Scoliosis may be a spinal manifestation of underlying disease and although most cases of scoliosis are idiopathic, imaging plays a very important role in determining the underlying aetiology and in monitoring the changes of the deformity that take place with growth. As a clinical problem scoliosis may present directly to the radiology department through a primary healthcare referral, or it may be referred from the paediatric, orthopaedic, spinal and neurosurgical hospital services. Growth affects all types of scoliosis irrespective of cause. There are no reliable predetermined algorithmic steps in the management of scoliosis, and treatment decisions require the inclusion of multiple extrinsic (e.g age, menarche) and intrinsic (curve magnitude, vertebral anomaly) factors. It is important to remember that most of what is known about curve behaviour and its progression applies to idiopathic scoliosis, and it is inappropriate to apply these criteria to the other specific types of scoliosis. It is imperative that radiation techniques are used judiciously to minimize the radiation burden. Although magnetic resonance imaging (MRI) has had a significant impact in the understanding of the scoliotic deformity, it is still evolving and it may well eventually play a very important role in uncovering the underlying aetiology of 'idiopathic' scoliosis. Cassar-Pullicino, V.N. and Eisenstein, S.M. (2002)

  17. Imaging in scoliosis: What, why and how?

    Energy Technology Data Exchange (ETDEWEB)

    Cassar-Pullicino, V.N.; Eisenstein, S.M

    2002-07-01

    Scoliosis may be a spinal manifestation of underlying disease and although most cases of scoliosis are idiopathic, imaging plays a very important role in determining the underlying aetiology and in monitoring the changes of the deformity that take place with growth. As a clinical problem scoliosis may present directly to the radiology department through a primary healthcare referral, or it may be referred from the paediatric, orthopaedic, spinal and neurosurgical hospital services. Growth affects all types of scoliosis irrespective of cause. There are no reliable predetermined algorithmic steps in the management of scoliosis, and treatment decisions require the inclusion of multiple extrinsic (e.g age, menarche) and intrinsic (curve magnitude, vertebral anomaly) factors. It is important to remember that most of what is known about curve behaviour and its progression applies to idiopathic scoliosis, and it is inappropriate to apply these criteria to the other specific types of scoliosis. It is imperative that radiation techniques are used judiciously to minimize the radiation burden. Although magnetic resonance imaging (MRI) has had a significant impact in the understanding of the scoliotic deformity, it is still evolving and it may well eventually play a very important role in uncovering the underlying aetiology of 'idiopathic' scoliosis. Cassar-Pullicino, V.N. and Eisenstein, S.M. (2002)

  18. European radiographers' challenges from mammography education and clinical practice - an integrative review.

    Science.gov (United States)

    Metsälä, Eija; Richli Meystre, Nicole; Pires Jorge, José; Henner, Anja; Kukkes, Tiina; Sá Dos Reis, Cláudia

    2017-06-01

    This study aims to identify European radiographers' challenges in clinical performance in mammography and the main areas of mammography that require more and better training. An extensive search was performed to identify relevant studies focused on clinical practice, education and training in mammography published between January 2010 and December 2015 in the English language. The data were analysed by using deductive thematic analysis. A total of 27 full text articles were read, evaluating their quality. Sixteen articles out of 27 were finally selected for this integrative review. The main challenges of radiographers' mammography education/training can be divided into three groups: training needs, challenges related to radiographers, and challenges related to the organization of education. The most common challenges of clinical performance in mammography among European radiographers involved technical performance, the quality of practices, and patient-centeredness. The introduction of harmonized mammography guidelines across Europe may serve as an evidence-based tool to be implemented in practice and education. However, the variability in human and material resources as well as the different cultural contexts should be considered during this process. • Radiographers' awareness of their professional identity and enhancing multiprofessional cooperation in mammography. • Radiographers' responsibilities regarding image quality (IQ) and optimal breast imaging performance. • Patient-centred mammography services focusing on the psychosocial needs of the patient. • Challenges: positioning, QC-testing, IQ-assessment, optimization of breast compression, communication, teamwork, and patient-centred care. • Introduction of evidence-based guidelines in Europe to harmonize mammography practice and education.

  19. Presentation and analysis of radiographic data in clinical trials and observational studies

    NARCIS (Netherlands)

    Landewé, R.; van der Heijde, D.

    2005-01-01

    Despite the advent of sophisticated imaging systems, plain radiography continues to be a valuable outcome variable in clinical trials of inflammatory disorders for a number of reasons. This paper discusses the pros and cons of the different ways in which radiographic data in trials is presented; the

  20. Clinical and radiographic outcome of revision surgery of radial head prostheses: midterm results in 16 patients

    NARCIS (Netherlands)

    Viveen, Jetske; Kodde, Izaäk F.; Koenraadt, Koen L. M.; Beumer, Annechien; The, Bertram; Eygendaal, Denise

    2017-01-01

    Little is known about revision surgery of radial head arthroplasty. The aim of this study was to report on the clinical and radiographic outcome of revision arthroplasty of the elbow with a bipolar metallic radial head prosthesis. Between 2006 and 2013, we used either a press-fit or cemented RHS

  1. The relevance of clinical and radiographic features of jaw lesions: A prospective study

    Directory of Open Access Journals (Sweden)

    Juliane Piragine ARAUJO

    Full Text Available Abstract The study was carried out in a Brazilian population and the aim was to describe the prevalence and the clinic-radiographical features of jaw lesions. In addition, a comparison between the main diagnosis hypothesis and final diagnosis was accessed. A prospective study which evaluated all patients with jaw lesions diagnosed in an Oral Diagnosis Center, between August 2013 and October 2014. A total of 450 patients were observed for the first time, and 130 had some type of jaw lesion. The mean age of the patients was 35.2 years ± 17.86. Among these, 71 were women (54.62% and 87 were Caucasian (66.92%. The mandible was affected more frequently (71.43% than the maxilla (28.57%. Swelling and pain were the most frequent clinical signs and symptoms and were observed in 60 (42.85% and 38 (27.14% cases, respectively. The panoramic x-ray was the main radiographic exam utilized (88.57%. Radiolucent lesions accounted for 89 cases (63.57% and the unilocular form was present in 114 cases (81.43%. A total of 93 cases had histopathological analyses and the periapical cyst was the most frequent lesion. In the other 47 lesions, the diagnosis was conducted by clinical and radiographic management. Bone lesions were frequent, being noted on first visit in approximately 30% of patients; in 1/3 of the cases, the diagnoses were completed with a combination of clinical and radiographic exams.

  2. Correlation of bone quality in radiographic images with clinical bone quality classification

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Woo; Huh, Kyung Hoe; Kim, Jeong Hwa; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Seoul National University, Seoul (Korea, Republic of); Park, Kwan Soo [Inje University, Seoul (Korea, Republic of)

    2006-03-15

    To investigate the validity of digital image processing on panoramic radiographs in estimating bone quality before endosseous dental implant installation by correlating bone quality in radiographic images with clinical bone quality classification. An experienced surgeon assessed and classified bone quality for implant sites with tactile sensation at the time of implant placement. Including fractal dimension eighteen morphologic features of trabecular pattern were examined in each anatomical sites on panoramic radiographs. Finally bone quality of 67 implant sites were evaluated in 42 patients. Pearson correlation analysis showed that three morphologic parameters had weak linear negative correlation with clinical bone quality classification showing correlation coefficients of -0.276, -0.280, and -0.289, respectively (p<0.05). And other three morphologic parameters had obvious linear negative correlation with clinical bone quality classification showing correlation coefficients of -0.346, -0.488, and -0.343 respectively (p<0.05). Fractal dimension also had a linear correlating with clinical bone quality classification with correlation coefficients -0.506 significantly (P<0.05). This study suggests that fractal and morphometric analysis using digital panoramic radiographs can be used to evaluate bone quality for implant recipient sites.

  3. How well do radiographic, clinical and self-reported diagnoses of knee osteoarthritis agree? Findings from the Hertfordshire cohort study.

    Science.gov (United States)

    Parsons, Camille; Clynes, Michael; Syddall, Holly; Jagannath, Darshan; Litwic, Anna; van der Pas, Suzan; Cooper, Cyrus; Dennison, Elaine M; Edwards, Mark H

    2015-01-01

    Epidemiological studies of knee osteoarthritis (OA) have often used a radiographic definition. However, the clinical syndrome of OA is influenced by a broad range of factors in addition to the structural changes required for radiographic OA. Hence more recently several studies have adopted a clinical or self-reported approach to OA diagnosis rather than a radiographic approach. The aim of this study was to investigate agreement between radiographic OA and the clinical and self-reported diagnoses of OA. Data were available for 199 men and 196 women in the Hertfordshire Cohort Study (HCS), UK. Participants completed a questionnaire detailing self-reported OA. Clinical OA was defined based on American College of Rheumatology (ACR) criteria. Knee radiographs were taken and graded for overall Kellgren and Lawrence (K&L) score. The mean (standard deviation (SD)) age of study participants was 75.2 (2.6) years and almost identical proportions of men and women. The prevalence of knee OA differed depending on the method employed for diagnosis; 21% of the study participants self-reported knee OA, 18% of the participants had clinical knee OA and 42% of the participants had radiographic OA. Of those 72 study participants with a self-reported diagnosis of knee OA 52 (72%) had a radiographic diagnosis of knee OA, while 66% (39 out of 59) of study participants with clinical knee OA had a diagnosis of radiographic knee OA. However 58% of those participants diagnosed with radiographic OA did not have either self-reported knee OA or a diagnosis of clinical OA. Therefore in comparison with the radiographic definition of OA, both the clinical and self-report definitions had high specificity (91.5% & 91.5% respectively) and low sensitivity (24.5% and 32.7% respectively). There is modest agreement between the radiographic, clinical and self-report methods of diagnosis of knee OA.

  4. CLASSIFICATION OF TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND INTERNAL DERANGEMENT .1. DIAGNOSTIC-SIGNIFICANCE OF CLINICAL AND RADIOGRAPHIC SYMPTOMS AND SIGNS

    NARCIS (Netherlands)

    STEGENGA, B; DEBONT, LGM; VANDERKUIJL, B; BOERING, G

    In the clinical setting, diagnosis primarily depends on the history and present status of the patient, and on the examiner's expertise in physical examination and interpretation of conventional radiographs. In order to evaluate the diagnostic significance of clinical and radiographic variables, the

  5. Clinical and Radiographic Evaluation of Double Teeth in Primary ...

    African Journals Online (AJOL)

    2016-01-16

    Jan 16, 2016 ... Conclusion: The findings of this study have clinical relevance for the diagnosis of ... dentition, with fusion in 94% of cases and gemination in 6% of cases. .... orthodontic problems, including spacing or crowding of teeth, loss of ...

  6. Childhood optic chiasm gliomas: radiographic response following radiotherapy and long-term clinical outcome

    International Nuclear Information System (INIS)

    Tao, May L.; Barnes, Patrick D.; Billett, Amy L.; Leong, Traci; Shrieve, Dennis C.; Scott, R. Michael; Tarbell, Nancy J.

    1997-01-01

    Purpose: In children with chiasmal gliomas, radiation therapy can arrest progressive visual and neurologic impairment. We examined the radiographic response and clinical outcomes after irradiation. Methods and Materials: Forty-two children (median age at diagnosis, 6.6 years) with chiasmal gliomas were managed as follows: 11 asymptomatic patients with neurofibromatosis-1 (NF-1) were observed only; 2 patients, less than 3 years old, underwent surgery and chemotherapy to delay irradiation; and 29 patients with progressive disease received radiation with or without prior surgery or chemotherapy. Time to radiographic response, long-term tumor control and late sequelae were reviewed for the 29 irradiated patients. Results: The probability of at least 50% radiographic response at 24 months after irradiation was 18.1% and increased to 38.2% by 48 months and 45.9% by 60 months. By actuarial analysis, the median time for such radiographic response was 62 months. For the 29 irradiated patients, the 10-year freedom from progression and overall survival rates were 100% and 89%, respectively (median follow-up for surviving patients, 108 months). Stabilization or improvement in vision occurred in 81% of 26 evaluable irradiated patients. Conclusions: Notable radiographic response may be observed years after irradiation. Radiation therapy provides excellent long-term tumor control and vision preservation or improvement in the majority of patients with progressive chiasmal gliomas

  7. New method of scoliosis assessment: preliminary results using computerized photogrammetry.

    Science.gov (United States)

    Aroeira, Rozilene Maria Cota; Leal, Jefferson Soares; de Melo Pertence, Antônio Eustáquio

    2011-09-01

    A new method for nonradiographic evaluation of scoliosis was independently compared with the Cobb radiographic method, for the quantification of scoliotic curvature. To develop a protocol for computerized photogrammetry, as a nonradiographic method, for the quantification of scoliosis, and to mathematically relate this proposed method with the Cobb radiographic method. Repeated exposure to radiation of children can be harmful to their health. Nevertheless, no nonradiographic method until now proposed has gained popularity as a routine method for evaluation, mainly due to a low correspondence to the Cobb radiographic method. Patients undergoing standing posteroanterior full-length spine radiographs, who were willing to participate in this study, were submitted to dorsal digital photography in the orthostatic position with special surface markers over the spinous process, specifically the vertebrae C7 to L5. The radiographic and photographic images were sent separately for independent analysis to two examiners, trained in quantification of scoliosis for the types of images received. The scoliosis curvature angles obtained through computerized photogrammetry (the new method) were compared to those obtained through the Cobb radiographic method. Sixteen individuals were evaluated (14 female and 2 male). All presented idiopathic scoliosis, and were between 21.4 ± 6.1 years of age; 52.9 ± 5.8 kg in weight; 1.63 ± 0.05 m in height, with a body mass index of 19.8 ± 0.2. There was no statistically significant difference between the scoliosis angle measurements obtained in the comparative analysis of both methods, and a mathematical relationship was formulated between both methods. The preliminary results presented demonstrate equivalence between the two methods. More studies are needed to firmly assess the potential of this new method as a coadjuvant tool in the routine following of scoliosis treatment.

  8. Possibilities of radiographic digitalisation in dental clinics; Possibilidades de digitalizacao radiografica na clinica odontologica

    Energy Technology Data Exchange (ETDEWEB)

    Zenobio, Madelon A.F. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), Belo Horizonte, MG (Brazil); Zenobio, Elton Goncalves [Pontificia Univ. Catolica de Minas Gerais, Belo Horizonte, MG (Brazil)

    2002-07-01

    In the evolution diagnostic processes by image, the improvement of the intrabucal radiographic sensibility generated and digitalized is today, of great expressiveness in the evolution and effectiveness in the odontological area. This methodology applicability as a possibility of a more precise and accurate diagnostic formulation among other advantages, justifies this technique use. This paper intends to, thorough the literature magazine and clinic case presentations to show its applicability in the daily odontological clinic, and specially, in the periodonty area. (author)

  9. Effect of patient position on the lordosis and scoliosis of patients with degenerative lumbar scoliosis.

    Science.gov (United States)

    Fei, Han; Li, Wei-Shi; Sun, Zhuo-Ran; Jiang, Shuai; Chen, Zhong-Qiang

    2017-08-01

    This study aimed to analyze the effect of patient positions on the lordosis and scoliosis of patients with degenerative lumbar scoliosis (DLS).Seventy-seven patients with DLS were retrospectively analyzed. We measured lordosis and Cobb's angle on preoperative upright x-rays and magnetic resonance imagings in supine position. The lordosis and scoliosis of surgical segments in intraoperative prone position were measured on intraoperative radiographs of 20 patients to compare with that in standing position. Paired t tests were performed to investigate the parameters of the sample.From standing to supine position the whole lordosis increased (29.2 ± 15.7 degree vs. 34.9 ± 11.2 degree), and the whole scoliosis decreased (24.3 ± 11.8 degree vs. 19.0 ± 10.5 degree); 53 of 77 (68.8%) cases had increased lordosis, and 67 of 77 (87%) cases had decreased scoliosis. The lordosis of surgical segments in standing position had no difference with that in intraoprerative prone position. But in changing from supine/standing position to intraoprerative prone position, the scoliosis of surgical segments decreased (14.7 ± 9.4 degree vs. 11.4 ± 7.0 degree; 19.0 ± 11.8 degree vs. 11.4 ± 7.0 degree, respectively), and 18 of 20 (90%) cases had decreased scoliosis in intraoperative prone position than that in standing position.Compared with standing position in DLS patients, supine position increased lordosis and reduced scoliosis, and intraoperative prone position reduced scoliosis significantly. When evaluating the severity of DLS and making preoperative surgical plans, lumbar lordosis in supine position should also be evaluated in addition to upright x-ray, and the effects of different positions should be taken into consideration to reduce deviation.

  10. Bone density determination using I125 densitometry with idiopathic scoliosis

    International Nuclear Information System (INIS)

    Weinberger, N.

    1984-01-01

    Based on the assumption that radiographs from patients with idiopathic scoliosis show osteoporotic changes in the curved area, investigation with I 125 -densitometry were made, and specifically with measurement points at the ulna and the calcaneus. A difference in the bone density between patients with scoliosis and normal controls could not be proven. The mineral-salt content of the scoliosis patients lay on the average 6.5 to 9.3% lower than the normal controls. No relation could be found between the degree of curvature of the scoliosis and the peripheral bone density, from which it can be concluded that no generalized mineral-salt deficiency exists. Radiographs show only local changes (photo densitometry, computed tomography). (TRV) [de

  11. Scoliosis surgery - child

    Science.gov (United States)

    ... from getting worse. But, when they no longer work, the child's health care provider will recommend surgery. There are several reasons to treat scoliosis: Appearance is a major concern. Scoliosis often causes back pain. If the curve is severe enough, ...

  12. Myositis ossificans with atypical clinical, radiographic, or pathologic findings

    International Nuclear Information System (INIS)

    Nuovo, M.A.; Chumas, J.; Ackerman, L.V.

    1992-01-01

    Myositis ossificans is a relatively rare, well-defined entity. The 23 cases sent for consultation to two of us (L.V.A. and A. N.) were reviewed. Clinical, radiologic, and microscopic information was reexamined, and special attention was given to features infrequently seen in typical myositis ossificans. Due to the uncommon location of 15 lesions and an unusual presentation in 5, the correct diagnosis was not obvious in these cases. Radiologic studies raised the possibility of a malignant bone-forming tumor in at least three instances; myositis ossificans was originally diagnosed in 6 cases radiologically. In 8 cases, histologic evidence suggested malignancy, including osteosarcoma, either parosteal or extraosseous, in 6. Other diagnoses included epithelioid sarcoma and callus formation. Presentation of these variations from the norm highlights the importance of recognizing the evolution of a nonneoplastic fibro-osseous and cartilaginous entity in which conservative treatment is curative. (orig./GDG)

  13. Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study

    Directory of Open Access Journals (Sweden)

    Vanessa Polina Pereira Costa

    Full Text Available Abstract This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child’s age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7% had clinical sequelae and 185 teeth (32.7%, radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%. Clinical sequelae increased with injury severity (p < 0.001, whereas radiographic sequelae did not (0.236. The predicted risk of color change was 29.0% (95%CI 19–41 for teeth with enamel fracture, and 26.0% (95%CI 14–40 for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35–82 and those with subluxation (15.8% 95%CI 10–22. Risk of premature loss was 27.3% (95%CI 13–45 for teeth with extrusive luxation, and 10.2% (95%CI 5–17 for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.

  14. The clinical significance of Epitrochlear lymphadenopathy on elbow radiographs in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Kwon, Bae Ju; Joo, Kyung Bin; Lee, Hak Soo; Song, Ho Taek; Park, Dong Woo; Lee, Seung Ro; Hahm, Chang Kok

    2000-01-01

    To evaluate the radiographic findings of epitrochlear lymphadenopathy with regard to the distribution and severity of the disease and clinal parameters in patients with rheumatoid arthritis. Forty six patients with rheumatoid arthritis in whom epitrochlear oval-shaped densities were seen on radiographs were involved in this study. There were 14 cases of unilateral epitrochlear lymphadenopathy in which bilateral arthritic evidence was revealed by radiographs (mixed group), and 32 of bilateral lymphadenopathy in which there was arthritic evidence (positive group). Twenty-three patients in whom lymphadenopathy was not seen on radiographs of the elbow and who were diagnosed as suffering from rheumatoid arthritis functioned as controls (negative group).For scoring the degree of arthritis using the simplified scoring method proposed by Kaye et al., joints were divided into six groups, as follows: Joint 1, elbow; Joint 2, wrist; Joint 3, radial (1st and 2nd) PIP and MCP; Joint 4, ulnar (3rd, 4th, 5th) PIP and MCP; Joint 5, Joints 1 + 2+ 3 + 4; Joint 6, Joints 1 + 4. For each joint, scores were compared with those on the contralateral side in the mixed group. Differences in clinical parameters ( disease duration, rheumatoid factor, ESR, and CRP), and scores for each joint in each arm were statistically compared between be positive and negative group. The number, mean diameter, and maximal diameter of epitrochlear lymph nodes were calculated and correlated with clinical parameters and scores for each joint. To evaluate the incidence of epitrochlear lymphadenopathy without radiographic evidence of arthritis in 46 patients (78 arms) with lymphadenopathy, the frequency of cases in which the score for the joint was zero was assessed. In the mixed group, the mean score for Joint 6 of the arm with epitrochlear lymphadenopathy was significantly higher than that for the contralateral side in the mixed group (p=3D0.022). Only CRP was significantly higher in the positive group than

  15. Radiographic pelvimetry for assessment of dystocia in bitches: a clinical study in two Terrier breeds

    International Nuclear Information System (INIS)

    Eneroth, A.; Linde-Forsberg, C.; Uhlhorn, M.; Hall, M.

    1999-01-01

    Radiographic pelvimetry was used to assess the role of pelvic anatomy in obstructive dystocia in bitches. Based on the history of previous whelpings,20 Boston terrier and 14 Scottish terrier bitches were divided into two equal groups: normally whelping bitches and bitches with obstructive dystocia. Additional whelpings during the period of study were closely observed and the pups were immediately weighed and measured. The bitches were clinically examined and the pelvis was radiographed in ventrodorsal and lateral projections. Measurements from the radiographs showed a significantly smaller pelvic size in the bitches with obstructive dystocia compared to the normally whelping bitches. Fetal-pelvic disproportion in the Scottish terrier was mainly due to a dorsoventrally flattened pelvic canal, whereas in the Boston terrier it arose from the combination of a dorsoventrally flattened pelvic canal and big fetuses with large heads. These results suggest that radiographic pelvimetry could be used to predict a disposition for dystocia in individual bitches, and as a basis for selection of breeding animals

  16. How well do radiographic, clinical and self-reported diagnoses of knee osteoarthritis agree? Findings from the Hertfordshire cohort study

    NARCIS (Netherlands)

    Parsons, C.; Clynes, M.; Syddall, H.; Jagannath, D.; Litwic, A.; van der Pas, S.; Cooper, C.; Dennison, E.M.; Edwards, M.H.

    2015-01-01

    Objective: Epidemiological studies of knee osteoarthritis (OA) have often used a radiographic definition. However, the clinical syndrome of OA is influenced by a broad range of factors in addition to the structural changes required for radiographic OA. Hence more recently several studies have

  17. Clinical assessment of the efficacy of SpineCor brace in the correction of postural deformities in the course of idiopathic scoliosis.

    Science.gov (United States)

    Plewka, Barbara; Sibiński, Marcin; Synder, Marek; Witoński, Dariusz; Kołodziejczyk-Klimek, Katarzyna; Plewka, Michał

    2013-03-26

    The objective of the study was to perform a clinical, comparative assessment of the degree of postural deformities before and after the treatment of idiopathic scoliosis in patients treated with SpineCor brace compared to the control group. A group of 90 children with idiopathic scoliosis (including 74 girls) at the average age of 12.2 was subject to prospective observation. Average pre-treatment Cobb angle was 24.9° in the thoracic spine and 25.8° in the lumbar spine. The group actively treated with the SpineCor brace consisted of 45 children, while the control group consisted of the remaining 45 children with the natural course of the disease. Both groups did not differ significantly in terms of age, gender, height, body weight, Risser sign of skeletal maturity and baseline clinical and radiological parameters of scoliosis. Significant reduction of rib hump was observed upon 2-year SpineCor brace treatment (P=0.04) compared to the group treated by physiotherapy only (P=0.91). Similarly, improvement in lumbar prominence was observed in the actively treated group (P=0.009), with a trend towards worse results in the control group (P=0.07) In the group treated with the SpineCor brace, significant reduction in pectoral and hamstring muscle contractures as well as reduction in shoulder asymmetry and reduction in anterior and posterior vertical deviation were observed. Treatment using the SpineCor dynamic brace leads to a clinical improvement in posture, particularly to reduction in rib hump, lumbar prominence and muscular contractures.

  18. Clinical, haematobiochemical, radiographic and ultrasonographic features of traumatic reticuloperitonitis in bovines

    International Nuclear Information System (INIS)

    Mohindroo, J.; Singh, Kiranjeet; Kumar, Ashwani; Randhawa, C.S.

    2010-01-01

    Study was conducted to compare the clinical, haematobiochemical, radiographic and ultrasonographic features of traumatic reticuloperitonitis in bovines. Clinical cases (4 cows and 17 buffaloes) presented with a history of anorexia, fever, decreased milk yield and loss of defecation/scant faeces, were used. Haematological picture revealed neutrophilic leucocytosis with left shift and blood biochemical status showed elevated levels of total protein, albumin, and fibrinogen. Decreased plasma concentration of sodium, potassium and chloride was observed in majority of the cases. Radiographic examination revealed presence of multiple metallic foreign densities in the reticulum of the bovines. Ultrasonographically, morphological changes of reticular wall and reticulophrenic adhesions in cases of localised peritonitis were visualized. The presence of anechoic fluid without echogenic margins, not restricted to reticulum and sometimes with floating fibrinous shreds was observed in cases of diffuse peritonitis. Ultrasonography in B mode and B+ mode found helpful for the diagnosis of traumatic reticuloperitonitis and differentiation of localised peritonitis from diffuse peritonitis

  19. Clinical and radiographic evaluation of cermet tunnel restorations on primary molars.

    Science.gov (United States)

    Zenkner, J E; Baratieri, L N; Monteiro, S J; de Andrada, M A; Vieira, L C

    1993-11-01

    Fifty-one restorations of the tunnel type were performed with "cermet" cement on primary molars. The restorations were assessed clinically, radiographically, and by direct examination of the proximal surface 6 months (group I) and 12 months (group II) after placement. The incidence of fractured marginal ridges was found to be 3.8% in group I and 4.2% in group II. All restorations had their occlusal portion intact and were caries-free. Clinically detectable occlusal wear was found in 7.7% of teeth in group I and in 4.2% of teeth in group II. No correlation was found between direct and radiographic assessment of proximal caries. White spots, without carious penetration, were detected on 53.8% of proximal surfaces at 6 months and on 60.0% of proximal surfaces at 12 months.

  20. Radiographic and clinical aspects of endodonty of the central incisor, in maxilla: a case report

    International Nuclear Information System (INIS)

    Panella, J.; Freitas, A. de; Freitas, C. de

    1989-01-01

    The authors in the current report introduce a study of the present features when of agenesis of dental elements on the maxilla-mandibular complex. They relate a case of right upper central incisor's hypodontia, describing its clinical and radiographic appearances. Through a large revision of literature about this field, they found out that a disappearance of this element on the human dentition is rare, associating for this: genetic, familiar, nutrient, hormonal, infections and traumatic agents. Finally, they alert for the fact that an accurate clinical examination, complemented by a exact radiographic survey, will make possible a precocious diagnosis and execution of more efficient therapeutic manipulations that reduce the problems of functional, esthetic and phonetics order. (author)

  1. Spinal Cord Injury without Radiographic Abnormality (SCIWORA) – Clinical and Radiological Aspects

    International Nuclear Information System (INIS)

    Szwedowski, Dawid; Walecki, Jerzy

    2014-01-01

    The acronym SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) was first developed and introduced by Pang and Wilberger who used it to define “clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability”. SCIWORA is a clinical-radiological condition that mostly affects children. SCIWORA lesions are found mainly in the cervical spine but can also be seen, although much less frequently, in the thoracic or lumbar spine. Based on reports from different authors, SCIWORA is responsible for 6 to 19% and 9% to 14% of spinal injuries in children and adults, respectively. Underlying degenerative changes, including spondylosis or spinal canal stenosis, are typically present in adult patients. The level of spinal cord injury corresponds to the location of these changes. With recent advances in neuroimaging techniques, especially in magnetic resonance imaging, and with increasing availability of MRI as a diagnostic tool, the overall detection rate of SCIWORA has significantly improved

  2. Advanced clinical practice for radiographers in Great Britain: professional roles, accountability and the educational provision

    International Nuclear Information System (INIS)

    Hogg, P.

    2004-01-01

    A change in British health care has resulted in a broadening of roles and responsibilities beyond 'traditional boundaries' for a range of health care professionals. This has occurred because of staff shortages (particularly within the medical profession) and the recognition that many 'non-doctor' health care staff can make safe, competent and effective contributions outside their 'normal' sphere of responsibilities. In the context of advanced clinical practice, this paper will explain the current arrangements for radiographers' roles and responsibilities, their accountability and the educational provision that underpins the development of competencies at these higher clinical levels. Some advanced roles that British radiographers perform, within their current normal responsibilities, will be identified and some British legislation and professional body guidance that make role advancement possible will be outlined. The article will conclude with an indication of the educational level at which the advanced competencies are learned and assessed. (author)

  3. Clinical and Radiographic Assessment of the Efficacy of Calcium Silicate Indirect Pulp Capping

    Science.gov (United States)

    Hashem, D.; Mannocci, F.; Patel, S.; Manoharan, A.; Brown, J.E.; Watson, T.F.

    2015-01-01

    The aims of this study were to assess the effectiveness of calcium silicate cement (Biodentine) versus glass ionomer cement (GIC; control group) as indirect pulp capping materials in patients with reversible pulpitis and to compare the effectiveness of cone beam computed tomography (CBCT) versus periapical (PA) radiographs in detecting PA changes at baseline (T0) and at 12 mo (T12) postoperatively. Seventy-two restorations (36 Biodentine, 36 Fuji IX) were placed randomly in 53 patients. CBCT/PA radiographs were taken at T0 and T12. Two calibrated examiners assessed the presence/absence and increase/decrease in the size of existing PA radiolucencies under standardized conditions. The Kappa coefficient evaluated statistically the effectiveness of CBCT versus PA radiographs in detecting PA changes. Chi-square/Mann-Whitney tests were used to evaluate the association between PA changes in CBCT with various clinical measures. Significance was predetermined at α = 0.05. Clinical success rates for Biodentine and Fuji IX GIC were 83.3%. CBCT was significantly more effective in detecting PA radiolucencies compared with radiographs (P = 0.0069). Of the teeth, 65.4% and 90.4% were deemed healthy using CBCT and PA radiographs, respectively, at T12. Healing/healed rates were 17.3%/0%, while new/progressed radiolucency were 30.8%/9.6% with CBCT/PA radiographs, respectively. Seventy-one percent of healed lesions had received Biodentine; 88% of new/progressed lesions received Fuji IX GIC. Teeth presenting with an initial CBCT PA lesion had a failure rate of 63%, whereas teeth with no initial lesion had a failure rate of 16%. Although no statistically significant difference was detected in the clinical efficacy of Biodentine/Fuji IX when used as indirect pulp capping materials in patients with reversible pulpitis, CBCT showed a significant difference in that most healed CBCT lesions had received Biodentine while most that did not heal received Fuji IX. Longer-term follow-up is

  4. Comparison of clinical, radionuclide, and radiographic features of osteoarthritis of the hands.

    OpenAIRE

    Macfarlane, D G; Buckland-Wright, J C; Emery, P; Fogelman, I; Clark, B; Lynch, J

    1991-01-01

    Simultaneous clinical, scintigraphic, and macroradiographic assessments were carried out on 32 patients with hand osteoarthritis and the results at entry and one year reported. The presence and growth of osteophyte correlated with symptoms and a positive scan. The scan did not detect the radiographic features of juxta-articular radiolucencies, subchondral sclerosis, or cartilage thinning. Osteophytes, particularly when fast growing, produce pain, a 'hot' scan, and may predict disintegration o...

  5. Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications

    Directory of Open Access Journals (Sweden)

    Bruno Dutra Roos

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVES: To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach. METHODS: Between January 2011 and March 2012, 49 patients (50 hips underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS, the Non-Arthritic Hip score (NAHS and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip. RESULTS: Out of the 41 hips treated, 31 (75.6% presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4° for the internal rotation of the hip ( p< 0.001. Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9° and mean increase of 0.10, respectively ( p< 0.001. CONCLUSION: Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

  6. Chronic valvular disease: correlation between clinical, electrocardiographic, radiographic and echocardiographic aspects in dogs

    International Nuclear Information System (INIS)

    Soares, E.C.; Larsson, M.H.M.A.; Yamato, R.J.

    2005-01-01

    Echocardiographic aspects of chronic mitral valvular disease were studied and compared to physical, radiographic and electrocardiographic aspects. Seventy dogs were used, and clinical examination, thoracic radiography, electrocardiogram and echocardiogram were performed. Correlations between regurgitation severity with cardiac failure functional class and murmur intensity were observed. The electrocardiogram showed a low sensibility in detecting cardiac chamber enlargement, caused by mitral regurgitation. All the dogs with severe mitral regurgitation showed cardiomegaly according to thoracic radiographies

  7. Imaging of painful scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Davies, Alun; Saifuddin, Asif [Royal National Orthopaedic Hospital Trust, Department of Radiology, London (United Kingdom)

    2009-03-15

    Scoliosis is defined as a lateral deviation of the spine from the normal plumb line. Commonly, there is a rotational component and deviation also in the sagittal plane (kyphosis or hyperlordosis). When scoliosis presents in adults, it is often painful. In contrast, back pain in a child is considered rare, and serious underlying pathology should be excluded, particularly since idiopathic scoliosis is typically painless. A painful scoliosis in a child or adolescent, especially if the patient has a left-sided curve, should be examined thoroughly. The aim of this review is to illustrate the causes of a painful scoliosis in children, adolescents and adults. (orig.)

  8. Imaging of painful scoliosis

    International Nuclear Information System (INIS)

    Davies, Alun; Saifuddin, Asif

    2009-01-01

    Scoliosis is defined as a lateral deviation of the spine from the normal plumb line. Commonly, there is a rotational component and deviation also in the sagittal plane (kyphosis or hyperlordosis). When scoliosis presents in adults, it is often painful. In contrast, back pain in a child is considered rare, and serious underlying pathology should be excluded, particularly since idiopathic scoliosis is typically painless. A painful scoliosis in a child or adolescent, especially if the patient has a left-sided curve, should be examined thoroughly. The aim of this review is to illustrate the causes of a painful scoliosis in children, adolescents and adults. (orig.)

  9. Pulp Calcification in Traumatized Primary Teeth - Classification, Clinical And Radiographic Aspects.

    Science.gov (United States)

    Mello-Moura, Anna Carolina Volpi; Santos, Ana Maria Antunes; Bonini, Gabriela Azevedo Vasconcelos Cunha; Zardetto, Cristina Giovannetti Del Conte; Moura-Netto, Cacio; Wanderley, Marcia Turolla

    The aim of this study was to standardize the nomenclature of pulp alteration to pulp calcification (PC) and to classify it according to type, quantity and location, as well as relate it to clinical and radiographic features. The dental records of 946 patients from the Research and Clinical Center for Dental Trauma in Primary Teeth were studied. Two hundred and fifty PC-traumatized upper deciduous incisors were detected. According to radiographic analysis of the records, 62.5% showed diffuse calcification, 36.3% tube-like calcification, and 1.2% concentric calcification. According to the extension of pulp calcification, the records showed: 80% partial calcification, 17.2% total coronal calcification and partial radicular calcification, and 2.8 % total coronal and radicular calcification. As for location, only 2.4% were on the coronal pulp, 5.2% on the radicular pulp and 92.4% on both radicular and coronal pulp. Regarding coronal discoloration, 54% were yellow and 2% gray. In relation to periradicular changes, 10% showed widened periodontal ligament space, 3.1% internal resorption, 10% external resorption, 10.4% periapical bone rarefaction. Since PC is a general term, it is important to classify it and correlate it to clinical and radiographic changes, in order to establish the correct diagnosis, treatment and prognosis of each case.

  10. Histological evaluation of pulp tissue from second primary molars correlated with clinical and radiographic caries findings

    Directory of Open Access Journals (Sweden)

    Vellore Kannan Gopinath

    2014-01-01

    Full Text Available Background: Managing dental caries in young children is demanding due to the elusions present on the right diagnostic criteria for treatment. The present study evaluated the histological status of pulp tissues extracted from primary second molar with caries involvement. Histological findings are correlated with clinical and radiographic assessment. Materials and Methods: Simple experimental study was conducted on upper or lower second primary molars with occlusal (22 teeth or proximal (22 teeth dental caries. Selected children were below 6 years of age. Percentage of caries involvement, residual dentin thickness (RDT, radiographic assessment of interradicular and periapical areas, clinical caries depth and signs and symptoms are the parameters considered for comparing with the histological findings. The specimens were grouped based on the nature of the inflammatory process as acute or chronic. The data were analyzed by Student t-test to compare histological types of inflammation with clinical parameters. P value < 0.05 was considered as significant. Results: Four cases revealed severe acute inflammation in coronal and relatively mild acute inflammation in radicular pulp. In the rest of the specimen coronal and radicular pulp had similar acute or chronic inflammatory changes. Histological evidence of pulpitis correlated with dental caries depth of ≥80%, RDT of ≤1 mm, radiographic rarefactions in the interradicular regions and symptoms of pain. Conclusion: Primary second molars with more than two-third caries involvement with symptoms of pain histologically showed inflammation of both coronal and radicular pulp tissues in all cases.

  11. Midterm Clinical and Radiographic Results of Mobile-Bearing Revision Total Knee Arthroplasty.

    Science.gov (United States)

    Kim, Raymond H; Martin, J Ryan; Dennis, Douglas A; Yang, Charlie C; Jennings, Jason M; Lee, Gwo-Chin

    2017-06-01

    Constrained implants are frequently required in revision total knee arthroplasty (TKA) and are associated with an increase in aseptic component loosening and damage or wear to the constraining mechanisms, compared with primary TKA. The purpose of the following study was to evaluate the midterm clinical and radiographic results including the incidence of bearing complications in a group of patients undergoing revision TKA using mobile-bearing revision TKA implants. We retrospectively reviewed 316 consecutive mobile-bearing revision TKAs performed at 2 centers between 2006 and 2010. There were 183 women and 133 men with a mean age of 66 years. The patients were evaluated clinically using the Knee Society scores. A radiographic analysis was performed. Bearing specific complications (ie, instability or dislocation) were recorded. Patients were followed-up for a minimum of 24 months and a median of 59.88 months (range 24-121.2). The average Knee Society knee score and function scores increased from 40.8 and 47.9 points preoperatively to 80 points and 70.3 points, respectively (P bearing complications were observed. Revision TKA using mobile-bearing revision components demonstrated favorable midterm clinical and radiographic results with no occurrence of bearing instability or dislocation. Longer follow-up is required to evaluate for potential advantages of mobile-bearings over fixed-bearing revision components in terms of polyethylene wear reduction, reduced stress transmission across fixation interfaces, and reduced stress on the polyethylene post. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Clinical study on minimally invasive transforaminal lumbar interbody fusion combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis

    Directory of Open Access Journals (Sweden)

    Hao WU

    2016-04-01

    Full Text Available Objective To discuss the operative essentials and therapeutic effects of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis (DLS.  Methods A total of 17 DLS patients without prior spinal diseases were treated by MIS-TLIF and percutaneous pedicle screw fixation from January 2013 to September 2015 in Xuanwu Hospital, Capital Medical University. The operation time, intraoperative blood loss, hospital stay, and postoperative complication were recorded in each patient. Visual Analogue Scale (VAS and Oswestry Disability Index (ODI were used to evaluate postoperative improvement of low back and leg pain, and clinical effects were assessed according to Medical Outcome Study 36-Item Short-Form Health Survey (SF-36. Coronal Cobb angle, sagittal lordosis angle and spinal deviation distances on coronal and sagittal plane were measured before operation, one week, 3 months after operation and in the last follow-up in spinal full-length X-ray examination. Fusion rate was calculated according to X-ray or CT scan, and the degree of decompression was evaluated by MRI.  Results Decompression and fusion levels ranged from T12-S1 vertebrae, and interbody fusion was performed in 17 patients and 56 levels were fused. Average operation time was 200 min (180-300 min, intraoperative blood loss was 320 ml (200-1000 ml and hospital stay was 8.21 d (5-12 d. All patients were followed-up for 12.13 months (5-24 months. Compared with preoperation, VAS (P = 0.000, for all and ODI scores (P = 0.000, for all decreased significantly, SF-36 score increased (P = 0.000, for all, coronal Cobb angle (P = 0.000, for all, sagittal lordosis angle (P = 0.000, for all, coronal and sagittal deviation (P = 0.000, for all decreased significantly one week and 3 months after operation and in the last follow-up. The improvement rate of ODI was (86.51 ± 6.02%, fusion rate of vertebral bodies

  13. The Effect of Manual Therapy on the Adolescent Idiopathic Scoliosis in a 28 Years Old Woman

    OpenAIRE

    Marzieh Mohamadi; Farahnaz Ghaffari-Nejhad

    2013-01-01

    Idiopathic scoliosis (IS) is the most common type of scoliosis. Clinical signs and symptoms of scoliosis impair quality of life and daily function. Manual therapy is commonly used for treatment of scoliosis. This is a case report of scoliosis treatment with manual therapy in a 28 years old patient. A 28 years old woman complained of low back pain for 4 years. Spine x-ray, showed scoliosis with a 32 degrees Cobb angle. The patient received a manual therapy procedure of two visits per week for ...

  14. Scoliosis treatment using spinal manipulation and the Pettibon Weighting System™: a summary of 3 atypical presentations

    Directory of Open Access Journals (Sweden)

    Joy Timothy

    2006-01-01

    Full Text Available Abstract Background Given the relative lack of treatment options for mild to moderate scoliosis, when the Cobb angle measurements fall below the 25–30° range, conservative manual therapies for scoliosis treatment have been increasingly investigated in recent years. In this case series, we present 3 specific cases of scoliosis. Case presentation Patient presentation, examination, intervention and outcomes are detailed for each case. The types of scoliosis presented here are left thoracic, idiopathic scoliosis after Harrington rod instrumentation, and a left thoracic scoliosis secondary to Scheuermann's Kyphosis. Each case carries its own clinical significance, in relation to clinical presentation. The first patient presented for chiropractic treatment with a 35° thoracic dextroscoliosis 18 years following Harrington Rod instrumentation and fusion. The second patient presented with a 22° thoracic levoscoliosis and concomitant Scheuermann's Disease. Finally, the third case summarizes the treatment of a patient with a primary 37° idiopathic thoracic levoscoliosis. Each patient was treated with a novel active rehabilitation program for varying lengths of time, including spinal manipulation and a patented external head and body weighting system. Following a course of treatment, consisting of clinic and home care treatments, post-treatment radiographs and examinations were conducted. Improvement in symptoms and daily function was obtained in all 3 cases. Concerning Cobb angle measurements, there was an apparent reduction in Cobb angle of 13°, 8°, and 16° over a maximum of 12 weeks of treatment. Conclusion Although mild to moderate reductions in Cobb angle measurements were achieved in these cases, these improvements may not be related to the symptomatic and functional improvements. The lack of a control also includes the possibility of a placebo effect. However, this study adds to the growing body of literature investigating methods by which

  15. Characterization and Predictive Value of Segmental Curve Flexibility in Adolescent Idiopathic Scoliosis Patients

    DEFF Research Database (Denmark)

    Yao, Guanfeng; Cheung, Jason P Y; Shigematsu, Hideki

    2017-01-01

    STUDY DESIGN: A prospective radiographic analysis of adolescent idiopathic scoliosis (AIS) patients managed with alternate-level pedicle screw fixation was performed. OBJECTIVE: The objective of this study was to characterize segmental curve flexibility and to determine its predictive value...

  16. Geometric and electromyographic assessments in the evaluation of curve progression in idiopathic scoliosis

    NARCIS (Netherlands)

    Cheung, J; Veldhuizen, AG; Halberts, JPK; Sluiter, WJ; Van Horn, [No Value

    2006-01-01

    Study Design. The natural history of patients with idiopathic scoliosis was analyzed radiographically and electromyographically in a prospective longitudinal study. Objectives. To identify changes in geometric variables and the sequence in which these changes occur during curve progression in the

  17. Clinical, radiographic, and magnetic resonance imaging findings of gastrocnemius musculotendinopathy in various dog breeds.

    Science.gov (United States)

    Kaiser, Susanne M; Harms, Oliver; Konar, Martin; Staudacher, Anne; Langer, Anna; Thiel, Cetina; Kramer, Martin; Schaub, Sebastian; von Pückler, Kerstin H

    2016-11-23

    To describe clinical, radiographic, and magnetic resonance imaging (MRI) findings in 16 dogs diagnosed with gastrocnemius musculotendinopathy. Retrospective evaluation of medical records, radiographs, and MRI results, as well as follow-up completed by telephone questionnaire. Most dogs had chronic hindlimb lameness with no history of trauma or athletic activities. Clinical examination revealed signs of pain on palpation without stifle joint instability. Seven dogs had radiographic signs of osteophyte formation on the lateral fabella. Magnetic resonance imaging revealed T2 hyperintensity and uptake of contrast agent in the region of the origin of the gastrocnemius muscle. Changes were found in the lateral and medial heads of the gastrocnemius. Conservative treatment resulted in return to full function in 11 dogs. Two dogs showed partial restoration of normal function, one dog showed no improvement. Two dogs were lost to follow-up. Gastrocnemius musculotendinopathy is a potential cause of chronic hindlimb lameness in medium to large breed dogs. A history of athletic activity must not necessarily be present. Magnetic resonance imaging shows signal changes and uptake of contrast agent in the region of the origin of the gastrocnemius muscle. A combination of T1 pre- and post-contrast administration and T2 weighted sequences completed by a fat-suppressed sequence in the sagittal plane are well-suited for diagnosis. Conservative treatment generally results in return to normal function.

  18. Honey preserved cortical allografts in the repair of diaphyseal femoral defect in dogs: clinical and radiographic

    International Nuclear Information System (INIS)

    Alievi, Marcelo Meller; Wallau Schossler, João Eduardo; Christo de Oliveira, Ana Néri; Almeida Ferreira, Carolina Kist TraeslelIV Patrícia; Dambrósio Guimarães, Luciana

    2007-01-01

    Fourteen adult mongrel dogs were used to evaluate the honey preserved cortical allografts in the repair of diaphyseal femoral defect. The allografts were inserted into a 5cm segmental defect created in the mid-diaphysis of the right femur in each dog. The bones were stabilized with a dynamic compression plate and eight bone screws. Healing was followed clinically and femora were evaluated radiographically, periodically. Nineteen (79.2%) of the twenty-four host-graft interfaces were radiographically incorporated. Average time to allograft incorporation was 67.1 days (range 45 days to 90 days). There was no statistical difference in the allograft incorporation time between proximal and distal host-graft interfaces. Complications observed were nonunion, allograft fracture, and allograft resorption. The conclusion is that despite the complications, honey preserved cortical allografts are a viable option to bone reconstruction [pt

  19. Physical and clinical evaluation of new high-strip-density radiographic grids

    International Nuclear Information System (INIS)

    Doi, K.; Frank, P.H.; Chan, H.P.; Vyborny, C.J.; Makino, S.; Iida, N.; Carlin, M.

    1983-01-01

    The imaging performance of new high-strip-density (HSD) grids having 57 lines/cm was compared with that of conventional low-strip-density (LSD) grids having 33 or 40 lines/cm. The unique advantage of HSD grids is that, under most standard radiographic conditions, the grid lines are not noticeable on the final image, even if the grid is stationary. This is due to the combined effect of the high fundamental spatial frequency of HSD grids, the modulation transfer function of screen-film systems and of the human visual system, and scattered radiation. Monte Carlo simulation studies, phantom images, and clinical evaluation indicate that HSD grids can provide contrast improvement factors and Bucky factors that are comparable to or slightly better than those obtained with LSD grids. Therefore, it may now be possible to eliminate moving Bucky trays from radiographic tables and fluoroscopic devices

  20. Selective versus hyperselective posterior fusions in Lenke 5 adolescent idiopathic scoliosis: comparison of radiological and clinical outcomes.

    Science.gov (United States)

    Ilharreborde, B; Ferrero, E; Angelliaume, A; Lefèvre, Y; Accadbled, F; Simon, A L; de Gauzy, J Sales; Mazda, K

    2017-06-01

    Recent literature has reported that the ]progression risk of Lenke 5 adolescent idiopathic scoliosis (AIS) during adulthood had been underestimated. Surgery is, therefore, proposed more to young patients with progressive curves. However, choice of the approach and fusion levels remains controversial. The aim of this study was to analyze the influence of the length of posterior fusion on clinical and radiological outcomes in Lenke 5 AIS. All Lenke 5 AIS operated between 2008 and 2012 were included with a minimum 2-year follow-up. Patients were divided into two groups according to the length of fusion. In the first group (selective), the upper instrumented level (UIV) was the upper end vertebra of the main structural curve and distally the fusion was extended to the stable and neutral vertebra, according to Lenke's classification. In the second group (hyperselective), shorter fusions were performed and the number of levels fused depended on the location of the apex of the curve (at maximum, 2 levels above and below, according to Hall's criteria). Apart from the fusion level selection, the surgical procedure was similar in both groups. Radiological outcomes and SRS-22 scores were reported. 78 patients were included (35 selective and 43 hyperselective). The number of levels fused was significantly higher in the first group (7.8 ± 3 vs 4.3 ± 0.6). None of the patients was fused to L4 in selective group. No correlation was found between length of fusion and complication rate. Eight patients had adding-on phenomenon among which 6 (75%) had initially undergone hyperselective fusions and had significantly higher postoperative lower instrumented vertebra (LIV) tilt. In the adding-on group, LIV was located above the last touching vertebra (LTV) in 62.5% of the cases and above the stable vertebra (SV) in 87.5%. Patients in the selective group reported a significantly lower score in the SRS function domain. Coronal alignment was restored in both groups. Hyperselective

  1. Corrective Surgery for Congenital Scoliosis Associated with Split Cord Malformation: It May Be Safe to Leave Diastematomyelia Untreated in Patients with Intact or Stable Neurological Status.

    Science.gov (United States)

    Shen, Jianxiong; Zhang, Jianguo; Feng, Fan; Wang, Yipeng; Qiu, Guixing; Li, Zheng

    2016-06-01

    The treatment of congenital scoliosis associated with split cord malformation (SCM) raises the issue of how to best manage such patients to avoid neurological deficit while achieving a satisfactory correction. This prospective clinical study was performed at our center from March 2000 through June 2013. We enrolled a total of 214 patients (61 male and 153 female) with congenital scoliosis associated with SCM who were undergoing spinal correction surgery. The mean age at surgery was 14.1 years. The inclusion criteria were congenital scoliosis with confirmed SCM; status as neurologically intact or stable over the preceding 2 years; and no neurological deterioration as evidenced on traction, side-bending, or fulcrum-bending radiographs. Patients with unstable neurological status or for whom vertebral column resection surgery was planned were excluded. All patients underwent scoliosis surgery without prophylactic detethering. On the basis of the Pang classification, 73 patients were in the type-I SCM group, and 141 were in the type-II SCM group. The groups did not differ significantly with respect to preoperative characteristics, operative time, blood loss, or number of levels fused. The mean follow-up was 37 months (range, 24 to 108 months). The rate of scoliosis correction was lower in the type-I group than in the type-II group (p patients experienced transient neurological complications, with no significant difference between the groups (p = 0.415). No patient experienced permanent neurological deficit during surgery or follow-up. Patients with congenital scoliosis associated with SCM, regardless of type, can safely and effectively undergo spinal deformity correction and achieve spinal balance without neurological intervention. For such patients with intact or stable neurological status, prophylactic detethering prior to scoliosis surgery may not be necessary. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence

  2. Radiographers and trainee radiologists reporting accident radiographs

    DEFF Research Database (Denmark)

    Buskov, L; Abild, A; Christensen, A

    2013-01-01

    To compare the diagnostic accuracy and clinical validity of reporting radiographers with that of trainee radiologists whom they have recently joined in reporting emergency room radiographs at Bispebjerg University Hospital....

  3. The impact of patient self assessment of deformity on HRQL in adults with scoliosis

    Directory of Open Access Journals (Sweden)

    Moss Nathan D

    2007-10-01

    Full Text Available Abstract Background Body image and HRQL are significant issues for patients with scoliosis due to cosmetic deformity, physical and psychological symptoms, and treatment factors. A selective review of scoliosis literature revealed that self report measures of body image and HRQL share unreliable correlations with radiographic measures and clinician recommendations for surgery. However, current body image and HRQL measures do not indicate which aspects of scoliosis deformity are the most distressing for patients. The WRVAS is an instrument designed to evaluate patient self assessment of deformity, and may show some promise in identifying aspects of deformity most troubling to patients. Previous research on adolescents with scoliosis supports the use of the WRVAS as a clinical tool, as the instrument shares strong correlations with radiographic measures and quality of life instruments. There has been limited use of this instrument on adult populations. Methods The WRVAS and the SF-36v2, a HRQL measure, were administered to 71 adults with scoliosis, along with a form to report age and gender. Preliminary validation analyses were performed on the WRVAS (floor and ceiling effects, internal consistency and collinearity, correlations with the SF-36v2, and multiple regression with the WRVAS total score as the predictor, and SF-36v2 scores as outcomes. Results The psychometric properties of the WRVAS were acceptable. Older participants perceived their deformities as more severe than younger participants. More severe deformities were associated with lower scores on the Physical Component Summary Score of the SF-36v2. Total WRVAS score also predicted Physical Component Summary scores. Conclusion The results of the current study indicate that the WRVAS is a reliable tool to use with adult patients, and that patient self assessment of deformity shared a relationship with physical rather than psychological aspects of HRQL. The current and previous studies

  4. Intrapulmonary arteriovenous anastomoses in dogs with severe Angiostrongylus vasorum infection: clinical, radiographic, and echocardiographic evaluation.

    Science.gov (United States)

    Novo Matos, J; Malbon, A; Dennler, M; Glaus, T

    2016-06-01

    In both humans and dogs the pulmonary vasculature is able to recruit large-diameter anatomical intrapulmonary arteriovenous anastomoses (IPAVAs). In healthy people the opening of these anastomoses affects the degree of exercise-induced increase in pulmonary arterial pressure. The presence of these IPAVAs can be demonstrated using saline contrast echocardiography. The aims of the present study were to characterize severely affected, naturally infected dogs with Angiostrongylus vasorum, to evaluate if these dogs can open IPAVAs, and to assess if the recruitment of such anastomoses affects the severity of pulmonary hypertension (PH). Eight client-owned dogs with severe A. vasorum infection were recruited. Dogs with A. vasorum infection that presented with severe dyspnea and/or syncope were prospectively screened by echocardiography for the presence of PH and IPAVAs. Only severely affected dogs, based on a combination of clinical, radiographic and echocardiographic abnormalities, were enrolled. Opening of IPAVAs could be demonstrated in three dogs with no to moderate PH, and could not be demonstrated in five dogs with severe PH. In two dogs thoracic radiographs showed only mild interstitial changes, while computer tomography and postmortem examination revealed severe pulmonary interstitial and vascular disease. These results suggest that dogs may open IPAVAs and that opening of such anastomoses may play a regulatory role in the development of PH. There may be a marked discrepancy between radiographic changes and disease severity in A. vasorum. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Primary infantile hyperparathyroidism: Clinical, laboratory, and radiographic features in 21 cases

    International Nuclear Information System (INIS)

    Eftekhari, F.; Yousefzadeh, D.K.

    1982-01-01

    Two cases of primary infantile hyperparathyroidism (PIH) are reported. In both cases the diagnosis was initially suspected from chest radiographs which were obtained to assess the etiology of fever and respiratory distress in one case and heart murmur in another. The first case responded well to subtotal parathyroidectomy. The second case had many unique features. (1) She never became overtly symptomatic. (2) She displayed a constellation of findings that are not yet emphasized. (3) Her indisputable radiographic findings of hyperparathyroidism vanished spontaneously by two months of age, whereas her biochemical alterations have persisted up to now, 2 1/2 years after birth. (4) Three members of her family have subclinical hyperparathyroidism (elevated serum parathormone, hypercalcemia, and hypophosphatemia). Our review of 19 more cases showed that PIH has no specific clinical symptoms and/or signs. Of the laboratory findings, hypercalcemia was most consistantly encountered. The radiographic findings, although not identical to those described in hyperparathyroid adults, had the greatest diagnostic specificity. The disorder carried a grave prognosis if not diagnosed promptly and managed surgically. (orig.)

  6. Inter-observer variation in masked and unmasked images for quality evaluation of clinical radiographs

    International Nuclear Information System (INIS)

    Tingberg, A.; Eriksson, F.; Medin, J.; Besjakov, J.; Baarth, M.; Haakansson, M.; Sandborg, M.; Almen, A.; Lanhede, B.; Alm-Carlsson, G.; Mattsson, S.; Maansson, L. G.

    2005-01-01

    Purpose: To investigate the influence of masking on the inter-observer variation in image quality evaluation of clinical radiographs of chest and lumbar spine. Background: Inter-observer variation is a big problem in image quality evaluation since this variation is often much bigger than the variation in image quality between, for example, two radiographic systems. In this study, we have evaluated the effect of masking on the inter-observer variation. The idea of the masking was to force every observer to view exactly the same part of the image and to avoid the effect of the overall 'first impression' of the image. A discussion with a group of European expert radiologists before the study indicated that masking might be a good way to reduce the inter-observer variation. Methods: Five chest and five lumbar spine radiographs were collected together with detailed information regarding exposure conditions. The radiographs were digitised with a high-performance scanner and five different manipulations were performed, simulating five different exposure conditions. The contrast, noise and spatial resolution were manipulated by this method. The images were printed onto the film and the individual masks were produced for each film, showing only the parts of the images that were necessary for the image quality evaluation. The quality of the images was evaluated on ordinary viewing boxes by a large group of experienced radiologists. The images were examined with and without the masks with a set of image criteria (if fulfilled, 1 point; and not fulfilled, 0 point), and the mean score was calculated for each simulated exposure condition. Results: The results of this study indicate that - contrary to what was supposed - the inter-observer variation increased when the images were masked. In some cases, especially for chest, this increase was statistically significant. Conclusions: Based on the results of this study, image masking in studies of fulfilment of image criteria cannot

  7. Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement

    Directory of Open Access Journals (Sweden)

    Guilherme dos Santos Trento

    2015-12-01

    Full Text Available Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%. Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002. Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness.

  8. Clinical education - place and part for becoming a practically trained radiographer

    International Nuclear Information System (INIS)

    Shangova, M.; Stavreva, E.; Panamska, K.; Bozhkova, M.

    2015-01-01

    Full text: The aim is to present the crucial role of clinical education for becoming a practically trained radiographer. It's been put on review and analysis the role of the clinic practice and pre-graduate practice into the education of the future specialist. It's presenting in detail every component of the program for study and the contribution of every module in it - image diagnostic, nuclear medicine and radiotherapy. the clinical education lasts six semesters in real working environment. The gradual increase of working hours creates conditions for higher educational quality. Students gradually master techniques, acquire skills and precision at working in an X-ray department, nuclear medicine units and radiotherapy, master communication techniques and acquire teamwork skills. the clinical education provides professional training, quick adaptation to realization and facilitates starting a job

  9. Surgical treatment of adult scoliosis: is anterior apical release and fusion necessary for the lumbar curve?

    Science.gov (United States)

    Kim, Youngbae B; Lenke, Lawrence G; Kim, Yongjung J; Kim, Young-Woo; Bridwell, Keith H; Stobbs, Georgia

    2008-05-01

    A retrospective study. To analyze radiographic and functional outcomes after posterior segmental spinal instrumentation and fusion (PSSIF) with and without an anterior apical release of the lumbar curve in adult scoliosis patients. No comparison study on PSSIF of adult lumbar scoliosis with apical release versus without has been published. Forty-eight adult patients with lumbar scoliosis (average age at surgery 49.6 years, average follow-up 3.7 years) who underwent PSSIF were analyzed with respect to radiographic change, perioperative and postoperative complications, and Scoliosis Research Society (SRS) outcome scores. Twenty-three patients underwent an anterior apical release of the lumbar curve via a thoracoabdominal approach followed by PSSIF (Group I). The remaining 25 patients underwent a PSSIF of the lumbar curve followed by anterior column support at the lumbosacral region through an anterior paramedian retroperitoneal or posterior transforaminal approach (Group II). Before surgery, Group I showed a somewhat larger lumbar major Cobb angle (63.2 degrees vs. 55.9 degrees , P = 0.07), and both groups demonstrated significant differences in lumbar curve flexibility (26.9% vs. 37.2%, P = 0.02) and thoracolumbar kyphosis (27.0 degrees vs. 15.0 degrees , P = 0.03). After surgery, at the ultimate follow-up, there were no significant differences in major Cobb angle, C7 plumbline to the center sacral vertical line (P = 0.17), C7 plumbline to the posterior superior endplate of S1 (P = 0.44), and sagittal Cobb angles at the proximal junction (P = 0.57), T10-L2 (P = 0.24) and T12-S1 (P = 0.51). There were 4 pseudarthroses in Group I and one in Group II (P = 0.02). Postoperative total normalized SRS outcome scores at ultimate follow-up were significantly higher in Group II (69% vs. 79%, P = 0.01). Posterior segmental spinal instrumentation and fusion without anterior apical release of lumbar curves in adult scoliosis demonstrated better total SRS outcome scores and no

  10. Long-term impact of pre-operative physical rehabilitation protocol on the 6-min walk test of patients with adolescent idiopathic scoliosis: A randomized clinical trial

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    V.L. dos Santos Alves

    2015-05-01

    Full Text Available Background: Monitored physical activities in patients with adolescent idiopathic scoliosis (AIS have been shown to improve physical performance, endurance and cardiopulmonary function and may be assessed by the 6-min walk test (6MWT. We aimed to evaluate the long-term results of the 6MWT after a rehabilitation protocol employed before surgical correction for AIS. Methods: This prospective randomized clinical trial studied the impact of a 4-month pre-operative physical rehabilitation protocol on post-operative cardiopulmonary function and physical endurance, by using the 6MWT, in patients with AIS submitted to surgical correction, comparing them to matched controls without physical rehabilitation. Studied variables were heart and respiratory rate, systolic and diastolic blood pressure, peripheral blood oxygen saturation, Borg score, and distance walked. Patients were assessed at baseline, after 4 months of rehabilitation, and 3, 6 and 12 months post-operatively. Results: A total of 50 patients with AIS were included in the study and allocated blindly, by simple randomization, into either one of the two groups, with 25 patients each: study group (pre-operative physical rehabilitation and control group. The physical rehabilitation protocol promoted significant progressive improvement in heart and respiratory rate, peripheral blood oxygen saturation, distance walked, and level of effort assessed by the Borg scale after surgery. Conclusions: Post-surgical recovery, evaluated by 6MWT, was significantly better in patients who underwent a 4-month pre-operative physical rehabilitation protocol. Keywords: Scoliosis, Exercise, Exercise movement techniques, Exercise therapy, Exercise test

  11. Long-term Clinical and Radiographic Outcomes of Pedicle Subtraction Osteotomy for Fixed Sagittal Imbalance: Does Level of Proximal Fusion Affect the Outcome? Minimum 5-Year Follow-up.

    Science.gov (United States)

    Yagi, Mitsuru; King, Akilah B; Cunningham, Matthew E; Boachie-Adjei, Oheneba

    2013-03-01

    Retrospective case series of surgically treated adult patients with fixed sagittal imbalance. To assess clinical and radiographic changes after pedicle subtraction osteotomy (PSO) to treat adult fixed sagittal imbalance. Although recent reports have shown favorable clinical outcomes for PSO, few reports have published long-term follow-up outcomes. It is also unknown whether long-term outcomes are correlated with the level of proximal fusion and the radiographic changes that are observed after PSO. We reviewed the charts, X-rays, and postoperative SRS-22 and Oswestry Disability Index (ODI) scores of 32 adult patients who presented with fixed sagittal imbalance and were treated with lumbar PSO. Long fusions were defined as those proximal to T6, and short fusions were defined as those below T8. Measured radiographic parameters included thoracic kyphosis, lumbar lordosis (LL), sacral slope, pelvic incidence, and sagittal balance (SVA). Statistical analysis included Student t test and chi-square test. A p value of imbalance, PSO provided good sagittal balance and maintained favorable clinical outcomes in both the short and long fusion groups despite a slight decrease in the SVA and a high complication rate. The data suggest that the loss of sagittal balance may be attributed to increase global and junctional kyphosis in short fusion groups, and should be monitored for long-term outcomes. Particular attention should be paid to the long-term deterioration of the SVA in adults who present with fixed sagittal imbalance after PSO. Copyright © 2013 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

  12. Clinical comparison of conventional and rare earth screen-film systems for cephalometric radiographs

    International Nuclear Information System (INIS)

    Kaugars, G.E.; Fatouros, P.

    1982-01-01

    This study compared cephalometric and P-A skull films taken with conventional (CaWO4) screens and rare earth screens. Patient exposure was reduced by 17 to 55 percent on two different x-ray machines by the use of rare earth screens. Results from 130 clinical evaluations showed that the diagnostic quality of radiographs taken with either system was roughly comparable. This presents a persuasive argument for the use of rare earth screens since the diagnostic quality of the films can be maintained while significantly reducing the patient's exposure to radiation

  13. Modern digital plain-radiography of the whole spine in scoliosis patients. Dose reduction and quality criteria

    International Nuclear Information System (INIS)

    Kloth, Jost Karsten; Stiller, W.; Kauczor, H.U.; Weber, M.A.

    2013-01-01

    To reduce the radiation exposure of plain radiographs of the entire spine depending on specific indications, since these are frequently performed examinations of children and young adults with scoliosis and to determine objective quality control criteria to ensure accurate assessment. In this prospective randomized study 323 patients underwent plain-radiography of the entire spine with standard and 50 % reduced dose. In an experimental pilot-study this target-dose was determined using an Alderson-Phantom. The evaluation of the experimental radiographs, as well as, the randomized plain-radiographs was conducted using the following criteria: endplates (Cobb-angle), spinal process and pedicel (rotation), lateral margin of the vertebral body (lateral alignment), identification of C7 / S1 (perpendicular). Two radiologists evaluated these criteria using a score ranging from 1 (definitely assessable) to 4 (not assessable). If one single criteria was evaluated with a score of 3 or more points or more than 2 criteria with 2 points, the radiograph was scored as ''not assessable''. The statistical analysis was conducted as a non-inferiority-trial. Seven (2.4 %) of the 290 examined x-rays were scored as not assessable. There was no statistic inferiority between the examinations with standard or reduced dose, while singular assessment of the defined criteria was likewise dose-independent. Plain-radiography of the total spine in patients with scoliosis can be performed with a dose reduction of 50 % without a loss of validity. The obtained quality control criteria were clinically applicable. (orig.)

  14. Prediction of Curve Correction Using Alternate Level Pedicle Screw Placement in Patients With Adolescent Idiopathic Scoliosis (AIS) Lenke 1 and 2 Using Supine Side Bending (SB) and Fulcrum Bending (FB) Radiograph.

    Science.gov (United States)

    Kwan, Mun Keong; Zeyada, Hassan E; Chan, Chris Yin Wei

    2015-10-15

    Prospective cohort study. To compare side bending (SB) and fulcrum bending (FB) radiographs in patients with adolescent idiopathic scoliosis (AIS) and effect of magnitude and AR curves on curve correctability. The prediction of correction using side bending flexibility (SBF) and fulcrum bending flexibility (FBF) in alternate level pedicle screw (PS) configuration and effect of curve magnitude and AR curves are not well understood. 100 AIS Lenke 1 and 2 were recruited. Curve magnitude was stratified to G1 (41°-60°), G2 (61°-80°), G3 (>80°). The main thoracic (MT) curves were subclassified to AR curves [Miyanji F, Pawelek JB, Van Valin SE, et al. Is the lumbar modifier useful in surgical decision making? Defining two distinct Lenke 1A curve patterns. Spine 2008;33:2545-51]. Preoperatively SBF and FBF were determined whereas postoperative parameters were correction rate (CR), fulcrum bending correction index (FBCI), and side bending correction index (SBCI). Correlation test were carried out between SBF, FBF versus CR for the cohort. There were 38 (G1), 42 (G2), and 20 (G3) patients. 34% were AR curves. SBF for G1, G2, and G3 were 61.3 ± 14.4, 59.2 ± 16.2 and 43.1 ± 13.1% (P = 0.000) whereas FBF for G1, G2, and G3 were 71.1 ± 16.5, 58.3 ± 18.1 and 52.7 ± 17.1% (P = 0.000). The CR was G1 (74.5 ± 11.5%), G2 (69.2 ± 12.7%), and G3 (70.2 ± 8.6%). FBCI was 1.11 ± 0.3 (G1), 1.28 ± 0.4 (G2) and 1.48 ± 0.6 for G3. SBCI was 1.26 ± 0.2 (G1), 1.50 ± 0.5 (G2), and 1.72 ± 0.4 for G3. There was strong correlation for SBF and FBF versus CR for G1 and G2. For G3, a very strong correlation was established between SBF (r = 0.846, r = 0.716) and FBF versus CR (r = 0.700, r = 0.540). AR curves demonstrated higher SBF and FBF. CR remains almost constant in G1, G2, and G3. SBCI and FBCI increase significantly in G1, G2, and G3. Correlation between SBF and FBF and CR was strong for G1, G2, and very strong for G3. AR curves showed better correctability with SB and FB films.

  15. Direct repair of spondylolysis presenting after correction of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Koptan, Wael M T; ElMiligui, Yasser H; ElSharkawi, Mohammad M

    2011-02-01

    Although spondylolysis is found in 6% of idiopathic scoliosis patients, very little was reported on management of pars defects in this group. These patients with painful spondylolysis are most eligible for direct repair of the defect rather than lumbosacral fusion in an attempt to save motion segments. The aim of this work was to analyze the clinical and radiologic outcome of pars repair in a group of adolescents who presented after surgical correction of their idiopathic scoliosis. A prospective nonrandomized study. Ten consecutive patients with spondylolysis presenting after an average of 3 months (range, 2-7 months) from correction of their idiopathic scoliosis with low back pain not responding to conservative therapy and interfering with everyday activities. The mean age at operation was 16 years (range, 14-19 years). Total blood loss, operative time, and hospital stay were recorded. Clinical outcome was assessed by the Oswestry Disability Index (ODI), visual analog scale (VAS), and Scoliosis Research Society (SRS)-22 questionnaire. Fusion of the pars interarticularis was assessed using plain, lateral, and oblique radiographs and a computed tomography (CT) scan. The surgical technique consisted of thorough debridement of the defect, impacting the gap created with a tricortical iliac crest graft, and rigid fixation by either pedicle screws and a V-shaped rod (five patients) or a cable-screw construct (five patients). Patients were followed up for an average of 4.5 years (range, 2-7 years). Nine patients had a good-to-excellent result, returned to normal everyday life, and participated in sports when desired. The mean ODI, VAS, and SRS total scores were 11 (range, 0-34), 1.1 (range, 0-2), and 92 (range, 61-108), respectively. Follow-up radiographs and CT scans revealed healing of all defects in nine cases, no signs of disc degeneration in any, and no implant-related complications. The results of direct repair of spondylolysis in idiopathic scoliosis patients were

  16. Clinical and radiographic features of solitary and cemento-osseous dysplasia-associated simple bone cysts.

    Science.gov (United States)

    Chadwick, J W; Alsufyani, N A; Lam, E W N

    2011-05-01

    The simple bone cyst (SBC) is a pseudocyst that can occur as a solitary entity in the jaws or may occur in association with cemento-osseous dysplasia (COD). The purpose of this study was to review the clinical and radiographic features of solitary and COD-associated SBCs. Archived imaging reports from the Special Procedures Clinic in Oral and Maxillofacial Radiology at the Faculty of Dentistry at the University of Toronto between 1 January 1989 and 31 December 2009 revealed 23 COD-associated SBCs and 68 solitary SBCs. Almost all solitary and COD-associated SBCs were found in the mandible. Furthermore, 87.0% of COD-associated SBCs were found in females in their fifth decade of life (P < 0.001) while solitary SBCs were found in equal numbers in both sexes in their second decade of life (P < 0.005). COD-associated SBCs were also more likely to cause thinning of the endosteal cortex, bone expansion and scalloping of the superior border between teeth (all P < 0.001) than solitary SBCs that are classically described as having these characteristics. Finally, COD-associated SBC demonstrated a loss of lamina dura more often (P < 0.05) than solitary SBCs. Knowledge of the sporadic association between COD and SBC and their potential radiographic appearances should prevent inappropriate treatment and management of these patients.

  17. Escoliose idiopática do adolescente (eia: perfil clínico e radiográfico da lista de espera para tratamento cirúrgico em hospital terciário de alta complexidade do Sistema Público de Saúde Brasileiro Escoliosis idiopática del adolescente (eia: perfil clínico y la radiografía de la lista de espera para el tratamiento quirúrgico en el hospital de tercer nivel de alta complejidad del Sistema Brasileño de Salud Pública Adolescent idiopathic scoliosis (ais: clinical and radiographic profile of waiting list for surgical treatment in tertiary hospital high complexity of Brazilian Public Heatlth System

    Directory of Open Access Journals (Sweden)

    Paulo Candido de Lima Júnior

    2011-01-01

    Moe, la clasificación de King y otros, y Lenke et al en el momento de la indicación de tratamiento quirúrgico y el tiempo de espera para la cirugía. RESULTADOS: De los 51 pacientes, 42 mujeres y 9 hombres, edad promedio de 15,53 años (10-46 años. Todos los pacientes tenían edades comprendidas entre 10 y 17 años al momento del diagnóstico. El promedio de espera fue de 25,41 meses (desde 2 a 180 meses. El promedio de edad de la menarquía fue 12,13 años (11-14 años, 10 pacientes no tenían la menarquía, y 23 pacientes con esqueleto inmaduro (Risser cero a tres. La curva primaria promedio fue de 60,4 grados (que va desde 40 hasta 120 grados. Los tipos de curva de las más frecuentes fueron de tipo King III y 19 pacientes con Lenke 1BN con 11 pacientes. CONCLUSIÓN: DEBIDO a la morbilidad se definen en la literatura en pacientes con EIA no tratadas y el número de la muestra, es las medidas apropiadas en términos de política pública para el tratamiento de estos pacientes en nuestro país.OBJECTIVE: To describe through descriptive cross-sectional study, the clinical and radiographic parameters of patients with adolescent idiopathic scoliosis (AIS that are on the waiting list for elective surgery in a tertiary university hospital of high complexity of the SUS. METHODS: To define the clinical and radiographic profile, the following data were collected: menarche, sex, age, Risser sign, Cobb value, Nash-Moe, classification of King et al. and Lenke et al., at the time of indication for surgical treatment, and waiting time for surgery. RESULTS: Of the 51 patients, 42 were females and 9 males, mean age was 15.53 years (10-46 years. All patients were aged between 10 and 17 years at diagnosis. The average wait was 25.41 months (ranging from 2 to 180 months. The average age at menarche was 12.13 years (11-14 years, 10 patients had no menarche, and 23 skeletally immature patients (Risser zero to three. The average primary curve was 60.4 degrees (ranging from 40 to 120

  18. Minimally invasive unicompartmental knee replacement: retrospective clinical and radiographic evaluation of 83 patients.

    Science.gov (United States)

    Bruni, Danilo; Iacono, Francesco; Russo, Alessandro; Zaffagnini, Stefano; Marcheggiani Muccioli, Giulio Maria; Bignozzi, Simone; Bragonzoni, Laura; Marcacci, Maurilio

    2010-06-01

    We performed a retrospective clinical and radiographic evaluation of 83 nonconsecutive patients operated in our institute between February 1996 and March 2003 with a mean follow-up of 60 months to assess the efficiency of unicompartmental knee replacement (UKR) performed with a minimally invasive technique. The aim of this study was to correlate the clinical outcome with the pre- and post-operative alignment and with implant positioning on coronal and sagittal plane. Eighty-three nonconsecutive patients (60 males, 23 females) underwent cemented UKR (De Puy Preservation Uni with all-poly tibial component), for both medial OA (80 patients) and AVN of the medial femoral condyle (3 patients). All patients were available at final follow-up evaluation, and they all presented an evident varus alignment at pre-operative clinical and radiographic evaluation. At radiographic measurement, we considered a knee with femoro-tibial angle (FTA) > 175 degrees as varus knee, 170 degrees FTA FTA 90 degrees for valgus knee and a TPA clinical result presented a mean varus deformity of 7.2 degrees (3.6 degrees-10.8 degrees) pre-operatively. According to literature, we demonstrated that a small amount of undercorrection with a small amount of residual varus deformity of 3 degrees-5 degrees is the goal to be reached in order to avoid both rapid degeneration of the nonreplaced compartment and the premature loosening of the replaced compartment. We performed a mean axial correction of 5 degrees (SD 3.9 degrees), leaving a mean axial varus deformity of 2.2 degrees in the excellent group. In our series, the group with excellent results also showed a post-operative PTS of 7 degrees (2.4 degrees-11.6 degrees), while mean pre-operative PTS was 6.5 degrees (2.7 degrees-10.3 degrees). In this study, results have shown that minimally invasive UKR producing a small amount of varus undercorrection in selected patients with medial tibio-femoral osteoarthritis or moderate avascular necrosis of the

  19. Curve progression and spinal growth in brace treated idiopathic scoliosis

    NARCIS (Netherlands)

    Tonseth, KA; Veldhuizen, AG; Cool, JC; van Horn, [No Value

    The risk of progression of idiopathic scoliosis is correlated primarily to factors that predict potential remaining skeletal growth. The aim of the current study was to evaluate spinal growth, measured as the length of the scoliotic spine on serial longitudinal radiographs, and its relationship to

  20. Optimal management of idiopathic scoliosis in adolescence

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    Kotwicki T

    2013-07-01

    Full Text Available Tomasz Kotwicki,1 Joanna Chowanska,1,2 Edyta Kinel,3 Dariusz Czaprowski,4,5 Marek Tomaszewski,1 Piotr Janusz1 1Department of Pediatric Orthopedics, University of Medical Sciences, Poznan, Poland; 2National Scoliosis Foundation, Stoughton, MA, USA; 3Department of Rehabilitation, University of Medical Sciences, Poznan Poland; 4Department of Physiotherapy, Józef Rusiecki University College, Olsztyn, 5Rehasport Clinic, Poznan, Poland Abstract: Idiopathic scoliosis is a three-dimensional deformity of the growing spine, affecting 2%–3% of adolescents. Although benign in the majority of patients, the natural course of the disease may result in significant disturbance of body morphology, reduced thoracic volume, impaired respiration, increased rates of back pain, and serious esthetic concerns. Risk of deterioration is highest during the pubertal growth spurt and increases the risk of pathologic spinal curvature, increasing angular value, trunk imbalance, and thoracic deformity. Early clinical detection of scoliosis relies on careful examination of trunk shape and is subject to screening programs in some regions. Treatment options are physiotherapy, corrective bracing, or surgery for mild, moderate, or severe scoliosis, respectively, with both the actual degree of deformity and prognosis being taken into account. Physiotherapy used in mild idiopathic scoliosis comprises general training of the trunk musculature and physical capacity, while specific physiotherapeutic techniques aim to address the spinal curvature itself, attempting to achieve self-correction with active trunk movements developed in a three-dimensional space by an instructed adolescent under visual and proprioceptive control. Moderate but progressive idiopathic scoliosis in skeletally immature adolescents can be successfully halted using a corrective brace which has to be worn full time for several months or until skeletal maturity, and is able to prevent more severe deformity and avoid

  1. Effect of higher implant density on curve correction in dystrophic thoracic scoliosis secondary to neurofibromatosis Type 1.

    Science.gov (United States)

    Li, Yang; Yuan, Xinxin; Sha, Shifu; Liu, Zhen; Zhu, Weiguo; Qiu, Yong; Wang, Bin; Yu, Yang; Zhu, Zezhang

    2017-10-01

    OBJECTIVE The aim of this study was to investigate how implant density affects radiographic results and clinical outcomes in patients with dystrophic scoliosis secondary to neurofibromatosis Type 1 (NF1). METHODS A total of 41 patients with dystrophic scoliosis secondary to NF1 who underwent 1-stage posterior correction between June 2011 and December 2013 were included. General information about patients was recorded, as were preoperative and postoperative scores from Scoliosis Research Society (SRS)-22 questionnaires. Pearson correlation analysis was used to analyze the associations among implant density, coronal Cobb angle correction rate and correction loss at last follow-up, change of sagittal curve, and apical vertebral translation. Patients were then divided into 2 groups: those with low-density and those with high-density implants. Independent-sample t-tests were used to compare demographic data, radiographic findings, and clinical outcomes before surgery and at last follow-up between the groups. RESULTS Significant correlations were found between the implant density and the coronal correction rate of the main curve (r = 0.505, p density and change of sagittal profile (p = 0.662) or apical vertebral translation (p = 0.062). The SRS-22 scores improved in the appearance, activity, and mental health domains within both groups, but there was no difference between the groups in any of the SRS-22 domains at final follow-up (p > 0.05 for all). CONCLUSIONS Although no significant differences between the high- and low-density groups were found in any of the SRS-22 domains at final follow-up, higher implant density was correlated with superior coronal correction and less postoperative correction loss in patients with dystrophic NF1-associated scoliosis.

  2. Which factors influence radiographic progression during treatment with tumor necrosis factor inhibitors in clinical practice?

    DEFF Research Database (Denmark)

    Ørnbjerg, Lykke Midtbøll; Østergaard, Mikkel; Bøyesen, Pernille

    2014-01-01

    OBJECTIVE: To investigate baseline characteristics associated with radiographic progression and the effect of disease activity, drug, switching, and withdrawal on radiographic progression in tumor necrosis factor (TNF) inhibitor-naive patients with rheumatoid arthritis (RA) followed for about 2...

  3. Progression of scoliosis in patients with spastic quadriplegia after the insertion of an intrathecal baclofen pump.

    Science.gov (United States)

    Ginsburg, Glen M; Lauder, Anthony J

    2007-11-15

    Medical and radiographic review of 19 consecutive patients with spastic quadriplegia before and after intrathecal baclofen pump insertion with special attention paid to progression of scoliosis. Many orthopedic surgeons who treat spastic quadriplegic patients have noticed a trend of marked scoliosis progression after the administration of intrathecal baclofen (ITB) via subcutaneous pump and catheter. The purpose of this study is to quantify scoliosis progression in this patient population before and after baclofen administration and compare this to published natural history data. The authors had noted rapid progression of scoliosis in spastic quadriplegic patients after intrathecal baclofen pump insertion. This had been noted at other centers, but no significant statistical analysis had been done comparing prepump to postpump scoliosis progression in these patients. To document the magnitude and rate of scoliosis progressions after the placement of an ITB pump, the charts and radiographs of 19 consecutive nonambulatory patients with spastic quadriplegia and an ITB pump were reviewed. To document the rate of scoliosis progression, each patient had at least 2 pre and 2 postpump insertion spinal radiographs made. All radiographs were made with the patients in the supine position without orthoses. A board-certified orthopedic surgeon reviewed these radiographs. Skeletal maturity was assessed using Risser grading. Catheter tip location and rate of baclofen administration were recorded. For 19 patients with complete radiographic data, average Cobb angles were 10.2 degrees before pump insertion and 25 degrees at an average of 20.9 months after pump insertion (P quadriplegia and ITB pump. The authors are now performing spinal fusions for curves that exceed 40 degrees to 50 degrees in the presence of an ITB pump as recommended by previous reviews of scoliosis and accompanying quadriplegia.

  4. Intraspinal anomalies in scoliosis: An MRI analysis of 177 consecutive scoliosis patients

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    Rajasekaran S

    2010-01-01

    Full Text Available Background : The association of intraspinal neural anomalies with scoliosis is known for more than six decades. However, there are no studies documenting the incidence of association of intraspinal anomalies in scoliotic patients in the Indian population. The guide lines to obtain an magnetic resonance imaging (MRI scan to rule out neuro-axial abnormalities in presumed adolescent idiopathic scoliosis are also not clear. We conducted a prospective study (a to document and analyze the incidence and types of intraspinal anomalies in different types of scoliosis in Indian patients. (b to identify clinico-radiological ′indicators′ that best predict the findings of neuro-axial abnormalities in patients with presumed adolescent idiopathic scoliosis, which will alert the physician to the possible presence of intraspinal anomalies and optimize the use of MRI in this sub group of patients. Materials and Methods : The data from 177 consecutive scoliotic patients aged less than 21 years were analyzed. Patients were categorized into three groups; Group A - congenital scoliosis (n=60, group B -presumed idiopathic scoliosis (n=94 and group C - scoliosis secondary to neurofibromatosis, neuromuscular and connective tissue disorders (n=23. The presence and type of anomaly in the MRI was correlated to patient symptoms, clinical signs and curve characteristics. Results : The incidence of intraspinal anomalies in congenital scoliosis was 35% (21/60, with tethered cord due to filum terminale being the commonest anomaly (10/21. Patients with multiple vertebral anomalies had the highest incidence (48% of neural anomalies and isolated hemi vertebrae had none. In presumed ′idiopathic′ scoliosis patients the incidence was higher (16% than previously reported. Arnold Chiari-I malformation (AC-I with syringomyelia was the most common neural anomaly (9/15 and the incidence was higher in the presence of neurological findings (100%, apical kyphosis (66.6% and early

  5. Radiological Outcomes in Adolescent Idiopathic Scoliosis Patients More Than 22 Years After Treatment

    DEFF Research Database (Denmark)

    Simony, Ane; Christensen, Steen Bach; Carreon, Leah Y

    2015-01-01

    STUDY DESIGN: Longitudinal cohort. OBJECTIVES: To evaluate the long-term radiologic outcomes in adolescent idiopathic scoliosis (AIS) patients more than 22 years after treatment. SUMMARY OF BACKGROUND DATA: Although treatment for AIS is prophylactic and is aimed at preventing curve progression......, very few studies report long-term outcomes of treatment. METHODS: AIS patients treated with Boston brace or posterior spinal fusion (PSF) with Harrington-dorso-transverse traction (DTT) instrumentation from 1983 to 1990 were requested to return to clinic. Subsequently, 36-inch standing radiographs were...... obtained after patient consent. Cobb angles were compared with pretreatment and immediate posttreatment radiographs. Any evidence of adjacent-level disease or local kyphosis was also noted. RESULTS: One hundred fifty-nine (78%) of 219 patients were available for follow-up, 66 braced and 93 surgical...

  6. Radiographic and tomographic aspects of meningeal hemangiosarcoma in a German Shepherd dog with clinical signs of cauda equina sindrome

    International Nuclear Information System (INIS)

    Pinto, A.C.B. de C.F.; Ferrigno, C.R.A.; Matera, J.M.; Torres, L.N.; Sinhorini, I.L.; Cortopassi, S.R.G.; Hage, M.C.F.N.S.

    2007-01-01

    Hemangiosarcoma is a highly malignant neoplasia derived from the endothelial cell line and, therefore, can arise in any tissue with blood vessels. A case of a rare meningeal site of hemangiosarcoma in an eight-year old German Shepherd dog with clinical signs of cauda equina sindrome is described. The diagnosis was made based on clinical, radiographic, tomographic and histopathological findings [pt

  7. The Inverted Discoid Meniscus Segment: Clinical, Radiographic, and Arthroscopic Description of a Hidden Tear Pattern.

    Science.gov (United States)

    LaMont, Lauren; Ellis, Henry; Wise, Kelsey; Wilson, Philip

    2016-06-01

    A flipped, or inverted, meniscus segment is easily visualized in the normal meniscus. However, an inverted discoid meniscus segment may be difficult to appreciate because the tear occurs more centrally and leaves more meniscal rim; thus, it may be undertreated if not addressed during arthroscopy. To describe findings on clinical history, radiographs, MRI, and arthroscopy of a lateral discoid meniscus with an inverted segment and compare them with characteristics of a lateral discoid meniscus without an inverted segment. Case-control study; Level of evidence, 3. Between 2009 and 2012, a retrospective series of 121 consecutive knee arthroscopies for symptomatic lateral discoid meniscus were reviewed for the presence of an inverted fragment. Chart review of clinical presentation, operative reports, radiographic images, and arthroscopic images was performed. Comparative analysis of the clinical presentation between lateral discoid menisci with an inverted segment and noninverted lateral discoid menisci was performed by use of Fisher exact test and Mann-Whitney test. Nineteen patients with an inverted discoid meniscus segment (14 males, 5 females; average age, 15.0 years; range, 9.5-17.0 years) were compared with 102 patients with a noninverted discoid meniscus (53 males, 49 females; average age, 12.3 years; range, 5-17.0 years) (P = .011 for sex and P meniscus patients with an inverted segment had activity-related knee pain. Only 4 patients (21.0%) reported mechanical symptoms. Patients with an inverted discoid segment, compared with patients with discoid menisci without inverted segments, were more likely to have instability and effusion (P = .012 and P meniscus patients with an inverted segment (94.7%) had an injury, while only 41.2% of patients with noninverted symptomatic discoid menisci had an injury (P meniscus. During arthroscopy, the inverted discoid segment appeared normal, without a tear; upon probing, however, the inverted segment could be exposed. An

  8. What is the Difference in Morphologic Features of the Thoracic Pedicle Between Patients With Adolescent Idiopathic Scoliosis and Healthy Subjects? A CT-based Case-control Study.

    Science.gov (United States)

    Gao, Bo; Gao, Wenjie; Chen, Chong; Wang, Qinghua; Lin, Shaochun; Xu, Caixia; Huang, Dongsheng; Su, Peiqiang

    2017-11-01

    Describing the morphologic features of the thoracic pedicle in patients with adolescent idiopathic scoliosis is necessary for placement of pedicle screws. Previous studies showed inadequate reliability owing to small sample size and heterogeneity of the patients surveyed. To use CT scans (1) to describe the morphologic features of 2718 thoracic pedicles from 60 female patients with Lenke Type 1 adolescent idiopathic scoliosis and 60 age-, sex-, and height-matched controls; and (2) to classify the pedicles in three types based on pedicle width and analyze the distribution of each type. A total of 2718 pedicles from 60 female patients with Lenke Type 1 adolescent idiopathic scoliosis and 60 matched female controls were analyzed via CT. All patients surveyed were diagnosed with adolescent idiopathic scoliosis, Lenke Type 1, at the First Affiliated Hospital of Sun Yat-sen University, and all underwent pedicle screw fixation between January 2008 and December 2013 with preoperative radiographs and CT images on file. We routinely obtained CT scans before these procedures; all patients who underwent surgery during that period had CT scans, and all were available for analysis here. Control subjects had CT scans for other clinical indications and had no abnormal findings of the spine. The control subjects were chosen to match patients in terms of age (15 ± 2.6 years versus 15 ± 2.6 years) and sex. Height of the two groups also was matched (154 ± 9 cm versus 155 ± 10 cm; mean difference, -1.06 cm; 95% CI, -1.24 to -0.81 cm; p adolescent idiopathic scoliosis (22%; 293 of 1322) compared with controls (13%; 178 of 1396) (odds ratio [OR] = 0.51; 95% CI, 0.42-0.63; p adolescent idiopathic scoliosis, they commonly occurred on the concave side 34% (228 of 661) and on the AV-SC region (32%; 43 of 136). Pedicle width on the concave side was narrower than pedicle width on the convex side and pedicle width in healthy control subjects. The apical vertebra in the structural curve was

  9. Effect of bracing and other conservative interventions in the treatment of idiopathic scoliosis in adolescents : A systematic review of clinical trials

    NARCIS (Netherlands)

    Lenssinck, MLB; Frijlink, AC; Berger, MY; Bierma-Zeinstra, SMA; Verkerk, K; Verhagen, AP

    2005-01-01

    Background and Purpose. Many conservative treatments are available for adolescents with idiopathic scoliosis, but the evidence for their accepted use is still unclear. The purpose of this study was to evaluate the effectiveness of braces and other conservative treatments of idiopathic scoliosis in

  10. Interleukin-1β level in peri-implant crevicular fluid and its correlation with the clinical and radiographic parameters

    Directory of Open Access Journals (Sweden)

    Aniruddha M Kajale

    2014-01-01

    Full Text Available Background and Objectives : Assessing only the clinical and radiographic parameters for evaluation of dental implants may not be enough as they often reflect extensive inflammatory changes in the periodontal tissues. As peri-implant crevicular fluid (PICF can give us a more prompt and objective measure of the disease activity, the purpose of this case series is to assess the peri-implant health status of single tooth dental implants not only clinically and radiographically but also biochemically. Materials and Methods: Thirteen patients were subjected to dental implants at single edentulous sites using a conventional surgical approach. At baseline, 6 months, and 12 months after implant placement, the clinical and radiographic parameters were recorded. Additionally, IL-1β in PICF was estimated using the ELISA kit at 6 th and 12 th month. Results: The clinical and radiographic parameters differed significantly around the implants at different time intervals with IL-1β levels showing highly significant differences between 6 months (31.79 ± 12.26 pg/μl and 12 months (113.09 ± 51.11 pg/μl. However, Spearman′s correlation coefficient showed no correlation with the clinical and radiographic parameters. Interpretation and Conclusion: Assessment of the various parameters confirmed that all the implants had a healthy peri-implant status. Although the levels of IL-1β in PICF were elevated at the 12 th month, they were well within the healthy range as observed by previous studies. This indicates that IL-1β, a biochemical marker, can be used as an adjunct to clinical and radiographic parameters in the assessment of EARLY inflammatory changes around implants.

  11. Clinical, radiographic, pathologic, and genetic features of osteochondrodysplasia in Scottish Deerhounds

    International Nuclear Information System (INIS)

    Breur, G.J.; Zerbe, C.A.; Slocombe, R.F.; Padgett, G.A.; Braden, T.D.

    1989-01-01

    Clinical, radiographic, pathologic, and genetic features of a form of osteochondrodysplasia in 5 related Scottish Deerhound pups from 2 litters were evaluated. All pups appeared to be phenotypically normal at birth. At approximately 4 or 5 weeks, exercise intolerance and retarded growth were observed. Kyphosis, limb deformities, and joint laxity gradually developed. Radiography of the affected pups revealed skeletal changes characterized by abnormalities in long bones and vertebrae, with involvement of epiphyses, growth plates, and metaphyses. Short long bones and vertebrae and irregular and delayed epiphyseal ossification were most noticeable in younger pups; in older pups, bony deformities became more prominent. In skeletally mature dogs, osteopenia and severe deformities were seen. The histologic changes of the growth plate were compatible with a diagnosis of chondrodysplasia. Growth plate chondrocytes contained periodic acid Schiff-positive, diastase-resistant cytoplasmic inclusions. A single autosomal recessive mode of inheritance was suspected

  12. Efficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic scoliosis surgery.

    Science.gov (United States)

    Sui, Wen-yuan; Ye, Fang; Yang, Jun-lin

    2016-04-27

    Adolescent idiopathic scoliosis (AIS) surgery usually require prolonged operative times with extensive soft tissue dissection and significant perioperative blood loss, and allogeneic blood products are frequently needed. Methods to reduce the requirement for transfusion would have a beneficial effect on these patients. Although many previous studies have revealed the efficacy of tranexamic acid (TXA) in spinal surgery, there is still a lack of agreement concerning the reduction of both blood loss and transfusion requirements of large dose tranexamic acid (TXA) in surgery for adolescent idiopathic scoliosis (AIS). The objective of this study was to elevate the efficacy and safety of a large dose tranexamic acid (TXA) in reducing transfusion requirements of allogeneic blood products in adolescent idiopathic scoliosis (AIS) surgery using a retrospective study designed with historical control group. One hundred thirty seven consecutive AIS patients who underwent surgery treatment with posterior spinal pedicle systems from August 2011 to March 2015 in our scoliosis center were retrospectively reviewed. Patients were divided into two groups, the TXA group and the historical recruited no TXA group (NTXA). Preoperative demographics, radiographic parameters, operative parameters, estimated blood loss (EBL), total irrigation fluid, number of patients requiring blood transfusion, mean drop of Hb (Pre-op Hb-Post-op Hb), haematocrit pre and post-surgery, mean volume of blood transfusion, hospitalization time, and adverse effect were recorded and compared. All the patients were successfully treated with satisfied clinical and radiographic outcomes. There were 71 patients in the TXA group and 66 patients in the NTXA group. The preoperative demographics were homogeneity between two groups (P > 0.05). There were no significant difference in average operative time between two groups (209 min vs 215 min, p >0.05). Number of patients in the TXA group showed a significant decrease in

  13. Rehabilitation of adolescent idiopathic scoliosis: results of exercises and bracing from a series of clinical studies. Europa Medicophysica-SIMFER 2007 Award Winner.

    Science.gov (United States)

    Negrini, S; Atanasio, S; Zaina, F; Romano, M

    2008-06-01

    Rehabilitation of adolescent idiopathic scoliosis (AIS) requires a careful choice from among the possible treatments, such as bracing and exercises, according to the patient's needs. According to the literature, there is little evidence regarding the efficacy of these rehabilitation instruments. During the past few years, a full series of studies has been carried out to investigate their efficacy. The aim of this paper was to summarize all these results. Three systematic reviews (two on exercises and one on manual therapy), and four cohort prospective studies were performed. The prospective studies included two trials with a prospective control group on exercises (one to avoid bracing and one in preparation to bracing) and two trials with retrospective control group on a new brace developed by the Authors (Sforzesco brace and SPoRT concept of correction versus Lyon brace and Risser cast). Results show that in literature there is proof of level 1b on exercises but no studies on manual therapy. High quality exercises like Scientific Exercises Approach to Scoliosis (SEAS) have more efficacy than usual physiotherapy, significantly reducing brace prescription in one year from 25% of cases to 6%. Moreover, such exercises help to obtain the best results in bracing first correction. The Sforzesco brace has proved to have more efficacy than the Lyon brace, whereas it has the same efficacy--but reduced side effects and impact on quality of life--than the Risser brace. With an efficient management of data collection, it is possible to develop a set of studies aimed at verifying the efficacy of clinical daily rehabilitation approaches.

  14. Sacroiliac Joint Fusion: One Year Clinical and Radiographic Results Following Minimally Invasive Sacroiliac Joint Fusion Surgery.

    Science.gov (United States)

    Kube, Richard A; Muir, Jeffrey M

    2016-01-01

    Recalcitrant sacroiliac joint pain responds well to minimally-invasive surgical (MIS) techniques, although long-term radiographic and fusion data are limited. To evaluate the one-year clinical results from a cohort of patients with chronic sacroiliac (SI) joint pain unresponsive to conservative therapies who have undergone minimally invasive SI joint fusion. SI joint fusion was performed between May 2011 and January 2014. Outcomes included radiographic assessment of fusion status, leg and back pain severity via visual analog scale (VAS), disability via Oswestry Disability Index (ODI) and complication rate. Outcomes were measured at baseline and at follow-up appointments 6 months and 12 months post-procedure. Twenty minimally invasive SI joint fusion procedures were performed on 18 patients (mean age: 47.2 (14.2), mean BMI: 29.4 (5.3), 56% female). At 12 months, the overall fusion rate was 88%. Back and leg pain improved from 81.7 to 44.1 points (p<0.001) and from 63.6 to 27.7 points (p=0.001), respectively. Disability scores improved from 61.0 to 40.5 (p=0.009). Despite a cohort containing patients with multiple comorbidities and work-related injuries, eight patients (50%) achieved the minimal clinically important difference (MCID) in back pain at 12 months, with 9 (69%) patients realizing this improvement in leg pain and 8 (57%) realizing the MCID in ODI scores at 12 months. No major complications were reported. Minimally invasive SI joint surgery is a safe and effective procedure, with a high fusion rate, a satisfactory safety profile and significant improvements in pain severity and disability reported through 12 months post-procedure.

  15. Presence of crevicular fluid Prostaglandin E2 in relation with clinical and radiographic periodontal status

    Directory of Open Access Journals (Sweden)

    Javier Elpidio Monzón

    2016-07-01

    Full Text Available Background and Objectives: Prostaglandin E2 (PGE2 is present in gingival crevicular fluid the (GCF and is evidenced in periodontal disease (PD. However, there are no enough reports to correlate the PGE2 concentrations in GCF in periodontal health and disease with clinical and radiographic indicators, age and gender. Hence, the present study is aimed to estimate the levels of PGE2 in GCF of subjects without periodontal disease (SEP and periodontal disease (CEP. Materials and Methods: 99 subjects were selected, 33 without PD (G1 and 66 with PD, 33 with gingivitis (G2 and 33 with periodontitis (G3, which were submitted to a clinical and radiographic diagnosis, registering samples FGC, being stored, centrifuged and refrigerated for preservation. Subsequently the concentration of crevicular PGE2 was measured by using the enzyme linked immunosorbent assay (ELISA, determining the concentration of each subject. Results: PGE2 was detected in all the samples. The G1 presented a concentration of 28.82 ± 2.88 pg / mL, G2 44.91 ± 4.37 pg / mL and G3 148.67 ± 74.74 pg / mL (0.0001. PGE2 levels were significantly correlated with bleeding on probing, probing depth, attachment loss and bone loss (0.05. PGE2 levels were modified by age, but not gender. Conclusion: It is well known that activated inflammatory cells produce inflammatory mediators that stimulate the production of PGE2. The findings of this study demonstrate an increased concentration of PGE2 in FCG according to the presence of greater severity of PD. PGE2 may be considered as a biomarker in PD progression. However, controlled, longitudinal studies are needed to confirm this possibility.

  16. Intraoperative visible bubbling of air may be the first sign of venous air embolism during posterior surgery for scoliosis.

    Science.gov (United States)

    Wills, John; Schwend, Richard M; Paterson, Andrew; Albin, Maurice S

    2005-10-15

    Case report of two children sustaining venous air embolism (VAE) during posterior surgery for scoliosis. To report 2 cases where visible bubbling at the operative site was the first clinical indication of VAE-induced cardiovascular collapse and to raise the level of consciousness that VAE in the prone position can occur, often with serious consequences. Twenty-two cases of VAE during surgery for scoliosis in the prone position have been reported. Ten were fatal and ten were in children. Visible bubbling at the operative site was noted in two published cases. Retrospective study of 2 cases of VAE at one institution. Clinical, anesthetic, and radiographic features are presented. Details of previously published cases are reviewed and discussed. Both patients were girls with adolescent scoliosis who underwent prone positioned posterior spinal fusion with instrumentation. Visible bubbling of air at the thoracic aspect of the surgical site was noted near the completion of instrumentation and was the first indication of VAE. In both cases, this was clinically recognized and promptly treated. One patient survived normally and the other died. Visible air bubbling at the operative site may herald the onset of massive VAE during multilevel posterior spinal fusion and instrumentation. A prospective multicenter study using precordial Doppler, central venous catheter, and end-tidal CO2 is recommended to determine the true incidence of VAE in spinal deformity surgery and to evaluate monitoring and treatment methods.

  17. Growth rates and the prevalence and progression of scoliosis in short-statured children on Australian growth hormone treatment programmes

    Directory of Open Access Journals (Sweden)

    McPhee Ian

    2007-02-01

    Full Text Available Abstract Study design and aim This was a longitudinal chart review of a diverse group (cohort of patients undergoing HGH (Human Growth Hormone treatment. Clinical and radiological examinations were performed with the aim to identify the presence and progression of scoliosis. Methods and cohort 185 patients were recruited and a database incorporating the age at commencement, dose and frequency of growth hormone treatment and growth charts was compiled from their Medical Records. The presence of any known syndrome and the clinical presence of scoliosis were included for analysis. Subsequently, skeletally immature patients identified with scoliosis were followed up over a period of a minimum four years and the radiologic type, progression and severity (Cobb angle of scoliosis were recorded. Results Four (3.6% of the 109 with idiopathic short stature or hormone deficiency had idiopathic scoliosis (within normal limits for a control population and scoliosis progression was not prospectively observed. 13 (28.8% of 45 with Turner syndrome had scoliosis radiologically similar to idiopathic scoliosis. 11 (48% of 23 with varying syndromes, had scoliosis. In the entire cohort, the growth rates of those with and without scoliosis were not statistically different and HGH treatment was not ceased because of progression of scoliosis. Conclusion In this study, there was no evidence of HGH treatment being responsible for progression of scoliosis in a small number of non-syndromic patients (four. An incidental finding was that scoliosis, similar to the idiopathic type, appears to be more prevalent in Turner syndrome than previously believed.

  18. The relationship between clinical characteristics, radiographic osteoarthritis and 3D bone area: data from the osteoarthritis initiative.

    Science.gov (United States)

    Barr, A J; Dube, B; Hensor, E M A; Kingsbury, S R; Peat, G; Bowes, M A; Conaghan, P G

    2014-10-01

    Radiographic measures of osteoarthritis (OA) are based upon two dimensional projection images. Active appearance modelling (AAM) of knee magnetic resonance imaging (MRI) enables accurate, 3D quantification of joint structures in large cohorts. This cross-sectional study explored the relationship between clinical characteristics, radiographic measures of OA and 3D bone area (tAB). Clinical data and baseline paired radiographic and MRI data, from the medial compartment of one knee of 2588 participants were obtained from the NIH Osteoarthritis Initiative (OAI). The medial femur (MF) and tibia (MT) tAB were calculated using AAM. 'OA-attributable' tAB (OA-tAB) was calculated using data from regression models of tAB of knees without OA. Associations between OA-tAB and radiographic measures of OA were investigated using linear regression. In univariable analyses, height, weight, and age in female knees without OA explained 43.1%, 32.1% and 0.1% of the MF tAB variance individually and 54.4% when included simultaneously in a multivariable model. Joint space width (JSW), osteophytes and sclerosis explained just 5.3%, 14.9% and 10.1% of the variance of MF OA-tAB individually and 17.4% when combined. Kellgren Lawrence (KL) grade explained approximately 20% of MF OA-tAB individually. Similar results were seen for MT OA-tAB. Height explained the majority of variance in tAB, confirming an allometric relationship between body and joint size. Radiographic measures of OA, derived from a single radiographic projection, accounted for only a small amount of variation in 3D knee OA-tAB. The additional structural information provided by 3D bone area may explain the lack of a substantive relationship with these radiographic OA measures. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Anterior or posterior surgery for right thoracic adolescent idiopathic scoliosis (AIS)? A prospective cohorts' comparison using radiologic and functional outcomes.

    Science.gov (United States)

    Rushton, Paul R P; Grevitt, Michael P; Sell, Philip J

    2015-04-01

    Prospective cohort study. Prospectively compare patient-reported as well as clinical and radiologic outcomes after anterior or posterior surgery for right thoracic adolescent idiopathic scoliosis (AIS) in a single center by the same surgeons. Anterior and posterior spinal instrumentation and arthrodesis are both well-established treatments of thoracic AIS. The majority of studies comparing the 2 approaches have focused on radiographic outcomes. There remains a paucity of prospectively gathered patient-reported outcomes comparing surgical approaches. Forty-two consecutive patients with right thoracic AIS were treated in a single center by one of 2 surgeons with either anterior (n=18) or posterior (n=24) approaches and followed up for over 2 years. Radiographic, clinical, and patient-reported outcomes of the Modified Scoliosis Research Society Outcome Instrument were gathered and analyzed by an independent surgeon. Patients reported significant improvements in all areas of the Modified Scoliosis Research Society Outcome Instrument, especially pain and self-image domains. There were no significant differences in the degree of improvement in any domains between the groups. Posterior and anterior surgery corrected rib hump by 53% and 61%, respectively (P=0.4). The Main thoracic curve Cobb angle was corrected from 69 to 26 degrees (62%) by posterior surgery and 61 to 23 degrees (64%) by anterior surgery (P=0.6). Posterior surgery significantly reduced kyphosis and lumbosacral lordosis. Anterior surgery had no overall affect of sagittal alignment but seemed able to correct those hypokyphotic preoperatively. Complications differed and were largely approach-related--intrathoracic in anterior and wound-related in posterior surgery. Patients with right thoracic AIS of differing curve types but otherwise similar preoperatively demonstrated that anterior and posterior surgery are largely equivalent. Patient-reported outcomes are improved similarly by either approach. Both offer

  20. Automated characterization of perceptual quality of clinical chest radiographs: Validation and calibration to observer preference

    International Nuclear Information System (INIS)

    Samei, Ehsan; Lin, Yuan; Choudhury, Kingshuk R.; Page McAdams, H.

    2014-01-01

    Purpose: The authors previously proposed an image-based technique [Y. Lin et al. Med. Phys. 39, 7019–7031 (2012)] to assess the perceptual quality of clinical chest radiographs. In this study, an observer study was designed and conducted to validate the output of the program against rankings by expert radiologists and to establish the ranges of the output values that reflect the acceptable image appearance so the program output can be used for image quality optimization and tracking. Methods: Using an IRB-approved protocol, 2500 clinical chest radiographs (PA/AP) were collected from our clinical operation. The images were processed through our perceptual quality assessment program to measure their appearance in terms of ten metrics of perceptual image quality: lung gray level, lung detail, lung noise, rib–lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm–lung contrast, and subdiaphragm area. From the results, for each targeted appearance attribute/metric, 18 images were selected such that the images presented a relatively constant appearance with respect to all metrics except the targeted one. The images were then incorporated into a graphical user interface, which displayed them into three panels of six in a random order. Using a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions, each of five participating attending chest radiologists was tasked to spatially order the images based only on the targeted appearance attribute regardless of the other qualities. Once ordered, the observer also indicated the range of image appearances that he/she considered clinically acceptable. The observer data were analyzed in terms of the correlations between the observer and algorithmic rankings and interobserver variability. An observer-averaged acceptable image appearance was also statistically derived for each quality attribute based on the collected individual acceptable ranges

  1. Automated characterization of perceptual quality of clinical chest radiographs: Validation and calibration to observer preference

    Energy Technology Data Exchange (ETDEWEB)

    Samei, Ehsan, E-mail: samei@duke.edu [Carl E. Ravin Advanced Imaging Laboratories, Departments of Radiology, Physics, Biomedical Engineering, Electrical and Computer Engineering, Medical Physics Graduate Program, Duke Clinical Imaging Physics Group, Duke University, Durham, North Carolina 27710 (United States); Lin, Yuan [Carl E. Ravin Advanced Imaging Laboratories, Departments of Radiology and Physics, Duke University, Durham, North Carolina 27710 (United States); Choudhury, Kingshuk R. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology and Biostatistics and Bioinformatics, Duke University, Durham, North Carolina 27710 (United States); Page McAdams, H. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University, Durham, North Carolina 27710 (United States)

    2014-11-01

    Purpose: The authors previously proposed an image-based technique [Y. Lin et al. Med. Phys. 39, 7019–7031 (2012)] to assess the perceptual quality of clinical chest radiographs. In this study, an observer study was designed and conducted to validate the output of the program against rankings by expert radiologists and to establish the ranges of the output values that reflect the acceptable image appearance so the program output can be used for image quality optimization and tracking. Methods: Using an IRB-approved protocol, 2500 clinical chest radiographs (PA/AP) were collected from our clinical operation. The images were processed through our perceptual quality assessment program to measure their appearance in terms of ten metrics of perceptual image quality: lung gray level, lung detail, lung noise, rib–lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm–lung contrast, and subdiaphragm area. From the results, for each targeted appearance attribute/metric, 18 images were selected such that the images presented a relatively constant appearance with respect to all metrics except the targeted one. The images were then incorporated into a graphical user interface, which displayed them into three panels of six in a random order. Using a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions, each of five participating attending chest radiologists was tasked to spatially order the images based only on the targeted appearance attribute regardless of the other qualities. Once ordered, the observer also indicated the range of image appearances that he/she considered clinically acceptable. The observer data were analyzed in terms of the correlations between the observer and algorithmic rankings and interobserver variability. An observer-averaged acceptable image appearance was also statistically derived for each quality attribute based on the collected individual acceptable ranges

  2. Congenital scoliosis: an up-to-date

    Science.gov (United States)

    Burnei, G; Gavriliu, S; Vlad, C; Georgescu, I; Ghita, RA; Dughilă, C; Japie, EM; Onilă, A

    2015-01-01

    Congenital scoliosis represents a spinal malformation due to defects of formation, segmentation or mixed ones. It is characterized by a longitudinal and rotational imbalance. 54 patients were analyzed and 39 out of them were operated by various approaches with anterior and posterior instrumentations during 2000 and 2012. The impossibility to appoint some patients encountered in the daily practice into the known classifications, allowed us to purpose two categories of congenital scoliosis related to the predominance of spinal deviances in the coronal and transversal views. No certain etiology of congenital scoliosis has been identified until today. The susceptibility of some polygenic defects is obvious due to the presence of a sum of defects associated to most of the congenital scoliosis cases and the rarity of the presence of a unique defect. The diagnosis requires a thorough clinical and imaging examination in order to establish an individualized therapeutic strategy. The treatment of congenital scoliosis is different from the adolescent idiopathic one. Therapeutic criteria are significantly different. It is essential to assess the difference in growth of the concavity related to the convexity when choosing a particular procedure. The magnitude of the curve and the progressive rate are fundamental issues to the surgeon PMID:26351546

  3. Clinical, clinicopathologic, radiographic, and ultrasonographic characteristics of intestinal lymphangiectasia in dogs: 17 cases (1996-1998).

    Science.gov (United States)

    Kull, P A; Hess, R S; Craig, L E; Saunders, H M; Washabau, R J

    2001-07-15

    To characterize the clinical, clinicopathologic, and imaging findings in dogs with intestinal lymphangiectasia and to compare the histologic grade of lymphangiectasia with clinicopathologic and imaging abnormalities. Retrospective study. 17 dogs with a histologic diagnosis of intestinal lymphangiectasia. Medical records of dogs with a histologic diagnosis of intestinal lymphangiectasia were reviewed for signalment, history, clinical signs, results of exploratory laparotomy, and clinicopathologic, radiographic, ultrasonographic, and histologic findings. Mean age of dogs was 8.3 years; the most common clinical signs were diarrhea, anorexia, lethargy, vomiting, and weight loss. Abnormal physical examination findings included dehydration, ascites, and signs of pain on palpation of the abdomen. The most notable clinicopathologic findings were low serum ionized calcium concentration and hypoalbuminemia. Abdominal ultrasonography was performed in 12 dogs and revealed intestinal abnormalities in 8 dogs and peritoneal effusion in 7 dogs. Exploratory laparotomy revealed abnormalities in 9 of 16 dogs including thickened small intestine, dilated lacteals, lymphadenopathy, and adhesions. On histologic examination of the small intestine, concurrent inflammation was observed in 15 of 17 dogs, crypt ectasia in 5 of 17, and lipogranulomas in 2 of 17. Intestinal lymphangiectasia in dogs appears to be a heterogeneous disorder characterized by various degrees of panhypoproteinemia, hypocholesterolemia, lymphocytopenia, and imaging abnormalities. In most dogs, the severity of hypoalbuminemia appears to offer the best correlation with severity of histologic lesions of lymphangiectasia. Imaging abnormalities are common in dogs with intestinal lymphangiectasia but are not specific enough to differentiate this disorder from other gastrointestinal disorders, nor are they predictive of histologic severity.

  4. A clinical and radiographic study of cystogenic ameloblastoma of the jaws

    International Nuclear Information System (INIS)

    Lee, Won Yeop; Park, Tae Won

    1988-01-01

    The purpose of this study is to investigate on the clinical and radiographic patterns of cystogenic ameloblastoma of the jaws. The author studied 64 cases of cystogenic ameloblastoma with regard to age, sex distribution, the side of the lesion and several radiographic features. The results were as follows: 1. The average age was found to be 23.0 years, with a range of 4 to 56 years. The incidence was highest in the second and third decades (72%) and total 64 cases consists of 36 males and 28 females. 2. Fifty-nine cases were found in mandible and 5 cases in maxilla. 3. The specific site distribution was found to be 57.8% ramus, coronoid process and condyle, 34.4% premolar-molar region, and 7.8% were located in mandibular symphysis bilaterally. 4. From the total 64 cases, 28 (44%) were associated with an impacted tooth, especially mandibular second and third molar, 36 (52%) failed to show any association with tooth impaction. It was found that the average age for impaction-associated tumors was 19.8% years, which was statistically significant. 5. Fifty-three (82%) cases showed unilocular radiolucencies, eleven (17%) cases showed multilocular radiolucencies. It was found that the average age for unilocular lesions was 22.3 years whereas lesions showing multilocularity occurred at an average age of 26.4 years, which was not statistically significant. 6. Of the 21 patients who had been followed for more than 2 years, only 4 patients treated by enucleation or curettage recurred (19% recurrence).

  5. A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis

    Directory of Open Access Journals (Sweden)

    Paulo Alvim Borges

    Full Text Available OBJECTIVES: Spinopelvic alignment has been associated with improved quality of life in patients with vertebral deformities, and it helps to compensate for imbalances in gait. Although surgical treatment of scoliosis in patients with neuromuscular spinal deformities promotes correction of coronal scoliotic deformities, it remains poorly established whether this results in large changes in sagittal balance parameters in this specific population. The objective of this study is to compare these parameters before and after the current procedure under the hypothesis is that there is no significant modification. METHODS: Sampling included all records of patients with neuromuscular scoliosis with adequate radiographic records treated at Institute of Orthopedics and Traumatology of Clinics Hospital of University of São Paulo (IOT-HCFMUSP from January 2009 to December 2013. Parameters analyzed were incidence, sacral inclination, pelvic tilt, lumbar lordosis, thoracic kyphosis, spinosacral angle, spinal inclination and spinopelvic inclination obtained using the iSite-Philips digital display system with Surgimap and a validated method for digital measurements of scoliosis radiographs. Comparison between the pre- and post-operative conditions involved means and standard deviations and the t-test. RESULTS: Based on 101 medical records only, 16 patients met the inclusion criteria for this study, including 7 males and 9 females, with an age range of 9-20 and a mean age of 12.9±3.06; 14 were diagnosed with cerebral palsy. No significant differences were found between pre and postoperative parameters. CONCLUSIONS: Despite correction of coronal scoliotic deformity in patients with neuromuscular deformities, there were no changes in spinopelvic alignment parameters in the group studied.

  6. Long-term evaluation of hollow screw and hollow cylinder dental implants : Clinical and radiographic results after 10 years

    NARCIS (Netherlands)

    Telleman, Gerdien; Meijer, Henny J. A.; Raghoebar, Gerry M.

    Background: In 1988, an implant manufacturer offered a new dental implant system, with a wide choice of hollow cylinder (HC) and hollow screw (HS) implants. The purpose of this retrospective study of HS and HC implants was to evaluate clinical and radiographic parameters of peri-implant tissue and

  7. Computed tomography versus magnetic resonance imaging versus bone scintigraphy for clinically suspected scaphoid fractures in patients with negative plain radiographs

    NARCIS (Netherlands)

    Mallee, Wouter H.; Wang, Junfeng; Poolman, Rudolf W.; Kloen, Peter; Maas, Mario; de Vet, Henrica C. W.; Doornberg, Job N.

    2015-01-01

    In clinically suspected scaphoid fractures, early diagnosis reduces the risk of non-union and minimises loss in productivity resulting from unnecessary cast immobilisation. Since initial radiographs do not exclude the possibility of a fracture, additional imaging is needed. Computed tomography (CT),

  8. Clinical and radiographical evaluation of mineral trioxide aggregate, biodentine and propolis as pulpotomy medicaments in primary teeth

    Directory of Open Access Journals (Sweden)

    Bharti Kusum

    2015-11-01

    Full Text Available Objectives The purpose of this study was to evaluate the efficacy of mineral trioxide aggregate (MTA, Biodentine and Propolis as pulpotomy medicaments in primary dentition, both clinically and radiographically. Materials and Methods A total of 75 healthy 3 to 10 yr old children each having at least one carious primary molar tooth were selected. Random assignment of the pulpotomy medicaments was done as follows: Group I, MTA; Group II, Biodentine; Group III, Propolis. All the pulpotomized teeth were evaluated at 3, 6, and 9 mon clinically and radiographically, based on the scoring criteria system. Results The clinical success rates were found to be similar among the three groups at 3 and 6 mon where as a significant decrease in success rate was observed in Group III (84% compared to both Group I (100% and Group II (100% at 9 mon. Radiographic success rates over a period of 9 mon in Groups I, II, and III were 92, 80, and 72%, respectively. Conclusions Teeth treated with MTA and Biodentine showed more favorable clinical and radiographic success as compared to Propolis at 9 mon follow-up.

  9. The clinical value of daily routine chest radiographs in a mixed medical-surgical intensive care unit is low

    NARCIS (Netherlands)

    Graat, Marleen E.; Choi, Goda; Wolthuis, Esther K.; Korevaar, Johanna C.; Spronk, Peter E.; Stoker, Jaap; Vroom, Margreeth B.; Schultz, Marcus J.

    2006-01-01

    INTRODUCTION: The clinical value of daily routine chest radiographs (CXRs) in critically ill patients is unknown. We conducted this study to evaluate how frequently unexpected predefined major abnormalities are identified with daily routine CXRs, and how often these findings lead to a change in care

  10. Evaluating the fundamental qualities of a nuclear medicine radiographer for the provision of an optimal clinical service

    International Nuclear Information System (INIS)

    Griffiths, Marc; King, Simon; Stewart, Rob; Dawson, Gary

    2010-01-01

    The developing nature of nuclear medicine practice highlights the need for an evaluation of the fundamental qualities of a Radiographer working within this discipline. Existing guidelines appear to be in place for clinical technologists working within nuclear medicine. However, limited guidance has been provided for Radiographers practicing within this discipline. This article aims to discuss the fundamental qualities that are considered essential for optimal service delivery, following consultation with various stakeholders. Areas such as technical expertise and knowledge, appropriate use of imaging equipment and current models of safe working practice will be discussed. Patient care and ethical considerations will also be evaluated, along with some core recommendations for future advanced practice.

  11. [Is local bone graft sufficient to maintain the surgical correction in adolescent idiopathic scoliosis curves?].

    Science.gov (United States)

    Mardomingo, A; Sánchez-Mariscal, F; Alvarez, P; Pizones, J; Zúñica, L; Izquierdo, E

    2013-01-01

    The purpose of this study was to compare postoperative clinical and radiological results in adolescent idiopathic scoliosis curves treated by posterior arthrodesis using autogenous bone graft from iliac crest (CI) versus only local autograft bone (HL). A retrospective matched cohort study was conducted on 73 patients (CI n=37 and HL n=36) diagnosed with adolescent idiopathic scoliosis and treated surgically by posterior arthrodesis. The mean post-operative follow-up was 126 months in the CI group vs. 66 months in the HL group. The radiographic data collected consisted of preoperative, postoperative, and final follow-up antero-posterior and lateral full-length radiographs. Loss of correction and quality of arthrodesis were evaluated by comparing the scores obtained from the Spanish version of the SRS-22 questionnaire. There were significant differences in the post-operative results as regards the correction of the Cobb angle of the main curve (HL 61 ± 15% vs. CI 51 ± 14%, P<.004), however a greater loss of correction was found in the local bone group (CI 4.5 ± 7.3° vs. HL 8.5 ± 6.3°, P=.02). There were no significant differences as regards the correction of the Cobb angle of the main curve at the end of follow-up. There were no clinical differences between the two groups in the SRS-22 scores. At 5 years of follow-up, there was a statistically significant greater loss of radiographic correction at the end of final follow-up in the local bone graft group. However clinical differences were not observed as regards the SRS-22 scores. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  12. Particulate bioglass in the regeneration of alveolar bone in dogs: clinical, surgical and radiographic evaluations

    Directory of Open Access Journals (Sweden)

    Alexandre Couto Tsiomis

    2011-04-01

    Full Text Available Bone loss, either by trauma or other diseases, generates an increasing need for substitutes of this tissue. This study evaluated Bioglass as a bone substitute in the regeneration of the alveolar bone in mandibles of dogs by clinical, surgical and radiological analysis. Twenty-eight adult dogs were randomly separated into two equal groups. In each animal, a bone defect was created on the vestibular surface of the alveolar bone between the roots of the fourth right premolar tooth. In the treated group, the defect was immediately filled with bioglass, while in the control, it remained unfilled. Clinical evaluations were performed daily for a week, as well as x-rays immediately after surgery and at 8, 14, 21, 42, 60, 90 and 120 days post-operative. Most animals in both groups showed no signs of inflammation and wound healing was similar. Radiographic examination revealed a gradual increase of radiopacity in the region of the defect in the control group. In the treated group, initial radiopacity was higher than that of adjacent bone, decreasing until 21 days after surgery. Then it gradually increased until 120 days after surgery, when the defect became undetectable. The results showed that Bioglass integrates into bone tissue, is biocompatible and reduced the period for complete bone regeneration.

  13. Clinical, radiographic, and bronchial cytologic features of cats with bronchial disease: 65 cases (1980-1986)

    International Nuclear Information System (INIS)

    Moise, N.S.; Wiedenkeller, D.; Yeager, A.E.; Blue, J.T.; Scarlett, J.

    1989-01-01

    Medical records, radiographs, and bronchial cytologic abnormalities of 65 cats with bronchial disease were reviewed. Bronchial disease was defined as abnormality of the lower airways to the exclusion of disease originating or mainly involving the alveoli, interstitium, vasculature, or pleura. Cats with bronchial disease were more likely to be female and older. Siamese cats were over represented and had more chronic disease. In order of frequency, the following clinical signs were reported: coughing, dyspnea, occasional sneezing, wheezing, and vomiting. Radiography revealed prominent bronchial markings, with some cats having collapse of the middle lobe of the right lung (n = 7), overinflation of the lungs (n = 9), or aerophagia (n = 13). Of 65 bronchial washes, 58 were considered exudative, with the predominant cell type being eosinophil in 24%, neutrophil in 33%, macrophage in 22%, and mixed population of cells in 21%. Cultures for bacteria were considered positive in 24% of the cats. Circulating eosinophilia was not helpful in predicting the predominant cell type in bronchial cytologic exudates. Hyperproteinemia without dehydration was present in a third of the cats, indicating an immunologic response. Half the cats had resolution of clinical signs, whereas half the cats required continuing medication with bronchodilators, antimicrobial agents, or corticosteroids

  14. Management approach for recurrent spontaneous pneumothorax in consecutive pregnancies based on clinical and radiographic findings

    Directory of Open Access Journals (Sweden)

    Dixson George R

    2006-10-01

    Full Text Available Abstract Objective To describe management and clinical features observed in a patient's seven spontaneous pneumothoraces that developed during two consecutive pregnancies involving both hemithoraces. Materials and methods A 21 year old former smoker developed three spontaneous left pneumothoraces in the index pregnancy, having already experienced four right pneumothorax events in a prior pregnancy at age 19. Results Chest tubes were required in several (but not all hospitalizations during these two pregnancies. Following her fourth right pneumothorax, thoracoscopic excision of right apical lung blebs and mechanical pleurodesis was performed. The series of left pneumothoraces culminated in mini-thoracotomy and thoracoscopically directed mechanical pleurodesis. For both pregnancies unassisted vaginal delivery was performed with no adverse perinatal sequelae. With the exception of multiple pneumothoraces, there were no additional pregnancy complications. Conclusion Spontaneous pneumothorax in pregnancy is believed to be a rare phenomenon, yet the exact incidence is unknown. Here we present the first known case of multiple spontaneous pneumothoraces in two consecutive pregnancies involving both hemithoraces. Clinical management coordinated with obstetrics and surgical teams facilitated a satisfactory outcome for both pregnancies. The diagnosis of pneumothorax should be contemplated in any pregnant patient with dyspnea and chest pain, followed by radiographic confirmation.

  15. Allograft Cellular Bone Matrix in Extreme Lateral Interbody Fusion: Preliminary Radiographic and Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    Antoine G. Tohmeh

    2012-01-01

    Full Text Available Introduction. Extreme lateral interbody fusion (XLIF is a minimally disruptive alternative for anterior lumbar interbody fusion. Recently, synthetic and allograft materials have been increasingly used to eliminate donor-site pain and complications secondary to autogenous bone graft harvesting. The clinical use of allograft cellular bone graft has potential advantages over autograft by eliminating the need to harvest autograft while mimicking autograft's biologic function. The objective of this study was to examine 12-month radiographic and clinical outcomes in patients who underwent XLIF with Osteocel Plus, one such allograft cellular bone matrix. Methods. Forty (40 patients were treated at 61 levels with XLIF and Osteocel Plus and included in the analysis. Results. No complications were observed. From preoperative to 12-month postoperative followup, ODI improved 41%, LBP improved 55%, leg pain improved 43.3%, and QOL (SF-36 improved 56%. At 12 months, 92% reported being “very” or “somewhat” satisfied with their outcome and 86% being either “very” or “somewhat likely” to choose to undergo the procedure again. Complete fusion was observed in 90.2% (55/61 of XLIF levels. Conclusions. Complete interbody fusion with Osteocel Plus was shown in 90.2% of XLIF levels, with the remaining 9.8% being partially consolidated and progressing towards fusion at 12 months.

  16. Clinical and radiographic evaluation of early loaded narrow-diameter implants

    DEFF Research Database (Denmark)

    Maiorana, Carlo; King, Paul; Quaas, Sebastian

    2015-01-01

    OBJECTIVE: To evaluate the clinical reliability of narrow implants placed in a one-stage procedure and early loaded in the upper and lower incisor region. MATERIAL AND METHODS: This is a prospective, single-arm, multicenter study in which patients with missing natural dentition in upper lateral a...... be considered as a valid solution in the treatment of the localized narrow bony defects in the anterior area with reduced spaces between the natural teeth....... healing period. Clinical and radiographic checks were performed at implant placement, loading, and at the 6, 12, 24, and 36 months follow-up visits. RESULTS: A total of 69 subjects with 97 implants have been included in this study. From surgery to 36 months follow-up, 5.6% of the implants showed bone loss...... loss between loading and the 1-year follow-up visit (Galindo-Moreno et al. 2012). This finding, associated with a stable probing pocket depth and a stable crown-gingiva distance, using a one-stage surgical procedure helps to maintain the integrity of the peri-implant soft tissues. Narrow implants can...

  17. Trunk imbalance in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Fortin, Carole; Grunstein, Erin; Labelle, Hubert; Parent, Stefan; Ehrmann Feldman, Debbie

    2016-06-01

    Trunk imbalance (ie, frontal trunk shift measured with a plumb line from C7 to S1) is part of the clinical evaluation in adolescent idiopathic scoliosis (AIS), but its prevalence and relationship with scoliosis, back pain, and health-related factors are not well documented. The principal objectives are to document trunk imbalance prevalence and to explore the association between trunk imbalance and the following factors: Cobb angle, type of scoliosis, back pain, function, mental health, and self-image. The secondary objective is to determine back pain prevalence and the relationship between back pain and each of the following: Cobb angle, function, mental health, and self-image. This is a cross-sectional study in a scoliosis clinic of a tertiary university hospital center. The sample includes youth with AIS (N=55). The outcome measures were trunk imbalance prevalence and magnitude, and back pain prevalence and intensity using the Numeric Pain Rating Scale (NPRS) and the Scoliosis Research Society-22 (SRS-22) pain score, and the function, self-image, and mental health domains of the SRS-22. Trunk imbalance and back pain were assessed in 55 patients with AIS (Cobb angle: 10-60°). Patients completed the SRS-22 questionnaire and the NPRS. Correlations were done between trunk imbalance and scoliosis (Cobb angle, type of scoliosis), back pain (NPRS and SRS-22 pain score), and health-related factors using Pearson correlation coefficients (r) and logistic regression models. Trunk imbalance prevalence is 85% and back pain prevalence is 73%. We found fair to moderate significant positive correlation between trunk imbalance and Cobb angle (r=0.32-0.66, pself-image, or type of scoliosis. Lower self-reported pain significantly correlated with lower Cobb angles (r=0.29, p=.03), higher function (r=0.55, p=.000), higher self-image (r=0.44, p=.001), and better mental health (r=0.48, p=.000). There was a trend for trunk imbalance to be related with lower pain in logistic regression

  18. Clinical and Radiographic Evaluation of Allium sativum Oil as a New Medicament for Vital Pulp Treatment of Primary Teeth.

    Science.gov (United States)

    Mohammad, Shukry Gamal; Raheel, Syed Ahmed; Baroudi, Kusai

    2014-01-01

    The objective of this study was to compare between the clinical and radiographic effects of Allium sativum oil and those of formocresol in vital pulpotomy in primary teeth. A total of 20 children age ranged from 4 to 8 years were included in the study. In every one of those children, the primary molars indicated for pulpotomy. Pulpotomy procedure was performed, and the radicular pulp tissue of one molar capped with A. sativum oil in a cotton pellet, whereas the other molar capped with formocresol, the teeth evaluated clinically and radiographically before and after 6 months, using standard clinical and radiographical criteria. Statistically, these results revealed no significant difference between the radiographic findings of vital pulpotomy in primary molars with the two medicaments was found. A. sativum oil offers a good healing potential, leaving the remaining pulp tissue healthy and functioning. Vital pulpotomy with allium sativa oil was given raise 90% success rate while that with formocresol was 85%. A. sativum oil is a biocompatible material that is compatible with vital human pulp tissue. It offers a good healing potential, leaving the remaining pulp tissue healthy and functioning.

  19. Why do we treat adolescent idiopathic scoliosis? What we want to obtain and to avoid for our patients. SOSORT 2005 Consensus paper

    Directory of Open Access Journals (Sweden)

    Negrini Stefano

    2006-04-01

    Full Text Available Abstract Background Medicine is a scientific art: once science is not clear, choices are made according to individual and collective beliefs that should be better understood. This is particularly true in a field like adolescent idiopathic scoliosis, where currently does not exist definitive scientific evidence on the efficacy either of conservative or of surgical treatments. Aim of the study To verify the philosophical choices on the final outcome of a group of people believing and engaged in a conservative treatment of idiopathic scoliosis. Methods We performed a multifaceted study that included a bibliometric analysis, a questionnaire, and a careful Consensus reaching procedure between experts in the conservative treatment of scoliosis (SOSORT members. Results The Consensus reaching procedure has shown to be useful: answers changed in a statistically significant way, and 9 new outcome criteria were included. The most important final outcomes were considered Aesthetics (100%, Quality of life and Disability (more than 90%, while more than 80% of preferences went to Back Pain, Psychological well-being, Progression in adulthood, Breathing function, Scoliosis Cobb degrees (radiographic lateral flexion, Needs of further treatments in adulthood. Discussion In the literature prevail outcome criteria driven by the contingent treatment needs or the possibility to have measurement systems (even if it seems that usual clinical and radiographic methods are given much more importance than more complex Disability or Quality of Life instruments. SOSORT members give importance to a wide range of outcome criteria, in which clinical and radiographic issues have the lowest importance. Conclusion We treat our patients for what they need for their future (Breathing function, Needs of further treatments in adulthood, Progression in adulthood, and their present too (Aesthetics, Disability, Quality of life. Technical matters, such as rib hump or radiographic lateral

  20. Golimumab in radiographic and nonradiographic axial spondyloarthritis: a review of clinical trials

    Directory of Open Access Journals (Sweden)

    Toussirot E

    2016-07-01

    Full Text Available Eric Toussirot,1–5 Charline Vauchy,1 Delphine Binda,1 Fabrice Michel6 1Clinical Investigation Center in Biotherapy, Intitut National de la Santé et de la Recherche Médicale CIC-1431, 2Fédération Hospitalo-Universitaire Integrated Center for Research in inflammatory Diseases, 3Department of Rheumatology, University Hospital of Besançon, Besançon, France; 4Department of Therapeutics, 5Equipe d’accueil EA 4266: “Pathogenic Agents and Inflammation”, University of Franche-Comté, 6Department of Neuromuscular Examinations and Diseases, University Hospital of Besançon, Besançon, FranceAbstract: Axial spondyloarthritis (Ax SpA refers to chronic inflammatory rheumatic diseases that mainly affect the axial skeleton, leading to erosions and new bone formation in the sacroiliac joints and/or the spine. Ax SpA includes the radiographic form of the disease, ie, ankylosing spondylitis (AS, and the nonradiographic Ax SpA (non-Rx Ax SpA forms. Anti-tumor necrosis factor alpha (TNFα agents are used in the treatment of Ax SpA in patients who do not respond to or are intolerant to nonsteroidal anti-inflammatory drugs. In these patients, anti-TNFα agents show promising results by targeting the inflammatory process and providing symptomatic relief. Golimumab is a fully human anti-TNFα agent that is currently approved for the treatment of both AS and non-Rx Ax SpA in Europe. This review focuses on the results of clinical trials with golimumab for the treatment of AS (GO-RAISE studies and non-Rx Ax SpA (GO-AHEAD study and on the effects of this agent on imaging findings (radiographic progression, magnetic resonance imaging inflammation as well as on biological parameters. Overall, golimumab is a valid therapeutic option in patients with AS and non-Rx Ax SpA in Europe.Keywords: anti-TNFα, golimumab, axial spondyloarthritis

  1. HIV-positive patients in Pusan servitude : clinical and chest radiographic findings

    International Nuclear Information System (INIS)

    Son, Young Keun; Kim, Kun Il

    2001-01-01

    To analyze the clinical and chest radiolographic findings of HIV-positive in Pusan survitude. We reviewed the medical records of 74 admission cases of 41 HIV-positive patients (38 mem and 3 women), confirmed in NIH and admitted to our hospital between May 1990 and September 1997. We evaluated the clinical findings including the pulmonary disease diagnosed at each admission, and using the pattern approach assessed the radiographic findings in 63 cases available among 74 admission cases. For statistical analysis the Pearson Chi-Square test was used, and the chest CT findings available in 19 cases among 17 patients were also evaluated. In all cases the mode of transmission was sexual contact, and they were more frequently contacted with foreigners (73%) than koreans (27%). During the follow-up period, pulmonary diseases were diagnosed in 52 (70%) of 74 admission cases. The diagnoses were pneumocystis cabrini pneumonia (PCP, n=15), pneumonia(n=15), pulmonary tuberculosis(n=15), combined infection with PCP and pulmonary tuberculosis(n=5), and combined infection with PCP and bacterial pneumonia(n=1). The count of CD4+ lymphocyte in 33 of 55 available admissions cases was less than 50 cells/mm?. In 28 patients(68%) who died, the time between confirmation of HIV-positive status to death ranged from 2 to 81 (mean, 39) months. Chest radiographs of 46 available admission cases (73%) showed the followingabnormal findings: interstitial opacities(n=26), consolidation(n=17), single or multiple nodules (n=9), hilar or mediastinal lymph node enlargement(n=10), pleural effusion(n=8), cyst(n=2), mass(n=1), and pericardial effusion(n=1). Diffuse ground glass opacity was observed in eight (89%) of nine PCP cases (p<0.05), and in cases of pulmonary tubercolosis, hilar or mediastinal lymph node enlargement was frequent (p<0.05). Pulmonary diseases in HIV-positive patients in Pusan servitude were diagnosed during follow-up in 70% of cases. The majority of these diseases were infectious

  2. HIV-positive patients in Pusan servitude : clinical and chest radiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Son, Young Keun; Kim, Kun Il [Pusan National Univ. College of Medicine, Pusan (Korea, Republic of)

    2001-04-01

    To analyze the clinical and chest radiolographic findings of HIV-positive in Pusan survitude. We reviewed the medical records of 74 admission cases of 41 HIV-positive patients (38 mem and 3 women), confirmed in NIH and admitted to our hospital between May 1990 and September 1997. We evaluated the clinical findings including the pulmonary disease diagnosed at each admission, and using the pattern approach assessed the radiographic findings in 63 cases available among 74 admission cases. For statistical analysis the Pearson Chi-Square test was used, and the chest CT findings available in 19 cases among 17 patients were also evaluated. In all cases the mode of transmission was sexual contact, and they were more frequently contacted with foreigners (73%) than koreans (27%). During the follow-up period, pulmonary diseases were diagnosed in 52 (70%) of 74 admission cases. The diagnoses were pneumocystis cabrini pneumonia (PCP, n=15), pneumonia(n=15), pulmonary tuberculosis(n=15), combined infection with PCP and pulmonary tuberculosis(n=5), and combined infection with PCP and bacterial pneumonia(n=1). The count of CD4+ lymphocyte in 33 of 55 available admissions cases was less than 50 cells/mm?. In 28 patients(68%) who died, the time between confirmation of HIV-positive status to death ranged from 2 to 81 (mean, 39) months. Chest radiographs of 46 available admission cases (73%) showed the followingabnormal findings: interstitial opacities(n=26), consolidation(n=17), single or multiple nodules (n=9), hilar or mediastinal lymph node enlargement(n=10), pleural effusion(n=8), cyst(n=2), mass(n=1), and pericardial effusion(n=1). Diffuse ground glass opacity was observed in eight (89%) of nine PCP cases (p<0.05), and in cases of pulmonary tubercolosis, hilar or mediastinal lymph node enlargement was frequent (p<0.05). Pulmonary diseases in HIV-positive patients in Pusan servitude were diagnosed during follow-up in 70% of cases. The majority of these diseases were infectious

  3. Meta-analysis of Clinical and Radiographic Outcomes After Arthroscopic Single-Row Versus Double-Row Rotator Cuff Repair

    OpenAIRE

    Perser, Karen; Godfrey, David; Bisson, Leslie

    2011-01-01

    Context: Double-row rotator cuff repair methods have improved biomechanical performance when compared with single-row repairs. Objective: To review clinical outcomes of single-row versus double-row rotator cuff repair with the hypothesis that double-row rotator cuff repair will result in better clinical and radiographic outcomes. Data Sources: Published literature from January 1980 to April 2010. Key terms included rotator cuff, prospective studies, outcomes, and suture techniques. Study Sele...

  4. Community-Acquired Pneumonia Visualized on CT Scans but Not Chest Radiographs: Pathogens, Severity, and Clinical Outcomes.

    Science.gov (United States)

    Upchurch, Cameron P; Grijalva, Carlos G; Wunderink, Richard G; Williams, Derek J; Waterer, Grant W; Anderson, Evan J; Zhu, Yuwei; Hart, Eric M; Carroll, Frank; Bramley, Anna M; Jain, Seema; Edwards, Kathryn M; Self, Wesley H

    2018-03-01

    The clinical significance of pneumonia visualized on CT scan in the setting of a normal chest radiograph is uncertain. In a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia (CAP), we compared the presenting clinical features, pathogens present, and outcomes of patients with pneumonia visualized on a CT scan but not on a concurrent chest radiograph (CT-only pneumonia) and those with pneumonia visualized on a chest radiograph. All patients underwent chest radiography; the decision to obtain CT imaging was determined by the treating clinicians. Chest radiographs and CT images were interpreted by study-dedicated thoracic radiologists blinded to the clinical data. The study population included 2,251 adults with CAP; 2,185 patients (97%) had pneumonia visualized on chest radiography, whereas 66 patients (3%) had pneumonia visualized on CT scan but not on concurrent chest radiography. Overall, these patients with CT-only pneumonia had a clinical profile similar to those with pneumonia visualized on chest radiography, including comorbidities, vital signs, hospital length of stay, prevalence of viral (30% vs 26%) and bacterial (12% vs 14%) pathogens, ICU admission (23% vs 21%), use of mechanical ventilation (6% vs 5%), septic shock (5% vs 4%), and inhospital mortality (0 vs 2%). Adults hospitalized with CAP who had radiological evidence of pneumonia on CT scan but not on concurrent chest radiograph had pathogens, disease severity, and outcomes similar to patients who had signs of pneumonia on chest radiography. These findings support using the same management principles for patients with CT-only pneumonia and those with pneumonia seen on chest radiography. Copyright © 2017 American College of Chest Physicians. All rights reserved.

  5. The adult spinal cord injury without radiographic abnormalities syndrome: magnetic resonance imaging and clinical findings in adults with spinal cord injuries having normal radiographs and computed tomography studies.

    Science.gov (United States)

    Kasimatis, Georgios B; Panagiotopoulos, Elias; Megas, Panagiotis; Matzaroglou, Charalambos; Gliatis, John; Tyllianakis, Minos; Lambiris, Elias

    2008-07-01

    Spinal cord injury without radiographic abnormalities (SCIWORA) is thought to represent mostly a pediatric entity and its incidence in adults is rather underreported. Some authors have also proposed the term spinal cord injury without radiologic evidence of trauma, as more precisely describing the condition of adult SCIWORA in the setting of cervical spondylosis. The purpose of the present study was to evaluate adult patients with cervical spine injuries and radiological-clinical examination discrepancy, and to discuss their characteristics and current management. During a 16-year period, 166 patients with a cervical spine injury were admitted in our institution (Level I trauma center). Upper cervical spine injuries (occiput to C2, 54 patients) were treated mainly by a Halo vest, whereas lower cervical spine injuries (C3-T1, 112 patients) were treated surgically either with an anterior, or posterior procedure, or both. Seven of these 166 patients (4.2%) had a radiologic-clinical mismatch, i.e., they presented with frank spinal cord injury with no signs of trauma, and were included in the study. Magnetic resonance imaging was available for 6 of 7 patients, showing intramedullary signal changes in 5 of 6 patients with varying degrees of compression from the disc and/or the ligamentum flavum, whereas the remaining patient had only traumatic herniation of the intervertebral disc and ligamentum flavum bulging. Follow-up period was 6.4 years on average (1-10 years). This retrospective chart review provides information on adult patients with cervical spinal cord injuries whose radiographs and computed tomography studies were normal. It furthers reinforces the pathologic background of SCIWORA in an adult population, when evaluated by magnetic resonance imaging. Particularly for patients with cervical spondylosis, special attention should be paid with regard to vascular compromise by predisposing factors such as smoking or vascular disease, since they probably contribute in

  6. Computer-assisted radiographic calculation of spinal curvature in brachycephalic "screw-tailed" dog breeds with congenital thoracic vertebral malformations: reliability and clinical evaluation.

    Directory of Open Access Journals (Sweden)

    Julien Guevar

    Full Text Available The objectives of this study were: To investigate computer-assisted digital radiographic measurement of Cobb angles in dogs with congenital thoracic vertebral malformations, to determine its intra- and inter-observer reliability and its association with the presence of neurological deficits. Medical records were reviewed (2009-2013 to identify brachycephalic screw-tailed dog breeds with radiographic studies of the thoracic vertebral column and with at least one vertebral malformation present. Twenty-eight dogs were included in the study. The end vertebrae were defined as the cranial end plate of the vertebra cranial to the malformed vertebra and the caudal end plate of the vertebra caudal to the malformed vertebra. Three observers performed the measurements twice. Intraclass correlation coefficients were used to calculate the intra- and inter-observer reliabilities. The intraclass correlation coefficient was excellent for all intra- and inter-observer measurements using this method. There was a significant difference in the kyphotic Cobb angle between dogs with and without associated neurological deficits. The majority of dogs with neurological deficits had a kyphotic Cobb angle higher than 35°. No significant difference in the scoliotic Cobb angle was observed. We concluded that the computer assisted digital radiographic measurement of the Cobb angle for kyphosis and scoliosis is a valid, reproducible and reliable method to quantify the degree of spinal curvature in brachycephalic screw-tailed dog breeds with congenital thoracic vertebral malformations.

  7. Meta-analysis of Clinical and Radiographic Outcomes After Arthroscopic Single-Row Versus Double-Row Rotator Cuff Repair.

    Science.gov (United States)

    Perser, Karen; Godfrey, David; Bisson, Leslie

    2011-05-01

    Double-row rotator cuff repair methods have improved biomechanical performance when compared with single-row repairs. To review clinical outcomes of single-row versus double-row rotator cuff repair with the hypothesis that double-row rotator cuff repair will result in better clinical and radiographic outcomes. Published literature from January 1980 to April 2010. Key terms included rotator cuff, prospective studies, outcomes, and suture techniques. The literature was systematically searched, and 5 level I and II studies were found comparing clinical outcomes of single-row and double-row rotator cuff repair. Coleman methodology scores were calculated for each article. Meta-analysis was performed, with treatment effect between single row and double row for clinical outcomes and with odds ratios for radiographic results. The sample size necessary to detect a given difference in clinical outcome between the 2 methods was calculated. Three level I studies had Coleman scores of 80, 74, and 81, and two level II studies had scores of 78 and 73. There were 156 patients with single-row repairs and 147 patients with double-row repairs, both with an average follow-up of 23 months (range, 12-40 months). Double-row repairs resulted in a greater treatment effect for each validated outcome measure in 4 studies, but the differences were not clinically or statistically significant (range, 0.4-2.2 points; 95% confidence interval, -0.19, 4.68 points). Double-row repairs had better radiographic results, but the differences were also not statistically significant (P = 0.13). Two studies had adequate power to detect a 10-point difference between repair methods using the Constant score, and 1 study had power to detect a 5-point difference using the UCLA (University of California, Los Angeles) score. Double-row rotator cuff repair does not show a statistically significant improvement in clinical outcome or radiographic healing with short-term follow-up.

  8. Intracranial arteriovenous malformation. Relationships between clinical and radiographic factors and cerebral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Batjer, H H; Devous, M D; Seibert, G B; Purdy, P D; Ajmani, A K; Delarosa, M; Bonte, F J [Texas Univ., Dallas, TX (USA). Southwestern Medical Center

    1989-05-01

    Arteriovenous malformations (AVMs) dramatically alter normal cerebral circulatory dynamics. Clinical and radiographic data from 62 patients were analyzed to determine their impact on total brain blood flow (TBF) measured by single-photon emission computed tomography. 48% of patients presented with hemorrhage and 34% with progressive deficits. 37% had angiographic steal and 21% developed postoperative hyperemic complications. 40% were under 30 years old, 45% were between 30 and 50 years of age, and 15% were over 50. TBF was less than 70 ml/100 gm/min in 32% of patients, between 70 and 84 ml/100 gm/min in 40%, and greater than 84 ml/100 gm/min in 27%. Female patients had higher TBF than males; 42% of females but only 17% of males had values greater than 84 ml/100 gm/min (p < 0.05). A trend toward decreased TBF with advancing age was noted. Intracranial hemorrhage was associated with lower TBF; 47% of patients with hemorrhage and 19% of those without had TBF of < 70 ml/100 gm/min (p < 0.05). 89% of patients with AVMs less than 5 cm in diameter had TBF of {le}84 ml/100 gm/min, and 65% of those with larger AVMs had similarly low flows (p < 0.05). A trend toward lower TBF was observed in patients with unfavorable outcomes. (author).

  9. Radiographic anatomy and technique for arthrography of the cubital joint in clinically normal dogs

    International Nuclear Information System (INIS)

    Lowry, J.E.; Carpenter, L.G.; Park, R.D.; Steyn, P.F.; Schwarz, P.D.

    1993-01-01

    A technique for arthrography of the cubital joint in clinically normal large-breed dogs was developed with the objective of improving visualization of the articular margin of the medial coronoid process. A lateral approach to the cubital joint for injection of contrast medium was selected. Arthrography of 24 cubital joints was performed by using 14 dogs. Twelve combinations of iodinated contrast medium, consisting of various concentrations (3) and volumes (4), were used. Two sets of arthrograms for each of the 12 combinations of contrast medium were obtained. Five radiographic views were used for each set. All arthrograms were examined by 3 evaluators, and each articular surface received a numerical rating for how well it could be seen in each view. Results of the evaluation indicated that low volumes of contrast medium were preferable to high volumes, with 2 ml providing the best visualization. Concentration of iodine seemed less important than did volume. The numerical ratings also indicated that the articular margin of the coronoid process was clearly observed a maximum of only 24% of the time on a slightly supinated mediolateral projection. The articular margins of the head of the radius, trochlea humeri, and trochlear notch were well visualized > 90% of the time. Arthrography of the cubital joint was technically easy to perform, and complications were not encountered, but arthrographic anatomy of the cubital joint is complex. Potential uses for arthrography of the cubital joint include diagnosis of osteochondrosis, intraarticular fragments, and joint capsule ruptures

  10. A retrospective clinical and radiographic study on healing of periradicular lesions in patients taking oral bisphosphonates.

    Science.gov (United States)

    Hsiao, Angela; Glickman, Gerald; He, Jianing

    2009-11-01

    Bisphosphonates have been related to impaired bone remodeling. The impact of oral bisphosphonates on periradicular healing has not been studied. The purpose of this study was to evaluate the healing of periradicular lesions in patients taking oral bisphosphonates after root canal therapy. Thirty-four teeth with preoperative periradicular radiolucencies were identified in patients undergoing oral bisphosphonate therapy. These cases were examined clinically and radiographically to determine treatment outcome. Thirty-eight control teeth were selected from a pool of patients not taking bisphosphonates. Nonsurgical root canal treatment and retreatment was performed by endodontic residents and undergraduate dental students at Baylor College of Dentistry using nonstandardized protocols. In the bisphosphonate group, 73.5% of the lesions healed, whereas the control cases had a healing rate of 81.6%. There was no statistically significant difference between the groups (p > 0.05). The results of this preliminary short-term study suggest that patients taking long-term oral bisphosphonates can expect a satisfactory outcome with evidence of periradicular healing after conventional root canal treatment. Thus, root canal treatment may be considered a safe and realistic alternative to extraction in patients on bisphosphonate therapy.

  11. Pulmonary infection in patients with cyclosporine, azathioprine, and corticosteroids after cardiac transplantation; Clinical and radiographic assessment

    Energy Technology Data Exchange (ETDEWEB)

    Murayama, Sadayuki; Ikezoe, Junpei; Godwin, J.D.; Marglin, S.I.; Allen, M.D. (University of Washington Medical Center, Seattle, WA (United States))

    1991-07-01

    Between November 1985 and November 1989, 54 patients have undergone 55 cardiac transplants, 5 of whom died during operation or one week after transplantation. The remaining 49 patients with a minimum follow-up of 5 months were studied to examine pulmonary infection clinically and radiologically while receiving triple drug immunosuppression consisting of cyclosporine, azathioprine, and prednisolone. Pulmonary infection occurred in 14 patients (29%) with a total of 21 occasions. Causative organisms were identified in 9 occasions, with the most common organism being Cytomegalovirus (CMV). One patient died of pulmonary infection with Aspergillus. Causative organisms occurring in the remaining 12 occasions of pulmonary infection were unknown, which did not lead to death. Because pulmonary infection of unknown organisms rapidly responded to convensional antibiotics, it seemed to have been caused by bacteria. Pulmonary infection of unknown organism occurred 13.2{+-}3.2 months after transplantation, as compared with 3.3{+-}1.0 months in pulmonary infection of known organisms. Chest plain radiographic features fell into four types: (1) interstitial shadow seen in pulmonary infection of CMV, Pneumocystis carinii, or Hemophilia influenza, (2) patchy, and basilar and lobular consolidation shadows in bacterial pneumonia, (3) localized nodular shadow in aspergillosis, and (4) multiple patchy and confluent opacity patterns occurring in herpes simplex viral infection. Pulmonary infection of influenza bacteria for one patient and pulmonary infection of unknown organisms for 4 patients were difficult to identify from pulmonary infection of CMV. (N.K.).

  12. CT saber-sheath trachea. Correlation with clinical, chest radiographic and functional findings

    International Nuclear Information System (INIS)

    Trigaux, J.P.; Hermes, G.; Dubois, P.; Beers, B. van; Delaunois, L.; Jamart, J.

    1994-01-01

    The diagnosis of saber-sheath trachea is easy at CT due to its cross-sectional imaging, but the significance of this CT sign has not been evaluated in the diagnosis of chronic obstructive pulmonary disease (COPD). Various signs of COPD were compared between a series of 20 patients with a saber-sheath trachea at CT (tracheal index ≤66%) and a group of 20 pneumologic control patients without saber-sheath trachea (tracheal index ≥70%). These signs include clinical and standard radiographic indices of COPD, sternum-spine distance and 3 functional tests of COPD: forced expiratory volume in one second, carbon monoxide diffusing lung capacity, and funtional residual capacity (FRC). A significant difference was found between the 2 groups, concerning the values of FRC and of sternum-spine distance (p -2 ). The tracheal index was significantly correlated with the FRC values and with the sternum-spine distance. No other significant difference was observed. It is concluded that saber-sheath trachea is basically a sign of hyperinflation. (orig./MG)

  13. Clinical and Radiographic Outcomes After Submuscular Plating (SMP) of Pediatric Femoral Shaft Fractures.

    Science.gov (United States)

    Stoneback, Jason W; Carry, Patrick M; Flynn, Katherine; Pan, Zhaoxing; Sink, Ernest L; Miller, Nancy H

    2018-03-01

    To evaluate lower extremity strength and alignment among children who underwent submuscular plating (SMP). Subjects who underwent SMP for a length unstable femoral fracture returned for isokinetic strength testing ≥2 years after surgery. Extensor and flexor strength deficits (percent difference) between the operative and nonoperative limbs were evaluated. Radiographic measurements of mechanical alignment [anatomic lateral distal femoral angle (aLDFA)] and qualitative measurements (The Pediatric Outcomes Data Collection Instrument, PODCI) were obtained from all subjects. The upper 97.5% confidence interval approach to establishing clinical equivalency was utilized to compare differences in strength and alignment between the operative and nonoperative limbs. An extensor strength deficit of >19% and an aLDFA discrepancy of >5 degrees were considered to be clinically significant. The average age at surgery of the 10 subjects included in the study was 8.7 years. The hardware was placed an average of 27.9 mm from the distal femoral physis and was removed 6.4 months postsurgery. Among all subjects, the median PODCI scores were ≥97 according to all subscales. There was no significant difference in extension torque between the operative versus nonoperative limbs at 60 degrees/s (P=0.5400), 120 degrees/s (P=0.4214), or 180 degrees/s (P=0.8166). More importantly, extension strength deficits between the operative and nonoperative limbs were not clinically significant at 60 degrees/s [upper 97.5% confidence interval (CI), 10.9%], 120 degrees/s (upper 97.5% CI, 11.0%), or 180 degrees/s (upper 97.5% CI, 10.7%). The difference in aLDFA between the operative and nonoperative limb was less than the predefined clinically significant threshold of 5 degrees for all subjects. SMP achieves satisfactory clinical and functional results. In this series, extensor strength deficits and/or lower extremity malalignment were not clinically meaningful. High patient satisfaction can be

  14. [Clinical application of three-dimensional O-arm navigation system in treating patients with dystrophic scoliosis secondary to neurofibromatosis type Ⅰ].

    Science.gov (United States)

    Liu, Z; Qiu, Y; Li, Y; Zhao, Z H; Wang, B; Zhu, F; Yu, Y; Sun, X; Zhu, Z Z

    2017-03-01

    Objective: To investigate the clinical outcomes and the accuracy of O-arm-navigation system assisted pedicle screw insertion in dystrophic scoliosis secondary to neurofibromatosis type Ⅰ(NF-1). Methods: A retrospective study was conducted in 41 patients with dystrophic NF-1-associated thoracic scoliosis who were surgically treated at Department of Orthopaedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School between June 2012 and October 2014 with more than 18 months follow-up. The patients were then divided into two groups: 18 patients were under the assistance of O-arm-navigation-based pedicle screw insertion (O-arm group) and the remaining 23 patients' pedicle screws insertion were conducted by free-hand (free-hand group). The X-ray and CT were analyzed to investigate the correction rate and safety of pedicle insertion. t -test was used to analyze measurement data and χ(2) test was used to analyze accuracy of screw insertion between the two groups. Results: The mean coronal Cobb angle was 63.2°±8.7° in the O-arm group and 66.9°±7.4° in the free-hand group ( P >0.05), which was then corrected into 23.1°±6.8° and 30.2°±7.6°( t =2.231, P =0.031) after surgery respectively.Operation time was (265.0±70.3)minutes and estimated blood loss was (1 024±465)ml in the O-arm group. Operation time and estimated blood loss was (243.0±49.6)minutes and (1 228±521)ml respectively in the free-hand group, which had no significant difference between the two groups. However, the implant density was higher in the O-arm group than that in the free-hand group ((64.1±10.8)% vs .(44.3±15.3)%)( t =4.652, P =0.000). The O-arm group comprised 122 screws, of which 72.9% were excellent, 22.1% were good and 4.9% were bad. The free-hand group comprised 136 screws and 48.5% of them were excellent, 33.8% were good and 17.6% were bad.Accuracy of pedicle screw insertion was higher in the O-arm group than that in the free-hand group(χ(2

  15. Optimal management of idiopathic scoliosis in adolescence

    Science.gov (United States)

    Kotwicki, Tomasz; Chowanska, Joanna; Kinel, Edyta; Czaprowski, Dariusz; Tomaszewski, Marek; Janusz, Piotr

    2013-01-01

    Idiopathic scoliosis is a three-dimensional deformity of the growing spine, affecting 2%–3% of adolescents. Although benign in the majority of patients, the natural course of the disease may result in significant disturbance of body morphology, reduced thoracic volume, impaired respiration, increased rates of back pain, and serious esthetic concerns. Risk of deterioration is highest during the pubertal growth spurt and increases the risk of pathologic spinal curvature, increasing angular value, trunk imbalance, and thoracic deformity. Early clinical detection of scoliosis relies on careful examination of trunk shape and is subject to screening programs in some regions. Treatment options are physiotherapy, corrective bracing, or surgery for mild, moderate, or severe scoliosis, respectively, with both the actual degree of deformity and prognosis being taken into account. Physiotherapy used in mild idiopathic scoliosis comprises general training of the trunk musculature and physical capacity, while specific physiotherapeutic techniques aim to address the spinal curvature itself, attempting to achieve self-correction with active trunk movements developed in a three-dimensional space by an instructed adolescent under visual and proprioceptive control. Moderate but progressive idiopathic scoliosis in skeletally immature adolescents can be successfully halted using a corrective brace which has to be worn full time for several months or until skeletal maturity, and is able to prevent more severe deformity and avoid the need for surgical treatment. Surgery is the treatment of choice for severe idiopathic scoliosis which is rapidly progressive, with early onset, late diagnosis, and neglected or failed conservative treatment. The psychologic impact of idiopathic scoliosis, a chronic disease occurring in the psychologically fragile period of adolescence, is important because of its body distorting character and the onerous treatment required, either conservative or surgical

  16. Cup Implant Planning Based on 2-D/3-D Radiographic Pelvis Reconstruction-First Clinical Results.

    Science.gov (United States)

    Schumann, Steffen; Sato, Yoshinobu; Nakanishi, Yuki; Yokota, Futoshi; Takao, Masaki; Sugano, Nobuhiko; Zheng, Guoyan

    2015-11-01

    In the following, we will present a newly developed X-ray calibration phantom and its integration for 2-D/3-D pelvis reconstruction and subsequent automatic cup planning. Two different planning strategies were applied and evaluated with clinical data. Two different cup planning methods were investigated: The first planning strategy is based on a combined pelvis and cup statistical atlas. Thereby, the pelvis part of the combined atlas is matched to the reconstructed pelvis model, resulting in an optimized cup planning. The second planning strategy analyzes the morphology of the reconstructed pelvis model to determine the best fitting cup implant. The first planning strategy was compared to 3-D CT-based planning. Digitally reconstructed radiographs of THA patients with differently severe pathologies were used to evaluate the accuracy of predicting the cup size and position. Within a discrepancy of one cup size, the size was correctly identified in 100% of the cases for Crowe type I datasets and in 77.8% of the cases for Crowe type II, III, and IV datasets. The second planning strategy was analyzed with respect to the eventually implanted cup size. In seven patients, the estimated cup diameter was correct within one cup size, while the estimation for the remaining five patients differed by two cup sizes. While both planning strategies showed the same prediction rate with a discrepancy of one cup size (87.5%), the prediction of the exact cup size was increased for the statistical atlas-based strategy (56%) in contrast to the anatomically driven approach (37.5%). The proposed approach demonstrated the clinical validity of using 2-D/3-D reconstruction technique for cup planning.

  17. The effect of robo-horseback riding therapy on spinal alignment and associated muscle size in MRI for a child with neuromuscular scoliosis: an experimenter-blind study.

    Science.gov (United States)

    Lee, Dong Ryul; Lee, Nam Gi; Cha, Hyun Jung; Yun Sung, O; You, Sung Joshua Hyun; Oh, Jin Hwan; Bang, Hyo Seong

    2011-01-01

    This case study was conducted to highlight the clinical and radiological features of a patient with progressive neuromuscular scoliosis before and after robo-horseback riding therapy (HBRT). A clinical, laboratory, and radiological analysis of a single case. An 11-year-old child, dignosed right thoracolumbar neuromuscular scoliosis secondary to cerebral palsy. The child received a 5-week course of robo-HBRT, comprising of 60-minute periods a day, five times a week. Postural alignment was determined by Cobb's method. A real-time magnetic resonance imaging (MRI) was performed to determine the robo-HBRT-induced changes in cross-sectional area (CSA) of bilateral thoracic (T2) and lumbar (L2) paraspinalis. Clinical tests including the standard Gross Motor Function Measure (GMFM) and manual muscle testing (MMT) with the Lafayette Manual Muscle Tester were used to compare the intervention-related changes in motor performance and power. The surface EMG was also used to examine therapy-induced changes in muscle activity amplitude for bilateral T2 and L2 paraspinalis and rectus abdominis muscles. Clinical motor and strength scores increased after the intervention. Radiographic Cobb's angle, MRI, and electromyographic amplitude data demonstrated notably enhanced spinal alignment and muscle fiber CSA and symmetry, respectively. This is the first study to provide evidence of the therapeutic efficacy of a novel form of robo-HBRT on motor function and associated structural and motor control improvements, thus suggesting a method of augmenting therapy in neuromuscular scoliosis.

  18. Geographical, clinical, clinicopathological and radiographic features of canine angiostrongylosis in Irish dogs: a retrospective study

    Directory of Open Access Journals (Sweden)

    Gallagher Barbara

    2012-03-01

    Full Text Available Abstract Background Angiostrongylus vasorum infection is associated with high morbidity and mortality in dogs. Although recognised in Ireland, there are no large series of cases reported. The aim of this retrospective study was to identify pertinent clinical and geographical features in Irish dogs. Results The case records of dogs presenting to the University College Dublin Veterinary Hospital (1999-2010 were reviewed. A contemporaneous review of external faecal parasitology and post mortem submissions was also performed. A positive diagnosis of angiostrogylosis was identified in 49 dogs including 24 clinical, 10 post mortem and 15 external faecal sample cases. The majority (n = 44 (90% resided on the East Coast. In the clinical cases, the median age was 20 months, 29% of cases were older than 2 years. Clinical features included cardiorespiratory (63%, coagulopathic (71% and other (63% signs. Cough (n = 10, dyspnoea (n = 5 and tachypnoea (n = 3 were the most common cardiorespiratory abnormalities. Of animals with evidence of coagulopathy, excessive haemorrhage from a wound (n = 5, airway haemorrhage (n = 9, epistaxis (n = 3, haematoma (n = 4, suspected haemarthrosis (n = 3, neurological signs (n = 2 and haematuria (n = 1 were found. Ten dogs were anaemic, of which two were severe (haematocrit ≤ 0.20 L/L. Ten animals had thrombocytopenia, with four severely affected (≤50 × 109/L. PT and APTT values were prolonged in 4 (24% of 17 and a BMBT was prolonged in 5 (63% of 8 cases. Vague signs of exercise intolerance (n = 6, lethargy (n = 6 and weakness (n = 2 were identified, with two (8% animals having only these signs. In one animal the diagnosis appeared to be incidental. Thoracic radiographs (n = 19 identified abnormalities in 100% of cases. Four (17% animals died before or within 24 hours of treatment and post mortem examinations confirmed angiostrongylosis. Fenbendazole was administered in 19 cases, 18 (95% recovered. Two animals were

  19. Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice

    DEFF Research Database (Denmark)

    Ornbjerg, Lykke Midtbøll; Østergaard, Mikkel; Bøyesen, Pernille

    2013-01-01

    radiographic progression rates during the DMARD (prebaseline to baseline x-ray) and TNF-I (baseline to follow-up x-ray) periods were calculated.RESULTS: 517 RA patients (76% women, 80% IgM rheumatoid factor positive, 65% anticyclic citrullinated peptide positive, 40% current smokers, age 54 years (range 21......OBJECTIVES: To compare radiographic progression during treatment with disease-modifying antirheumatic drugs (DMARD) and subsequent treatment with tumour necrosis factor α inhibitors (TNF-I) in rheumatoid arthritis (RA) patients in clinical practice.METHODS: Conventional radiographs (x......-1002) and the median TNF-I period was 562 days (IQR 405-766). The median radiographic progression rate decreased from 0.7 (IQR 0-2.9) total Sharp score units/year (dTSS) in the DMARD period to 0 (0-0.9) units/year in the TNF-I period (p0) in the DMARD period compared with 158 patients in the TNF-I period (p...

  20. Clinically Detectable Dental Identifiers Observed in Intra-oral Photographs and Extra-oral Radiographs, Validated for Human Identification Purposes.

    Science.gov (United States)

    Angelakopoulos, Nikolaos; Franco, Ademir; Willems, Guy; Fieuws, Steffen; Thevissen, Patrick

    2017-07-01

    Screening the prevalence and pattern of dental identifiers contributes toward the process of human identification. This research investigated the uniqueness of clinical dental identifiers in photographs and radiographs. Panoramic and lateral cephalometric radiographs and five intra-oral photographs of 1727 subjects were used. In a target set, two observers examined different subjects. In a subset, both observers examined the same subjects (source set). The distance between source and target subjects was quantified for each identifier. The percentage of subjects in the target set being at least as close as the correct subject was assessed. The number of molars (34.6%), missing teeth (42%), and displaced teeth (59.9%) were the most unique identifiers in photographs and panoramic and lateral cephalometric radiographs, respectively. The pattern of rotated teeth (14.9%) was the most unique in photographs, while displaced teeth was in panoramic (37.6%) and lateral cephalometric (54.8%) radiographs. Morphological identifiers were the most unique, highlighting their importance for human identifications. © 2016 American Academy of Forensic Sciences.

  1. The role of the paravertebral muscles in adolescent idiopathic scoliosis evaluated by temporary paralysis

    DEFF Research Database (Denmark)

    Wong, Christian; Gosvig, Kasper; Sonne-Holm, Stig

    2017-01-01

    using ultrasonic and EMG guidance in the selected spine muscles. Radiographic and clinical examinations were performed before and 6 weeks after the injection. Primary outcome parameters of radiological changes were analyzed using Wilcoxon signed-rank test and binomial test, and secondary outcome...... parameters of short- and long-term clinical effects were obtained. RESULTS: Significant radiological corrective changes were seen in the frontal plane in the thoracic and lumbar spine as well as significant derotational corrective change in the lumbar spine according to Cobb's angle measurements and to Nash...... and Moe's classification, respectively. No serious adverse events were detected at follow-up. CONCLUSIONS: In conclusion, this study demonstrated that the psoas major muscle do play a role into the pathology in adolescent idiopathic scoliosis by maintaining the curvature of the lumbar spine and thoracic...

  2. Thumb Ossification Composite Index (TOCI) for Predicting Peripubertal Skeletal Maturity and Peak Height Velocity in Idiopathic Scoliosis: A Validation Study of Premenarchal Girls with Adolescent Idiopathic Scoliosis Followed Longitudinally Until Skeletal Maturity.

    Science.gov (United States)

    Hung, Alec L H; Chau, W W; Shi, B; Chow, Simon K; Yu, Fiona Y P; Lam, T P; Ng, Bobby K W; Qiu, Y; Cheng, Jack C Y

    2017-09-06

    Accurate skeletal maturity assessment is important to guide clinical evaluation of idiopathic scoliosis, but commonly used methods are inadequate or too complex for rapid clinical use. The objective of the study was to propose a new simplified staging method, called the thumb ossification composite index (TOCI), based on the ossification pattern of the 2 thumb epiphyses and the adductor sesamoid bone; to determine its accuracy in predicting skeletal maturation when compared with the Sanders simplified skeletal maturity system (SSMS); and to validate its interrater and intrarater reliability. Hand radiographs of 125 girls, acquired when they were newly diagnosed with idiopathic scoliosis prior to menarche and during longitudinal follow-up until skeletal maturity (a minimum of 4 years), were scored with the TOCI and SSMS. These scores were compared with digital skeletal age (DSA) and radius, ulna, and small hand bones (RUS) scores; anthropometric data; peak height velocity; and growth-remaining profiles. Correlations were analyzed with the chi-square test, Spearman and Cramer V correlation methods, and receiver operating characteristic curve analysis. Reliability analysis using the intraclass correlation (ICC) was conducted. Six hundred and forty-five hand radiographs (average, 5 of each girl) were scored. The TOCI staging system was highly correlated with the DSA and RUS scores (r = 0.93 and 0.92, p systems predicted peak height velocity with comparable accuracy, with a strong Cramer V association (0.526 and 0.466, respectively; p 0.97. The new proposed TOCI could provide a simplified staging system for the assessment of skeletal maturity of subjects with idiopathic scoliosis. The index needs to be subjected to further multicenter validation in different ethnic groups.

  3. Clinical and radiographic evaluation of zinc oxide eugenol and metapex in root canal treatment of primary teeth

    Directory of Open Access Journals (Sweden)

    S Gupta

    2011-01-01

    Full Text Available Objectives: The aim of this study was to evaluate clinically and radiographically zinc oxide eugenol (ZOE and Metapex as root canal filling material in primary teeth. Materials and Methods: Forty-two necrotic primary teeth in two groups of children in the age group of 4−7 years were obturated with ZOE and Metapex and were followed up clinically and radiographically for a period of 6 months postoperatively. Results: The overall success rates of ZOE and Metapex were 85.71% and 90.48%, respectively. Conclusion: Both ZOE and Metapex gave encouraging results; however, Metapex can be used more safely whenever there is a doubt about the patient′s return for follow-up.

  4. Injuries to the cranial cruciate ligament and associated structures: summary of clinical, radiographic, arthroscopic and pathological findings from 10 horses

    International Nuclear Information System (INIS)

    Prades, M.; Grant, B.D.; Turner, T.A.; Nixon, A.J.; Brown, M.P.

    1989-01-01

    The clinical, radiographic, arthroscopic and pathological findings of 10 horses with injury to the cranial cruciate ligament are presented. The most consistent clinical signs included moderate to severe distension of the femoropatellar joint and a Grade III to a Grade V out of V lameness. Craniocaudal instability could be elicited in five horses under general anaesthesia and in one conscious horse. Radiographic evaluation of the stifles revealed that avulsion fracture of the medial intercondylar eminence was the most common finding in six out of 10 horses. Arthroscopic examination of the affected femorotibial joints were performed in five horses. This confirmed the presumptive diagnosis of cranial cruciate ligament injury or rupture. Post mortem examinations were performed on two horses which documented partial tears of the cranial cruciate ligament

  5. Horizontal gaze palsy with progressive scoliosis: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Bomfim, Rodrigo C.; Tavora, Daniel G.F.; Nakayama, Mauro; Gama, Romulo L. [Sarah Network of Rehabilitation Hospitals, Department of Radiology, Ceara (Brazil)

    2009-02-15

    Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare congenital disorder characterized by absence of conjugate horizontal eye movements and progressive scoliosis developing in childhood and adolescence. We present a child with clinical and neuroimaging findings typical of HGPPS. CT and MRI of the brain demonstrated pons hypoplasia, absence of the facial colliculi, butterfly configuration of the medulla and a deep midline pontine cleft. We briefly discuss the imaging aspects of this rare entity in light of the current literature. (orig.)

  6. Radiation-induced scoliosis

    International Nuclear Information System (INIS)

    Sekine, Kiichi; Morii, Kazue; Ohmi, Keiko; Akanuma, Atsuo.

    1976-01-01

    Observation was made as to 9 cases who received x-ray therapy (1,500 - 3,500 R) over the abdomen at their childhood and description was also made as to scoliosis. Mild scoliosis was recognized in 6 cases, which was probably due to their age under ten years old. The future observation was necessary in cases who passed through the period of adolescent growth spurt. There was a case who showed wedge shape deformation of the spine at 1,500 R. Abnormal case was not recognized in lordosis. (Serizawa, K.)

  7. Radiation-induced scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Sekine, K [Saitama Cancer Center, Ageo (Japan); Morii, K; Ohmi, K; Akanuma, A

    1976-02-01

    Observation was made as to 9 cases who received x-ray therapy (1,500 - 3,500 R) over the abdomen at their childhood and description was also made as to scoliosis. Mild scoliosis was recognized in 6 cases, which was probably due to their age under ten years old. The future observation was necessary in cases who passed through the period of adolescent growth spurt. There was a case who showed wedge shape deformation of the spine at 1,500 R. Abnormal case was not recognized in lordosis.

  8. Exercises for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Romano, Michele; Minozzi, Silvia; Bettany-Saltikov, Josette; Zaina, Fabio; Chockalingam, Nachiappan; Kotwicki, Tomasz; Maier-Hennes, Axel; Negrini, Stefano

    2012-08-15

    ). There is a lack of high quality evidence to recommend the use of SSE for AIS. One very low quality study suggested that these exercises may be more effective than electrostimulation, traction and postural training to avoid scoliosis progression, but better quality research needs to be conducted before the use of SSE can be recommended in clinical practice.

  9. Intracranial arteriovenous malformation: relationships between clinical and radiographic factors and ipsilateral steal severity

    International Nuclear Information System (INIS)

    Batjer, H.H.; Devous, M.D. Sr.; Seibert, G.B.; Purdy, P.D.; Ajmani, A.K.; Delarosa, M.; Bonte, F.J.

    1988-01-01

    Intracranial arteriovenous malformations (AVMs) are high flow shunts that may jeopardize the perfusion of adjacent tissue. Clinical and radiographic data from 62 patients were analyzed to determine their relationship to the severity of steal measured by single photon emission computed tomography (SPECT). The ipsilateral steal index [ISteal(i)] was determined by dividing regional cerebral blood flow (rCBF) values within hand-drawn regions of hypoperfusion in the ipsilateral hemisphere by total brain flow, which was calculated as the average rCBF of each hemisphere. Of the patients, 40% were less than 30 years of age, 45% were 30 to 50 years old, and 15% were over 50. Forty-eight per cent presented with hemorrhage and 34% presented with progressive deficits. There was angiographic steal in 37%, and postoperative hyperemic complications developed in 21%. All patients had ipsilateral regions of hypoperfusion. The ISteal(i) was less than 0.7 in 23 (37%), 0.7 to 0.8 in 20 (32%), and greater than 0.8 in 19 (31%). The ISteal(i) was significantly less severe in the patients over 50; 78% of these patients had an ISteal(i) of greater than 0.8 (P less than 0.01). A history of hemorrhage was associated with less severe steal than that in patients who had not bled (P = 0.088). Patients presenting with a history of progressive deficits had increased severity of steal compared with those without progressive deficits (P less than 0.05). A trend toward decreased severity of steal was noted in patients with unfavorable outcomes

  10. Clinical and radiographic evaluation of zinc oxide with aloe vera as an obturating material in pulpectomy: An in vivo study

    Directory of Open Access Journals (Sweden)

    Abhishek Khairwa

    2014-01-01

    Full Text Available Background: Pulp therapy for pulpally involved primary teeth continues to be a challenge to clinicians. One of the major areas of continued research is in the area of finding obturating materials to suit the specific properties of these teeth. Zinc oxide eugenol is used frequently in pulpectomy for the obturation of the primary teeth. Aims: To evaluate clinically and radiographically a mixture of zinc oxide eugenol and aloe vera as an obturating material. Materials and Methods: A total of 50 children, aged between 4 and 9 years, who were screened for unilateral or bilateral carious deciduous molars were studied. Out of these, 15 children were randomly selected for endodontic treatment. Obturation was done with a mixture of zinc oxide powder and aloe vera gel. Clinical and radiographic evaluation was done after 7 days, 1 month, 3 months, 6 months, and 9 months. The data were statistically analyzed. Results and Conclusion: Endodontic treatment using a mixture of zinc oxide powder and aloe vera gel in primary teeth has shown good clinical and radiographic success. A detailed observational study with longer follow-up will highlight the benefits of aloe vera in primary teeth as an obturating medium.

  11. Clinical and radiographic evaluation of indirect pulp treatment with MTA and calcium hydroxide in primary teeth (in-vivo study

    Directory of Open Access Journals (Sweden)

    Vimi George

    2015-01-01

    Full Text Available Objectives: Clinical and radiographic effects of mineral trioxide aggregate (white MTA and calcium hydroxide (Dycal in indirect pulp treatment (IPT of primary teeth over a period of 6 months. Materials and Methods: A clinical trial with sample size of 40 primary molars between the age group of 5-9 years, of which, 20 teeth were considered, each for MTA and Dycal. Measurements on the digitized radiographs were performed at baseline, third and sixth month, increase in dentin was then measured using Corel Draw software. Result: Independent t-test had indicated that at the end of 3 months and 6 months, a statistically significant increase in dentin thickness with both MTA and Dycal (P-value ≤ 0.001 was found. Within the MTA group, the thickness of dentin formed was 0.089 mm ± 0.031 mm at first 3 months and 0.055 ± 0.022 mm at the second 3 months, (P ≤ 0.001 evaluated using paired t-test. In the Dycal group, increment in dentin deposited was 0.068 mm at the first 3 months and second 3 months, it was 0.030 mm (P-value ≤ 0.001. Conclusion: Clinically and radiographically, MTA is superior to Dycal as a good IPT medicament in primary teeth.

  12. Clinical and radiographic evaluation of indirect pulp treatment with MTA and calcium hydroxide in primary teeth (in-vivo study).

    Science.gov (United States)

    George, Vimi; Janardhanan, Suresh Kumar; Varma, Balagopal; Kumaran, Parvathy; Xavier, Arun Mamachan

    2015-01-01

    Clinical and radiographic effects of mineral trioxide aggregate (white MTA) and calcium hydroxide (Dycal) in indirect pulp treatment (IPT) of primary teeth over a period of 6 months. A clinical trial with sample size of 40 primary molars between the age group of 5-9 years, of which, 20 teeth were considered, each for MTA and Dycal. Measurements on the digitized radiographs were performed at baseline, third and sixth month, increase in dentin was then measured using Corel Draw software. Independent t-test had indicated that at the end of 3 months and 6 months, a statistically significant increase in dentin thickness with both MTA and Dycal (P-value ≤ 0.001) was found. Within the MTA group, the thickness of dentin formed was 0.089 mm ± 0.031 mm at first 3 months and 0.055 ± 0.022 mm at the second 3 months, (P ≤ 0.001) evaluated using paired t-test. In the Dycal group, increment in dentin deposited was 0.068 mm at the first 3 months and second 3 months, it was 0.030 mm (P-value ≤ 0.001). Clinically and radiographically, MTA is superior to Dycal as a good IPT medicament in primary teeth.

  13. Scoliosis correction with shape-memory metal: results of an experimental study.

    Science.gov (United States)

    Wever, D J; Elstrodt, J A; Veldhuizen, A G; v Horn, J R

    2002-04-01

    The biocompatibility and functionality of a new scoliosis correction device, based on the properties of the shape-memory metal nickel-titanium alloy, were studied. With this device, the shape recovery forces of a shape-memory metal rod are used to achieve a gradual three-dimensional scoliosis correction. In the experimental study the action of the new device was inverted: the device was used to induce a scoliotic curve instead of correcting one. Surgical procedures were performed in six pigs. An originally curved squared rod, in the cold condition, was straightened and fixed to the spine with pedicle screws. Peroperatively, the memory effect of the rod was activated by heating the rod to 50 degrees C by a low-voltage, high-frequency current. After 3 and after 6 months the animals were sacrificed. The first radiographs, obtained immediately after surgery, showed in all animals an induced curve of about 40 degrees Cobb angle - the original curve of the rod. This curve remained constant during the follow-up. The postoperative serum nickel measurements were around the detection limit, and were not significantly higher compared to the preoperative nickel concentration. Macroscopic inspection after 3 and 6 months showed that the device was almost overgrown with newly formed bone. Corrosion and fretting processes were not observed. Histologic examination of the sections of the surrounding tissues and sections of the lung, liver, spleen and kidney showed no evidence of a foreign body response. In view of the initiation of the scoliotic deformation, it is expected that the shape-memory metal based scoliosis correction device also has the capacity to correct a scoliotic curve. Moreover, it is expected that the new device will show good biocompatibility in clinical application. Extensive fatigue testing of the whole system should be performed before clinical trials are initiated.

  14. A critical evaluation of student radiographers' experience of the transition from the classroom to their first clinical placement

    International Nuclear Information System (INIS)

    Hyde, Emma

    2015-01-01

    Introduction: Students studying for qualifications which enable them to apply for registration as health care professionals are expected to undertake a large amount of clinical placement to support their learning. The BSc Hons Diagnostic Radiography at one post-1992 UK University is no exception. It was identified in a previous study by this researcher that a relatively large number of first year student radiographers were unsure, or nervous, about some aspects of the transition to their first clinical placement. It was felt that further investigation into the student experience of the transition to the first clinical placement was warranted. Methodology: A mixed-methods survey approach was used to elicit quantitative and qualitative data from current radiography students, academic staff and clinical staff about student experience of the transition to the first clinical placement. Results: In general, most students enjoyed their first clinical placement, and the opportunity to put theory into practice. However, three key themes emerged from the data that caused students difficulty in the first clinical placement; working with clinical staff, working with very ill patients, and moving around the department each week. Key Conclusions: This study has identified that some aspects of the transition into the first clinical placement need to be improved. Recommendations have been made for curriculum development in the academic block prior to the first clinical placement, and to improve student support during clinical placement. The implementation of these recommendations is crucial to reduce the dissonance between theory and practice, and improve student experience of the transition to the first clinical placement. - Highlights: • Issues for student radiographers during their first clinical placement are identified. • Recommendations made for curriculum development to improve preparation for clinical placement. • Recommendations made to improve student support in

  15. Genetics Home Reference: adolescent idiopathic scoliosis

    Science.gov (United States)

    ... Facebook Twitter Home Health Conditions Adolescent idiopathic scoliosis Adolescent idiopathic scoliosis Printable PDF Open All Close All ... Javascript to view the expand/collapse boxes. Description Adolescent idiopathic scoliosis is an abnormal curvature of the ...

  16. CT colonography: accuracy of initial interpretation by radiographers in routine clinical practice

    International Nuclear Information System (INIS)

    Burling, D.; Wylie, P.; Gupta, A.; Illangovan, R.; Muckian, J.; Ahmad, R.; Marshall, M.; Taylor, S.A.

    2010-01-01

    Aim: To investigate performance of computed-assisted detection (CAD)-assisted radiographers interpreting computed tomography colonography (CTC) in routine practice. Materials and methods: Three hundred and three consecutive symptomatic patients underwent CTC. Examinations were double-read by trained radiographers using primary two-dimensional/three-dimensional (2D/3D) analysis supplemented by 'second reader' CAD. Radiographers recorded colonic neoplasia, interpretation times, and patient management strategy code (S0, inadequate; S1, normal; S2, 6-9 mm polyp; S3, ≥10 mm polyp; S4, cancer; S5, diverticular stricture) for each examination. Strategies were compared to the reference standard using kappa statistic, interpretation times using paired t-test, learning curves using logistic regression and Pearson's correlation coefficient. Results: Of 303 examinations, 69 (23%) were abnormal. CAD-assisted radiographers detected 17/17 (100%) cancers, 21/28 (72%) polyps ≥10 mm and 42/60 (70%) 6-9 mm polyps. The overall agreement between radiographers and the reference management strategy was good (kappa 0.72; CI: 0.65, 0.78) with agreement for S1 strategy in 189/211 (90%) exams; S2 in 19/27 (70%); S3 in 12/19 (63%); S4 in 17/17 (100%); S5 in 5/6 (83%). The mean interpretation time was 17 min (SD = 11) compared with 8 min (SD = 3.5) for radiologists. There was no learning curve for recording correct strategies (OR 0.88; p = 0.12) but a significant reduction in interpretation times, mean 14 and 31 min (last/first 50 exams; -0.46; p < 0.001). Conclusion: Routine CTC interpretation by radiographers is effective for initial triage of patients with cancer, but independent reporting is currently not recommended.

  17. BIOMECHANICS OF THERAPEUTIC RIDING DURING THE DISEASES OF I-II DEGREE DYSPLASTIC LUMBAR AND STATIC (SHORT LEG) SCOLIOSIS.

    Science.gov (United States)

    Sheshaberidze, E; Merabishvili, I; Loria, M

    2015-11-01

    The goal of the paper is to substantiate the essence of ridetherapy biomechanics as the pathogenetic therapeutic and prophylactic method at lumbar dysplastic (the I and II degrees) and static (short-legged induced) scoliosis. Uneven lower extremities caused by any reason and asymmetric support induce the change in the arrangement of trochantin to the vertebra and correspondingly the uneven loading of lumbar muscles. The asymmetric strength of lumbar muscles evoked by the change in rotator condition becomes the cause of the formation of scoliosis primary arc which, in its turn, causes a compensatory spinal curvature. In case of dysplastic scoliosis a leading role belongs to the beginning of dystrophic changes in intervertebral discs and its further decentration. At riding position the lower extremities are completely disengaged from the antigravity redistribution, the child is in direct contact with vibrations and jolts coming from the horseback; the antigravity loading is distributed on the muscles of the torso and thus, it creates an opportunity to purposefully affect the correction of the spine. During scoliosis the pathogenic essence of ridetherapy is due to the comprehensiveness of its procedures, expressed in the fact that during one procedure several factors are influenced simultaneously: nucleus pulpous, the torso and iliopsoas muscles, the antigravity system, etc. According to the clinical-functional and radiographic studies carried out in the dynamics on 11-16 years old adolescents it has been established that in those groups where the rehabilitation was conducted in a complex with ridetherapy the authentically higher results were obtained as compared to the groups where the rehabilitation was held using therapeutic exercises and massage.

  18. Clinical, radiographic, and histological findings of florid cemento-osseous dysplasia: a case report

    International Nuclear Information System (INIS)

    Kim, Jeong Hee; Song, Byeong Chul; Kimn, Sun Ho; Park, Yang Soon

    2011-01-01

    Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.

  19. Clinical, radiographic, and histological findings of florid cemento-osseous dysplasia: a case report.

    Science.gov (United States)

    Kim, Jeong-Hee; Song, Byeong-Chul; Kim, Sun-Ho; Park, Yang-Soon

    2011-09-01

    Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.

  20. Clinical, radiographic, and histological findings of florid cemento-osseous dysplasia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Hee; Song, Byeong Chul; Kimn, Sun Ho; Park, Yang Soon [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2011-09-15

    Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.

  1. Endocrine Disorders in Head Neck Region: A Radiographic Perspective in Dental Clinic

    Directory of Open Access Journals (Sweden)

    Aparna M

    2014-04-01

    Full Text Available Endocrine diseases may have manifestations locally or in a generalized manner. When an imbalance in normal bone homeostasis occurs, regulated by various hormones such as parathyroid hormone, growth hormone it results in conditions like hypercalcemia, hypophosphatemia etc. which may affect bone density in a generalized manner. The condition cause: excessive resorption of bone or excessive deposition of bone. Intraoral or extraoral radiographs are thus useful in detecting diseases like hyperparathyroidism, hyperpituitarism, hypoparathyroidism, and hypopituitarism which are subclinical and are detected accidently on routine radiographic examination.

  2. The genetic implication of scoliosis in osteogenesis imperfecta: a review

    Science.gov (United States)

    Liu, Gang; Chen, Jia; Zhou, Yangzhong; Zuo, Yuzhi; Liu, Sen; Chen, Weisheng

    2017-01-01

    Osteogenesis imperfecta (OI) is a kind of heritable connective tissue disorder, including blue sclerae, hearing loss, skeletal dysplasia causing bone fragility and deformities. It is typically caused by collagen related gene mutations, which could lead to bone formation abnormalities. Scoliosis is one of the most common and severe spinal phenotype which has been reported in approximately 26–74.5% of all OI patients. Recent breakthroughs have suggested that OI can be divided into more than 16 types based on genetic mutations with different degrees of scoliosis. In this review, we summarize the etiology of scoliosis in OI, especially the genetic studies of different types. We aim to provide a systematic review of the genetic etiology and clinical suggestions of scoliosis in OI. PMID:29354746

  3. The Effect of Manual Therapy on the Adolescent Idiopathic Scoliosis in a 28 Years Old Woman

    Directory of Open Access Journals (Sweden)

    Marzieh Mohamadi

    2013-04-01

    Full Text Available Idiopathic scoliosis (IS is the most common type of scoliosis. Clinical signs and symptoms of scoliosis impair quality of life and daily function. Manual therapy is commonly used for treatment of scoliosis. This is a case report of scoliosis treatment with manual therapy in a 28 years old patient. A 28 years old woman complained of low back pain for 4 years. Spine x-ray, showed scoliosis with a 32 degrees Cobb angle. The patient received a manual therapy procedure of two visits per week for 16 weeks including myofascial release technique, mobilization and manipulation. The Cobb angle was reduced 15.62% after 8 weeks and 21.87% after 16 weeks. In addition the pain was reduced by 50%. We can state that manual therapy was useful for this patient.

  4. Risk factors for adjacent segment degeneration after surgical correction of degenerative lumbar scoliosis

    Directory of Open Access Journals (Sweden)

    Kee-yong Ha

    2013-01-01

    Full Text Available Background: Degenerative lumbar scoliosis surgery can lead to development of adjacent segment degeneration (ASD after lumbar or thoracolumbar fusion. Its incidence, risk factors, morbidity and correlation between radiological and clinical symptoms of ASD have no consensus. We evaluated the correlation between the occurrence of radiologic adjacent segment disease and certain imperative parameters. Materials and Methods: 98 patients who had undergone surgical correction and lumbar/thoracolumbar fusion with pedicle screw instrumentation for degenerative lumbar scoliosis with a minimum 5 year followup were included in the study. We evaluated the correlation between the occurrence of radiologic adjacent segment disease and imperative patient parameters like age at operation, sex, body mass index (BMI, medical comorbidities and bone mineral density (BMD. The radiological parameters taken into consideration were Cobb′s angle, angle type, lumbar lordosis, pelvic incidence, intercristal line, preoperative existence of an ASD on plain radiograph and magnetic resonance imaging (MRI and surgical parameters were number of the fusion level, decompression level, floating OP (interlumbar fusion excluding L5-S1 level and posterolateral lumbar interbody fusion (PLIF. Clinical outcomes were assessed with the Visual Analogue Score (VAS and Oswestry Disability Index (ODI. Results: ASD was present in 44 (44.9% patients at an average period of 48.0 months (range 6-98 months. Factors related to occurrence of ASD were preoperative existence of disc degeneration (as revealed by MRI and age at operation ( P = 0.0001, 0.0364. There were no statistically significant differences between radiological adjacent segment degeneration and clinical results (VAS, P = 0.446; ODI, P = 0.531. Conclusions: Patients over the age of 65 years and with preoperative disc degeneration (as revealed by plain radiograph and MRI were at a higher risk of developing ASD.

  5. Radiographic bone changes in multibacillary leprosy patients in Aburof mission clinic

    International Nuclear Information System (INIS)

    Mustafa, El Rayah Mohamed

    1996-08-01

    Leprosy is an infectious, chronic granulomatous disease, caused by M. leprae. It is one of the most seriously disabling and economically important disease. In Sudan it affects about 20 thousands people. In this study 60 patients of MB leprosy were included. Historry and physical examination were carried out for each patient. BI was done for all patients and were subjected to x-ray investigations of the paranasal sinuses, hands and feet. 85%(51) of these patients were found to have radiographic changes in paranasal sinuses, 35 patients with mucosal thickening and 16 with diffuse opacified sinuses. 86.7% (52) of those patients were found to have radiographic bone changes in their hand and feet. 23.6% and 75.4% were found with specific and non-specific bone changes in their hands and feet respectively. A spectrum of radiographic bone changes was found in the hands and feet including; destruction, fractures, phalangeal resoption, distal phalangeal tapering, flexion deformities, osteoarthritic changes, charcot's joints, osteoporosis cystic bone changes and enlarged nutrient bone foramina. The majority of patients with radiographic changes in the paranasal sinsuses, hands and feet, were found to have long duration of the disease and more bacterial load. The disability in hands and feet is the major risk factor in bone affection in MB leprosy. (Author)

  6. A taxonomy of anatomical and pathological entities to support commenting on radiographs (preliminary clinical evaluation)

    International Nuclear Information System (INIS)

    Cosson, Philip; Dash, Robert

    2015-01-01

    It has been shown that radiographers have a lot to offer the patient by providing their expert opinion in a timely intervention; including the possibility of Radiographer Led Discharge. Some excellent paper based ‘commenting’ systems have been developed locally and the Society and College of Radiographers has issued national guidance with a pro-forma to support implementation. However, delivery and audit of the PCE service can be burdensome. There is also an ongoing training need linked in to annual reviews. This paper provides a brief introduction to the field of controlled vocabularies and ontologies in radiology and serves to identify their potential for PCE systems. The current work has constructed a prototype taxonomy and accompanying ontology (list of relationships) that enable the generation of radiographer comments using an electronic, fast, and structured web based interface. For example, in the current implementation any one of thousands of possible unique comments could be constructed by making just six selections from filtered lists of terms. The prototype taxonomy has been tested to refine and validate the concept. The resulting taxonomy and its evolution is described here. Finally, the taxonomy was trialled by 23 participants who generated structured PCE's after reviewing 27 cases on DICOM workstations. An analysis of agreement between participants and the ‘gold standard’ is presented. In conclusion, a taxonomy has been created that would provide for: a standardised framework for training staff and students, efficient and robust delivery of the service, and audit of individual practice

  7. Intraspinal anomalies in early-onset idiopathic scoliosis.

    Science.gov (United States)

    Pereira, E A C; Oxenham, M; Lam, K S

    2017-06-01

    In the United Kingdom, lower incidences of intraspinal abnormalities in patients with early onset idiopathic scoliosis have been observed than in studies in other countries. We aimed to determine the rates of these abnormalities in United Kingdom patients diagnosed with idiopathic scoliosis before the age of 11 years. This retrospective study of patients attending an urban scoliosis clinic identified 71 patients satisfying a criteria of: clinical diagnosis of idiopathic scoliosis; age of onset ten years and 11 months or less; MRI screening for intraspinal abnormalities. United Kingdom census data combined with patient referral data was used to calculate incidence. Mean age at diagnosis was six years with 39 right-sided and 32 left-sided curves. Four patients (5.6%) were found to have intraspinal abnormalities on MRI. These consisted of: two combined Arnold-Chiari type 1 malformations with syrinx; one syrinx with a low lying conus; and one isolated syrinx. Overall annual incidence of early onset idiopathic scoliosis was one out of 182 000 (0.0006%). This study reports the lowest rates to date of intraspinal anomalies in patients with early onset idiopathic scoliosis, adding to knowledge regarding current incidences of these abnormalities as well as any geographical variation in the nature of the disease. Cite this article: Bone Joint J 2017;99-B:829-33. ©2017 The British Editorial Society of Bone & Joint Surgery.

  8. Behavior of scoliosis during growth in children with osteogenesis imperfecta.

    Science.gov (United States)

    Anissipour, Alireza K; Hammerberg, Kim W; Caudill, Angela; Kostiuk, Theodore; Tarima, Sergey; Zhao, Heather Shi; Krzak, Joseph J; Smith, Peter A

    2014-02-05

    Spinal deformities are common in patients with osteogenesis imperfecta, a heritable disorder that causes bone fragility. The purpose of this study was to describe the behavior of spinal curvature during growth in patients with osteogenesis imperfecta and establish its relationship to disease severity and medical treatment with bisphosphonates. The medical records and radiographs of 316 patients with osteogenesis imperfecta were retrospectively reviewed. The severity of osteogenesis imperfecta was classified with the modified Sillence classification. Serial curve measurements were recorded throughout the follow-up period for each patient with scoliosis. Regression analysis was used to determine the effect of disease severity (Sillence type), patient age, and bisphosphonate treatment on the progression of scoliosis as measured with the Cobb method. Of the 316 patients with osteogenesis imperfecta, 157 had associated scoliosis, a prevalence of 50%. Scoliosis prevalence (68%) and mean progression rate (6° per year) were the highest in the group of patients with the most severe osteogenesis imperfecta (modified Sillence type III). A group with intermediate osteogenesis imperfecta severity, modified Sillence type IV, demonstrated intermediate scoliosis values (54%, 4° per year). The patient group with the mildest form of osteogenesis imperfecta, modified Sillence type I, had the lowest scoliosis prevalence (39%) and rate of progression (1° per year). Early treatment-before the patient reached the age of six years-of type-III osteogenesis imperfecta with bisphosphonate therapy decreased the curve progression rate by 3.8° per year, which was a significant decrease. Bisphosphonate treatment had no demonstrated beneficial effect on curve behavior in patients with other types of osteogenesis imperfecta or in patients of older age. The prevalence of scoliosis in association with osteogenesis imperfecta is high. Progression rates of scoliosis in children with osteogenesis

  9. Clinical and Radiographic Study of Benign Odontogenic Tumors in the Jaws

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gyung Yae; Park, Chang Seo [Dept. of Oral Radiology, College of Dentistry, Yonsei University, Seoul (Korea, Republic of)

    1989-11-15

    The author observed and analyzed the age, sex, chief complaint and radiographic finding of sixty-one cases of benign odontogenic tumors seen in Yonsei Medical Center, for the period of Jan. 1979 to Aug. 1989. The results were as follows: 1. Benign odontogenic tumors of 61 cases included 52 cases (85.3%) of ameloblastoma and odontoma, and 9 cases of other lesions. Radiographically, the border of the lesions were well-defined. 2. Ameloblastoma constituting twenty-seven cases (44.3%) occurred the average age of 31.1 years and had a 3:1 male predominance. The most common complaint was swelling (20 cases, 74.0%) and followed by pain (13 cases, 48.2%). Radiographically, the most common site was mandibular body area (74.0%) and the lesions were mainly multiocular radiolucency; in 17 cases (63.0%) and unilocular radiolucent lesion were seen in 10 cases (37.0%). 16 cases (59.3%) showed the resorption of roots of adjacent teeth. 3. Odontoma constituting twenty-five cases (41.0%) discovered at the average age of 16.9 years and had a 3:2 male predominance. The most common complaint was delayed eruption of tooth (8 cases, 31.0%) and 7 cases (27.0%) detected on a routine radiograph of the area. Radiographically, 17 cases (68.0%) were of compound type and 8 were of complex variety and compound odontomas were common in the anterior maxilla, whereas complex odontomas occurred more frequently in the posterior mandible. 19 cases (76.0%) showed the impaction of adjacent teeth.

  10. The long-term use of zygomatic implants: a 10-year clinical and radiographic report.

    Science.gov (United States)

    Aparicio, Carlos; Manresa, Carolina; Francisco, Karen; Ouazzani, Wafaa; Claros, Pedro; Potau, Josep M; Aparicio, Arnau

    2014-06-01

    The zygoma implant has been an effective option in the short-term management of the atrophic edentulous maxilla. To report on long-term outcomes in the rehabilitation of the atrophic maxilla using zygomatic (ZI) and regular implants (RI). 22 consecutive zygomatic patients in a maintenance program were included. Cumulative survival rate (CSR) of ZI, RI, prostheses, and complications were recorded during, at least, 10 years of loading. Implant mobility was tested using Periotest(®). Sinus health was radiographically and clinically assessed according to Lund-Mackay (L-M) score and Lanza and Kennedy survey, respectively. A satisfaction questionnaire and anatomical measurements were also performed. Patients received 22 prostheses, anchored on 172 implants. Forty-one were ZI. Three RI failed (10 years CSR = 97.71%). Two ZI were partly removed due to perimplant infection (10 years CSR = 95.12%). All patients maintained functional prostheses. One patient fractured framework twice. Loosening or fracturing screws happened in 11 patients. Seven patients fractured occlusal material. Four ZI abutments in two patients were disconnected because of uncomfortable prostheses. Alveolar height at the ZI head level on the right and left sides was 2.64 mm and 2.25 mm, respectively. Mean distance of ZI head center to ridge center, on the right and left sides was 4.54 mm and 5.67 mm, respectively. Mean Periotest values (PTv) of ZI were -4.375 PTv and -4.941 PTv before prostheses placement and after 10 years, respectively. Six patients experienced sinusitis 14-127 months postoperatively. 54.55% of the L-M scores did not present opacification (L-M = 0) in any sinus. Osteomeatal obstruction happened in eight patients (two bilateral). Two (9.09%) were diagnosed with sinusitis. Eighty-four percent reported satisfaction levels above 80%. 31.81% reported maximum satisfaction score (100%). The long-term rehabilitation of the severely atrophic maxillae using ZI is a predictable procedure. © 2012

  11. Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously

    DEFF Research Database (Denmark)

    Simony, Ane; Hansen, Emil Jesper; Christensen, Steen Bach

    2016-01-01

    , is comparable to modern equipment. This is to our knowledge the first study to report increased rates of endometrial cancers in a cohort of AIS patients, and future attention is needed to reduce the radiation dose distributed to the AIS patients both pre-operatively and during surgery.......PURPOSE: To report the incidence of cancer in a cohort of adolescent idiopathic scoliosis (AIS) patients treated 25 years previously. METHODS: 215 consecutive AIS patients treated between 1983 and 1990 were identified and requested to return for clinical and radiographic examination. The incidence....... RESULTS: From the original cohort of 215 consecutive AIS patients, radiation information was available in 211 of the patients, and medical charts were available in 209 AIS patients. 170 (83 %) of the 205 AIS patients participated in the follow-up study with questionnaires. The calculated mean total...

  12. Congenital scoliosis associated with agenesis of the uterine cervix. Case report

    Directory of Open Access Journals (Sweden)

    Monica Matteo

    2004-06-01

    Full Text Available Abstract Background Alterations in the normal sequence of development of müllerian ducts lead to a wide spectrum of reproductive tract abnormalities. A rare form of lack of development, regarding a short tract of the müllerian ducts, leads to the isolated agenesis of the uterine cervix. Anomalies identified among patients with müllerian agenesis include skeletal deformities (i.e., scoliosis of the spine and Klippel-Feil anomaly. Case presentation A 46 years old woman presenting cyphoscoliosis and very low stature (120 cm – 3,93 feet, came to our observation for acute pelvic pain; she also reported primary amenorrhoea associated with cyclic pelvic pain. Clinical and imaging evaluation, evidenced a blind vaginal duct of normal length, left cystic adnexal mass, and enlarged uterus with hematometra. FSH, LH, 17β estradiol and CA-125, karyotype and radiographic study of limbs and vertebral column were also evaluated. At laparotomy, a left ovarian cyst was found. Uterus ended at the isthmus; under this level a thin fibrous tissue band was found, joining the uterus to the vagina. Uterine cervix was replaced by fibrous tissue containing some dilated glands lined with müllerian epithelium. Karyotype resulted 46, XX. The described skeletal deformity, were consistent with Klippel-Feil syndrome. Conclusion We report a case of congenital scoliosis associated with müllerian agenesis limited to uterine cervix, association thus far seen only among patients with Mayer-Rokitansky-Kuster-Hauser syndrome (utero-vaginal agenesis. This case report supports the necessity to evaluate, for accompanying müllerian anomalies, all cases of congenital structural scoliosis in view of the possibility for many müllerian development abnormalities, if timely diagnosed, to be surgically corrected.

  13. Surgical treatment of double thoracic adolescent idiopathic scoliosis with a rigid proximal thoracic curve.

    Science.gov (United States)

    Sudo, Hideki; Abe, Yuichiro; Abumi, Kuniyoshi; Iwasaki, Norimasa; Ito, Manabu

    2016-02-01

    There is limited consensus on the optimal surgical strategy for double thoracic adolescent idiopathic scoliosis (AIS). Recent studies have reported that pedicle screw constructs to maximize scoliosis correction cause further thoracic spine lordosis. The objective of this study was to apply a new surgical technique for double thoracic AIS with rigid proximal thoracic (PT) curves and assess its clinical outcomes. Twenty one consecutive patients with Lenke 2 AIS and a rigid PT curve (Cobb angle ≥30º on side-bending radiographs, flexibility ≤30 %) treated with the simultaneous double-rod rotation technique (SDRRT) were included. In this technique, a temporary rod is placed at the concave side of the PT curve. Then, distraction force is applied to correct the PT curve, which reforms a sigmoid double thoracic curve into an approximate single thoracic curve. As a result, the PT curve is typically converted from an apex left to an apex right curve before applying the correction rod for PT and main thoracic curve. All patients were followed for at least 2 years (average 2.7 years). The average main thoracic and PT Cobb angle correction rate at the final follow-up was 74.7 and 58.0 %, respectively. The average preoperative T5-T12 thoracic kyphosis was 9.3°, which improved significantly to 19.0° (p corrected using SDRRT for Lenke 2 AIS with a rigid PT curve.

  14. Early Clinical and Radiographic Results of Minimally Invasive Anterior Approach Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tamara Alexandrov

    2014-01-01

    consecutive patients with 43 total hip arthroplasties performed through an anterior muscle sparing minimally invasive approach. We found the early complication rates and radiographic outcomes comparable to those reported from arthroplasties performed via traditional approaches. Complications included dislocation (2%, femur fracture (2%, greater trochanteric fracture (12%, postoperative periprosthetic intertrochanteric fracture (2%, femoral nerve palsy (5%, hematoma (2%, and postoperative iliopsoas avulsion (2%. Radiographic analysis revealed average cup anteversion of 19.6°±6.6, average cup abduction angle of 48.4°±7, stem varus of 0.9°±2, and a mean leg length discrepancy of 0.7 mm. The anterior approach to the hip is an attractive alternative to the more traditional approaches. Acceptable component placement with comparable complication rates is possible using a muscle sparing technique which may lead to faster overall recovery.

  15. Implant-supported mandibular removable partial dentures: Functional, clinical and radiographical parameters in relation to implant position.

    Science.gov (United States)

    Jensen, Charlotte; Speksnijder, Caroline M; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

    2017-06-01

    Patients with a Kennedy class I situation often encounter problems with their removable partial denture (RPD). To assess the functional benefits of implant support to RPDs, the clinical performance of the implants and teeth and to determine the most favorable implant position: the premolar (PM) or molar (M) region. Thirty subjects received 2 PM and 2 M implants. A new RPD was made. Implant support was provided 3 months later. In a cross-over model, randomly, 2 implants (PM or M) supported the RPD during 3 months. Masticatory performance was assessed using the mixing ability index (MAI). Clinical and radiographic parameters were assessed. Non-parametric statistical analysis for related samples and post hoc comparisons were performed. Masticatory performance differed significantly between the stages of treatment (P < .001). MAI-scores improved with implant support although the implant position had no significant effect. No complications to the implants or RPD were observed and clinical and radiographical parameters for both implants and teeth were favorable. Higher scores for bleeding on probing were seen for molar implants. Implant support to a Kennedy class I RPD significantly improves masticatory function, regardless of implant position. No major clinical problems were observed. © 2017 Wiley Periodicals, Inc.

  16. Reliability and concurrent validity of postural asymmetry measurement in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Prowse, Ashleigh; Aslaksen, Berit; Kierkegaard, Marie; Furness, James; Gerdhem, Paul; Abbott, Allan

    2017-01-18

    To investigate the reliability and concurrent validity of the Baseline ® Body Level/Scoliosis meter for adolescent idiopathic scoliosis postural assessment in three anatomical planes. This is an observational reliability and concurrent validity study of adolescent referrals to the Orthopaedic department for scoliosis screening at Karolinska University Hospital, Stockholm, Sweden between March-May 2012. A total of 31 adolescents with idiopathic scoliosis (13.6 ± 0.6 years old) of mild-moderate curvatures (25° ± 12°) were consecutively recruited. Measurement of cervical, thoracic and lumbar curvatures, pelvic and shoulder tilt, and axial thoracic rotation (ATR) were performed by two trained physiotherapists in one day. The intraclass correlation coefficient (ICC) was used to determine the inter-examiner reliability (ICC2,1) and the intra-rater reliability (ICC3,3) of the Baseline ® Body Level/Scoliosis meter. Spearman's correlation analyses were used to estimate concurrent validity between the Baseline ® Body Level/Scoliosis meter and Gold Standard Cobb angles from radiographs and the Orthopaedic Systems Inc. Scoliometer. There was excellent reliability between examiners for thoracic kyphosis (ICC2,1 = 0.94), ATR (ICC2,1 = 0.92) and lumbar lordosis (ICC2,1 = 0.79). There was adequate reliability between examiners for cervical lordosis (ICC2,1 = 0.51), however poor reliability for pelvic and shoulder tilt. Both devices were reproducible in the measurement of ATR when repeated by one examiner (ICC3,3 0.98-1.00). The device had a good correlation with the Scoliometer (rho = 0.78). When compared with Cobb angle from radiographs, there was a moderate correlation for ATR (rho = 0.627). The Baseline ® Body Level/Scoliosis meter provides reliable transverse and sagittal cervical, thoracic and lumbar measurements and valid transverse plan measurements of mild-moderate scoliosis deformity.

  17. Clinical and Radiographic Assessment of Reasons for Replacement of Metal- Ceramic Fixed Dental Prostheses in Patients Referring to Dental School.

    Science.gov (United States)

    Al Refai, Roa'a; Saker, Samah

    2018-01-01

    The expected length of service and reasons for fixed dental prostheses (FDPs) replacement are a frequent inquiry by patients while the answers were mainly based on studies reports that was conducted outside the middle east region. This clinical and radiographic survey was constructed to assess and survey clinically and radiographically the reasons of replacement of metal-ceramic fixed dental prostheses, amongst patients reporting at dental school in Taibah University. Between January and May 2016, 151 patients were recruited for this study. Interview (include questions pertained to the length of service of the prosthesis, the nature of complaint as told by patient in her own words), clinical examination, intra-oral photographs, and periapical radiographs, were done by the researchers. The parameters assessed were secondary caries, open margins, loss of retention, failure of endodontic treatment of the abutment and periodontal diseases. A total number of 249 failed fixed dental prostheses were evaluated. Of which 180 (39.7%) were single crowns, 159 (35.0%) were retainers and 117 (25.8%) were pontics in 69 fixed partial denture. The most common reason for replacement of fixed restorations was periodontal diseases affecting 92.8% of all types' restorations, followed by defective margin in 90.4% of examined restoration, poor aesthetic in 88% of restorations, while periapical involvement was found in 85.5% of fixed dental prosthesis. The survival rates of fixed prostheses were not predictable, and no association was found between number of years in service and the number of restorations. The most common reasons for replacing single unit fixed dental prostheses are periodontal diseases and periapical involvement, while defective margins and poor aesthetic mainly associated with multi-unit fixed dental prostheses. Key words: Failure, Fixed dental prosthesis, Survival, Replacement.

  18. Clinical and radiographic aspects of the bovine pericardium as a substitute of the canine cranial cruciate ligament

    International Nuclear Information System (INIS)

    Brendolan, A.P.; Rezende, C.M.F.; Melo, E.G.; Malm, C.; Gheller, V.A.; Oliveira, H.P.; Torres, R.C.S.; Araujo, F.A.

    2007-01-01

    The clinical and radiographic aspects of the bovine pericardium preserved in glicerin, were evaluated as a substitute for canine cranial cruciate ligament. Fifteen male mongrel dogs weighing between 17.4 and 31.6kg had the ligament experimentally ruptured and the stifle joint stabilized by an arthroscopical technique with bovine pericardium as a graft. The dogs were divided into three groups of five animals each. They were evaluated at 30, 90 and 120 days. The operated limb was imobillized for two weeks and clinical examination was performed weekly. Radiographs were taken monthly and the sinovial fluid was collect at 30, 90 and 120 days. Clinically, dogs presented high to moderate lameness, muscle hipotrophy in the operated limb and accentuated cranial drawer movement. Degenerative disease was detected in radiography. All dogs showed total rupture of the graft. Sinovial fluid analysis showed characteristics of inflammation. It can be concluded that pericardium graft failed prematurely, incited persistent inflammatory reaction and rejection phenomena. Thus, it cannot be recommended as a xenograft for cranial cruciate ligament replacement [pt

  19. Clinical and radiographic comparison of indirect pulp treatment using light-cured calcium silicate and mineral trioxide aggregate in primary molars: A randomized clinical trial.

    Science.gov (United States)

    Menon, Navya P; Varma, Balagopal R; Janardhanan, Sureshkumar; Kumaran, Parvathy; Xavier, Arun Mamachan; Govinda, Bhat Sangeetha

    2016-01-01

    To clinically and radiographically evaluate the reparative dentin formation in indirect pulp treatment (IPT) using mineral trioxide aggregate (MTA) and light cured calcium silicate (TheraCal) in primary molars over a period of 6 months. A clinical trial on IPT on 43 primary molars in 21 patients between the age of 4-7 years, divided into two groups: 22 teeth in MTA group and 21 in TheraCal group. Measurement of the variation in dentin thickness was done on the digitalized radiograph at baseline, 3 months and 6 months using CorelDRAW X3 software. Statistical analysis using an independent t -test for intragroup and intergroup comparison showed a significant increase in dentin thickness in both the MTA and TheraCal group (intragroup comparison [ P 0.05). Clinically and radiographically, both MTA and TheraCal are good IPT materials. The better handling characteristics and comparable reparative dentin-forming ability of TheraCal make this material an alternative to MTA in pediatric restorative procedures.

  20. Clinical and radiographic comparison of indirect pulp treatment using light-cured calcium silicate and mineral trioxide aggregate in primary molars: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Navya P Menon

    2016-01-01

    Full Text Available Aim: To clinically and radiographically evaluate the reparative dentin formation in indirect pulp treatment (IPT using mineral trioxide aggregate (MTA and light cured calcium silicate (TheraCal in primary molars over a period of 6 months. Materials and Methods: A clinical trial on IPT on 43 primary molars in 21 patients between the age of 4–7 years, divided into two groups: 22 teeth in MTA group and 21 in TheraCal group. Measurement of the variation in dentin thickness was done on the digitalized radiograph at baseline, 3 months and 6 months using CorelDRAW X3 software. Results: Statistical analysis using an independent t-test for intragroup and intergroup comparison showed a significant increase in dentin thickness in both the MTA and TheraCal group (intragroup comparison [P 0.05. Conclusion: Clinically and radiographically, both MTA and TheraCal are good IPT materials. The better handling characteristics and comparable reparative dentin-forming ability of TheraCal make this material an alternative to MTA in pediatric restorative procedures.

  1. THE EFFECT OF CORRECTIVE SURGERY OF SCOLIOSIS ON CERVICAL LORDOTIC AXIS

    OpenAIRE

    CALADO, ALDO; SANTOS, JULIANO RODRIGUES DOS; BAPTISTA, JOSE ALEXANDRE CUNHA; BRACONI, ANTONIO CARLOS MONTEIRO; HENRIQUES, GUILHERME GALITO; ROZINDO, DANUSA DE MELO; LEAL, JEFFERSON SOARES

    2017-01-01

    ABSTRACT Objectives: To quantify the changes in cervical sagittal alignment of patients with adolescent idiopathic scoliosis (AIS) who underwent surgical treatment. Methods: Retrospective study of radiographic data analysis. Data were collected from 25 radiographs of patients with AIS, and 18 cases were included. The mean age was 15.2 years (13-17 years); all subjects were female, operated from March 2010 to October 2015. Pre and postoperatively, cervical lordosis (C2-C7), thoracic kyphos...

  2. Chronic Recurrent Multifocal Osteomyelitis Causing an Acute Scoliosis

    Directory of Open Access Journals (Sweden)

    Alexander Armstrong

    2013-01-01

    Full Text Available Study Design. A Case Report. Objective. We present a 15-year-old girl with an acute atypical scoliosis secondary to chronic recurrent multifocal osteomyelitis (CRMO. Summary of Background Data. CRMO is a rare nonpyogenic inflammatory bone condition with unclear aetiology. CRMO mainly affects the metaphyses of long bones, the pelvis, shoulder girdle, and less commonly the spine. Methods. Our case presented with a 6-month history of worsening thoracic back pain, asymmetry of her shoulders and abnormal posture. Whole spine radiographs revealed a right atypical thoracic scoliosis. Magnetic Resonance Imaging showed abnormal signal on the short TI inversion recovery (STIR sequences in multiple vertebrae. A bone biopsy demonstrated evidence of fibrosis and chronic inflammatory changes. Interval MRI scans revealed new oedematous lesions and disappearance of old lesions. Symptoms improved. Results. It is important to consider CRMO as an acute cause of atypical scoliosis. Malignancy, pyogenic infections and atypical presentations of juvenile arthritis need excluding. Conclusion. This 24-month follow-up describes a rare cause of an atypical scoliosis and fortifies the small amount of the currently available literature. The case highlights the relapsing and remitting nature of CRMO with new lesions developing and older lesions burning out. We advise close radiological surveillance and symptomatic management.

  3. Scoliosis associated with airflow obstruction due to endothoracic vertebral hump.

    Science.gov (United States)

    Ito, Kenyu; Kawakami, Noriaki; Miyasaka, Kazuyoshi; Tsuji, Taichi; Ohara, Tetsuya; Nohara, Ayato

    2012-12-01

    A retrospective clinical study of scoliosis-associated airflow obstruction due to endothoracic vertebral hump. The purpose of this study was to evaluate and present anatomical features of patients with scoliosis who showed airflow obstruction caused by endothoracic vertebral hump. It is well known that severe scoliosis causes airflow restriction due to thoracic cage deformity. There have been few reports of clinical data and anatomical features on scoliosis associated with airflow obstruction due to endothoracic vertebral hump. The subjects were 6 patients. The diagnoses were idiopathic scoliosis in 3 patients, symptomatic scoliosis in 2 patients, and thoracogenic scoliosis in 1 patient. The radiological outcome, comorbidities, pre- and postoperative respiratory function, and surgical complication were analyzed. Four patients had preoperative atelectasis on the convex side of the lower lobe and improved after the operations. All patients showed main thoracic curves and their apex was located at T7-T9. All patients had lordoscoliosis except 1, who demonstrated kyphosing scoliosis. The correction rate was 78% (62.8%-83.5%). Preoperative thoracic lordosis within the range of -5° to -47° was postoperatively corrected to a substantially normal kyphosis within the range of 9° to 24°. The average vital capacity, percent VC improved from 0.72 L (0.33-1.17 L) to 1.21 L (0.82-1.71 L) and 45.5% (37.3%- 50.8%) to 63.7% (41.0%-88.6%) relatively. Spine Penetration Index improved from 23% (18%-35%) to 16% (13%-19%). Endothoracic hump ratio improved from 1.34 (0.98-1.93) to 1.12 (0.86-1.28). Each patient with symptomatic scoliosis and thoracogenic scoliosis required relatively long periods of respiration management. Patients having lordoscoliosis with an apex located between T7 and T9 may develop airflow obstruction due to an endothoracic vertebral hump. Correction of lordoscoliosis through anterior and posterior approaches successfully improved endothoracic hump ratio and

  4. A protocol for classifying normal- and flat-arched foot posture for research studies using clinical and radiographic measurements

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2009-07-01

    Full Text Available Abstract Background There are several clinical and radiological methods available to classify foot posture in research, however there is no clear strategy for selecting the most appropriate measurements. Therefore, the aim of this study was to develop a foot screening protocol to distinguish between participants with normal- and flat-arched feet who would then subsequently be recruited into a series of laboratory-based gait studies. Methods The foot posture of ninety-one asymptomatic young adults was assessed using two clinical measurements (normalised navicular height and arch index and four radiological measurements taken from antero-posterior and lateral x-rays (talus-second metatarsal angle, talo-navicular coverage angle, calcaneal inclination angle and calcaneal-first metatarsal angle. Normative foot posture values were taken from the literature and used to recruit participants with normal-arched feet. Data from these participants were subsequently used to define the boundary between normal- and flat-arched feet. This information was then used to recruit participants with flat-arched feet. The relationship between the clinical and radiographic measures of foot posture was also explored. Results Thirty-two participants were recruited to the normal-arched study, 31 qualified for the flat-arched study and 28 participants were classified as having neither normal- or flat-arched feet and were not suitable for either study. The values obtained from the two clinical and four radiological measurements established two clearly defined foot posture groups. Correlations among clinical and radiological measures were significant (p r = 0.24 to 0.70. Interestingly, the clinical measures were more strongly associated with the radiographic angles obtained from the lateral view. Conclusion This foot screening protocol provides a coherent strategy for researchers planning to recruit participants with normal- and flat-arched feet. However, further research is

  5. The horizontal plane appearances of scoliosis

    DEFF Research Database (Denmark)

    Illés, Tamás S.; Burkus, Máté; Somoskeőy, Szabolcs

    2017-01-01

    Purpose: A posterior-anterior vertebral vector is proposed to facilitate visualization and understanding of scoliosis. The aim of this study was to highlight the interest of using vertebral vectors, especially in the horizontal plane, in clinical practice. Methods: We used an EOS two-/three-dimen......Purpose: A posterior-anterior vertebral vector is proposed to facilitate visualization and understanding of scoliosis. The aim of this study was to highlight the interest of using vertebral vectors, especially in the horizontal plane, in clinical practice. Methods: We used an EOS two...... cases of a normal spine and a thoracic scoliosis are presented. Results: For a normal spine, vector projections in the transverse plane are aligned with the posterior-anterior anatomical axis. For a scoliotic spine, vector projections in the horizontal plane provide information on the lateral...... decompensation of the spine and the lateral displacement of vertebrae. In the horizontal plane view, vertebral rotation and projections of the sagittal curves can also be analyzed simultaneously. Conclusions: The use of posterior-anterior vertebral vector facilitates the understanding of the 3D nature...

  6. Transverse plane pelvic rotation increase (TPPRI following rotationally corrective instrumentation of adolescent idiopathic scoliosis double curves

    Directory of Open Access Journals (Sweden)

    Asher Marc A

    2010-08-01

    Full Text Available Abstract Background We have occasionally observed clinically noticeable postoperative transverse plane pelvic rotation increase (TPPRI in the direction of direct thoracolumbar/lumbar rotational corrective load applied during posterior instrumentation and arthrodesis for double (Lenke 3 and 6 adolescent idiopathic scoliosis (AIS curves. Our purposes were to document this occurrence; identify its frequency, associated variables, and natural history; and determine its effect upon patient outcome. Methods Transverse plane pelvic rotation (TPPR can be quantified using the left/right hemipelvis width ratio as measured on standing posterior-anterior scoliosis radiographs. Descriptive statistics were done to determine means and standard deviations. Non-parametric statistical tests were used due to the small sample size and non-normally distributed data. Significance was set at P Results Seventeen of 21 (81% consecutive patients with double curves (7 with Lenke 3 curves and 10 with Lenke 6 instrumented with lumbar pedicle screw anchors to achieve direct rotation had a complete sequence of measurable radiographs. While 10 of these 17 had no postoperative TPPRI, 7 did all in the direction of the rotationally corrective thoracolumbar instrumentation load. Two preoperative variables were associated with postoperative TPPRI: more tilt of the vertebra below the lower instrumented vertebra (-23° ± 3.1° vs. -29° ± 4.6°, P = 0.014 and concurrent anterior thoracolumbar discectomy and arthrodesis (5 of 10 vs. 7 of 7, P = 0.044. Patients with a larger thoracolumbar/lumbar angle of trunk inclination or larger lower instrumented vertebra plus one to sacrum fractional/hemicurve were more likely to have received additional anterior thoracolumbar discectomy and arthrodesis (c = 0.90 and c = 0.833, respectively. Postoperative TPPRI resolved in 5 of the 7 by intermediate follow-up at 12 months. Patient outcome was not adversely affected by postoperative TPPRI

  7. Clinical and Radiographic Characteristics as Predictive Factors of Swelling and Trismus after Mandibular Third Molar Surgery: A Longitudinal Approach

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    José Manuel Pérez-González

    2018-01-01

    Full Text Available Introduction. Factors that contribute to swelling and trismus are complex, and they are originated by surgical trauma. The aim of the present study was to determine whether clinical and radiographic factors could predict the level of swelling and trismus after lower third molar surgery, through longitudinal approach. Methodology. A prospective longitudinal trial was carried out. Forty-five patients of both genders with clinical and radiographic diagnosis of asymptomatic mandibular impacted third molar and with no intake of analgesic or anti-inflammatory drugs 12 h prior to surgery were recruited and evaluated in a 72 h follow-up period. A mixed repeated measures model and backward and restricted maximal likelihood methods were used to analyze the data. Results. Male gender, body mass index (BMI, the relation to the lingual and buccal walls, and age were determinants for predicting postoperative swelling and for exerting a significant influence (P<0.05. Conclusions. This study suggests the association of male gender, the relation to lingual and buccal walls, BMI, and age with measurement of swelling.

  8. Clinical and radiographic comparison of platelet-rich fibrin and mineral trioxide aggregate as pulpotomy agents in primary molars

    Directory of Open Access Journals (Sweden)

    Surendra Patidar

    2017-01-01

    Full Text Available Aim: This study aimed to evaluate and compare the Platelet-rich fibrin (PRF and Mineral trioxide aggregate (MTA as a pulpotomy agent in primary molars. Material and Methods: In this study, 50 primary molars from 50 healthy children aged 5–9 years requiring pulpotomy were randomly allocated into two groups. In PRF group, after coronal pulp removal and hemostasis, remaining pulp tissue was covered with PRF preparation. In the MTA group, the pulp stumps were covered with MTA (Pro Root MTA-Root Canal Repair Material, Dentsply International Inc. paste obtained by mixing MTA powder with sterile water at a 3:1 powder to water ratio. All teeth were restored with reinforced zinc oxide eugenol base and glass – ionomer cement. Stainless steel crowns were given in both groups 24 h after treatment. Clinical evaluation was undertaken at 1, 3, and 6 months intervals whereas radiographic evaluation of the treated teeth was carried out at the interval of 6 months. Results: By the end of 6 months, the overall success rate was 90% in PRF group and 92% in MTA Group. A statistically significant difference was observed between the groups at 6 months of follow-up (P 0.05. Conclusion: Radiographic and clinical outcome in PRF group could suggest it as an acceptable alternative in pulpotomy of primary teeth. PRF holds a promising future in the area of primary tooth vital pulp therapy.

  9. EVALUATION OF PROGNOSTIC FACTORS IN QUALITY OF LIFE OF PATIENTS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS UNDERGOING SPINAL FUSION BY THE POSTERIOR APPROACH

    Directory of Open Access Journals (Sweden)

    FELIPE DE MORAES POMAR

    Full Text Available ABSTRACT Objective: To evaluate the prognostic factors in the treatment of patients diagnosed with adolescent idiopathic scoliosis undergoing spinal fusion by the posterior approach. Methods: The study included 48 patients with idiopathic adolescent scoliosis (43 females and 5 males who underwent spinal fusion by the posterior approach, with an average age at diagnosis of 12 years, and clinical signs of Risser between 3 and 4 at the time of surgery. Clinical and radiographic measurements were performed, the participants answered the SRS-30 questionnaire, and the analysis of the medical record data was performed in two occasions during the preoperative period and at the end of two years of follow-up. Results: All satisfaction measures showed statistically significant change after the procedure (p<0.05 with respect to the radiographic characteristics, except for the lumbar apical vertebral translation (p=0.540 and Cobb L1-L5 (p=0.225. Conclusion: In general, it was found that patients who received surgical treatment were more satisfied with their appearance than those who underwent conservative treatment.

  10. Radiographic evaluations

    International Nuclear Information System (INIS)

    Williams, J.L.

    1988-01-01

    The author describes how to: perform a systematic evaluation of a chest radiograph; state the classic radiographic description of hyaline membrane disease; list the conditions that cause hyperaeration and describe the radiologic feature of hyperaeration; describe the radiograph of a patient with a congenital diaphragmatic hernia; identify optimum placement of an endotracheal tube, gastric feeding tube, and umbilical artery catheter on a radiograph; differentiate between pulmonary interstitial air and hyaline membrane disease; select radiographic features that would indicate the presence of a tension pneumothorax; describe a lateral decubitus projection and state the type of problem it is most often used to identify; explain the procedure used in obtaining a lateral neck radiograph and list two problems that may require this view; and describe the radiograph of a patient with cystic fibrosis

  11. Clinical application of a triombrin in urology, a new Soviet radiographic contrast agent

    International Nuclear Information System (INIS)

    Perel'man, V.M.

    1980-01-01

    A water-soluble radiographic contrast agent triombrin which is a methylglucosamine sodium salt mixture of diatrizoate was studied. The analysis is based on the observation of 175 patients subjected to 186 tests, mainly excretory urography with the double dose of the contrast agent. The correlation between the quality of the picture obtained and the individual features of the patients has been established. Assessment of urograms obtained with the use of hypaque, urografin, verografin, urotrast and triombrin has revealed results similar to those with triombrin. Allergic reactions and complications have been noted in 23 (14%) of 164 patients after excretory and infusion urography. Satisfactory contrast and a good tolerance of the agent allowed recommending triombrin for wide use in medical practice

  12. A report of laser-assisted modified Widman flap for periodontal regeneration: Clinical and radiographic evaluation

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar Salaria

    2010-01-01

    Full Text Available Periodontitis is a relatively common disease. Various therapies have been recommended for its treatment which includes nonsurgical, antimicrobial, and surgical therapy. In recent years lasers have been used for all the three above-mentioned purposes. Lasers have been applied for hard and soft tissue debridement, contouring as well as the bacterial load reduction in the pocket. Here we present a case report of chronic periodontitis treated with the help of a new technique, laser-assisted modified Widman flap (LAMWF. The surgical procedure followed with a 980 nm diode laser has been described. The present case report resulted in significant pocket depth reduction, attachment gain, and radiographic evidence of bone fill. The laser-assisted modified Widman flap provided excellent results without complications and high patient as well as clinician satisfaction.

  13. Evaluation of moxifloxacin-hydroxyapatite composite graft in the regeneration of intrabony defects: A clinical, radiographic, and microbiological study

    Directory of Open Access Journals (Sweden)

    Y V Nagarjuna Reddy

    2016-01-01

    Full Text Available Background: The formation of new connective periodontal attachment is contingent upon the elimination or marked reduction of pathogens at the treated periodontal site. An anti-microbial agent, i.e. moxifloxacin has been incorporated into the bone graft to control infection and facilitate healing during and after periodontal therapy. Materials and Methods: By purposive sampling, 15 patients with at least two contralateral vertical defect sites were selected. The selected sites in each individual were divided randomly into test and control sites according to split-mouth design. Test site received moxifloxacin-hydroxyapatite composite graft and control site received hydroxyapatite-placebo gel composite graft. Probing depth (PD and Clinical attachment level (CAL were assessed at baseline, 3, 6, 9, and 12 months. Bone probing depth (BPD and hard tissue parameters such as amount of defect fill, percentage of defect fill, and changes in alveolar crest were assessed at baseline, 6, and 12 months. Changes in subgingival microflora were also assessed by culturing the subgingival plaque samples at baseline and at 3-month follow-up. The clinical, radiographic, and microbiological data obtained were subjected to statistical analysis using descriptive statistics, paired sample t-test, independent t-test, and contingency test. Results: On intragroup comparison at test and control sites, there was a significant improvement in all clinical and radiographic parameters. However, on intergroup comparison of the same, there was no statistically significant difference between test and control sites at any interval. Although test sites showed slightly higher amount of bone fill, it was not statistically significant. There was a significant reduction in the counts of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis at both sites from baseline to 3 months. In addition, there was a significant reduction at test sites as compared to control sites at 3

  14. Treatment of the idiopathic scoliosis with brace and physiotherapy.

    Science.gov (United States)

    Hundozi-Hysenaj, Hajrije; Dallku, Iliriana Boshnjaku; Murtezani, Ardiana; Rrecaj, Shkurte

    2009-01-01

    Scoliosis is a three-dimensional deformation of the spine with a lateral curvature or deviation greater than 10 degrees and associated with vertebral rotation. Many conservative treatments are available for adolescents with idiopathic scoliosis, but the evidence for their effectiveness is still questioned. The objective of this study was to define the effectiveness of braces and individual physiotherapy for the comprehensive treatment of idiopathic scoliosis in adolescents. A retrospective study of 57 children with idiopathic thoracic dextroscoliosis with the magnitude of the thoracic curve between 20 degrees-35 degrees, treated in Orthopedic and Physiatrist Clinic as well as National Ortho-prosthetic Center within University Clinical Center of Kosova in Prishtina, during the period of 2003-2006. Inclusion of kinesitherapy in the comprehensive management of idiopathic scoliosis varied in the improvement of the muscle strength (satisfied and moderate) in almost 80% of the children while the correction of the curve was small in approximately 42.1% of cases. For children with idiopathic scoliosis, who require braces, an exercise program helps chest mobility, muscle strength, proper breathing flexibility in the spine, correct posture and keeps muscles in tone so that the transition period after brace removal is easier.

  15. Evaluation of scoliosis using baropodometer and artificial neural network

    Directory of Open Access Journals (Sweden)

    Caroline Meireles Fanfoni

    Full Text Available Abstract Introduction: One of the most recurrent pathologies in the spine is scoliosis. It occurs in the frontal plane and is formed by one or more curves in the spinal column. The scoliosis causes global postural misalignment in an individual. One of the modifications produced by postural misalignment is the way in which an individual distributes weight to the feet. We aimed to implement an electronic system for separating patients with Degree I scoliosis (i.e., 1° to 19° scoliosis according to the Ricard classification into two groups: C1 (1°-9° and C2 (10°-9°. The highest percentage of patients with scoliosis is in this range: those who do not need to wear vests or undergo surgery and whose treatment is performed via special physical exercise and frequent evaluations by healthcare professionals. Methods The electronic system consists of a baropodometer and artificial neural networks (ANNs. The classification of patients in the scoliosis groups was performed with MATLAB software and a Single Layer Perceptron network using the backpropagation training algorithm. Evaluations were performed on 63 volunteers. Results The mean classification sensitivity was 93.7% in the C1 group and 94.5% in the C2 group. The classification accuracy was 83.3% in the C1 group and 96.0% in the C2 group. Conclusion The implemented system can contribute to the treatment of patients with scoliosis grades ranging from 1° to 19°, which represents the highest incidence of this pathology, for which the monitoring of the clinical condition using noninvasive techniques is of fundamental importance.

  16. Florid cemento-osseous dysplasia: Report of a case documented with clinical, radiographic, biochemical and histological findings.

    Science.gov (United States)

    Kutluay Köklü, Harika; Cankal, Dilek A; Bozkaya, Süleyman; Ergün, Gülfem; Bar, Emre

    2013-02-01

    Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. It usually exhibits as multiple radiopaque cementum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This article reports the case of a 45-year-old white man who was diagnosed with FCOD on the basis of clinical, radiographic, biochemical and histological findings. It is of major importance to realize that all dentists have a unique opportunity as well as ethical obligation to assist in the struggle against wrong dental treatments that might save patients dental health. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment. Key words:Florid cemento-osseous dysplasia, florid osseous dysplasia, fibro-osseous lesions.

  17. Long-term outcomes of dental implants placed in elderly patients: a retrospective clinical and radiographic analysis.

    Science.gov (United States)

    Park, Jung-Chul; Baek, Won-Sun; Choi, Seong-Ho; Cho, Kyoo-Sung; Jung, Ui-Won

    2017-02-01

    The aim of this retrospective study was to determine the clinical and the radiographic outcomes of dental implants placed in elderly people older than 65 years. In total, 902 implants in 346 patients (age: 65-89 years) were followed up for 2-17 years following the implant surgery. The survival rate of these implants was recorded and analyzed. Changes in marginal bone levels were also analyzed in serial radiographs, and Cox regression analysis for implant loss was performed. The survival rates were 95.39% and 99.98% in the implant- and patient-based analyses, respectively (involving a total of 29 implant failures), and the marginal bone loss at the implants was 0.17 ± 0.71 mm (mean ± SD). The number of failures was greatest in patients aged 65-69 years. The Cox regression with shared frailty analysis showed that implant loss was significantly greater in those aged 65-69 years than in those aged 70-74 years (P implant systems. Within the limitations of this retrospective study, it was concluded that implant therapy can be successfully provided to elderly patients and that age alone does not seem to affect the implant survival rate. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. The prevalence of disc aging and back pain after fusion extending into the lower lumbar spine. A matched MR study twenty-five years after surgery for adolescent idiopathic scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Danielsson, A J; Nachemson, A L [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Orthopaedics; Cederlund, C G; Ekholm, S [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Diagnostic Radiology

    2001-03-01

    To determine the long-term outcome after fusion for adolescent idiopathic scoliosis in terms of degenerative disc findings diagnosed using MR imaging and to elucidate the clinical consequences. Material and methods: Thirty-two patients with adolescent idiopathic scoliosis, who had undergone spinal fusion using Harrington rods to the lower lumbar spine with one or two unfused discs below the fusion, were re-examined 25 years after the fusion. The re-examinations included validated questionnaires, clinical examination, full standing frontal and lateral radiographs and MR examination of the lower lumbar region. Curve size and degenerative findings on MR images were evaluated by two unbiased radiologists, blinded to the clinical findings. A matched control group of 32 persons without scoliosis was subjected to the same examinations. Results and conclusion: There were significantly more degenerative disc changes (p<0.0001), disc height reduction (p=0.0010) and end-plate changes (p<0.0001 for both upper and lower end-plates) in the lowest unfused disc in the patient group compared with the control group. The MR findings in the lowest unfused disc, but not the one above, in the patient group correlated to lumbar pain intensity as well as to the diminished lumbar lordosis.

  19. The prevalence of disc aging and back pain after fusion extending into the lower lumbar spine. A matched MR study twenty-five years after surgery for adolescent idiopathic scoliosis

    International Nuclear Information System (INIS)

    Danielsson, A.J.; Nachemson, A.L.; Cederlund, C.G.; Ekholm, S.

    2001-01-01

    To determine the long-term outcome after fusion for adolescent idiopathic scoliosis in terms of degenerative disc findings diagnosed using MR imaging and to elucidate the clinical consequences. Material and methods: Thirty-two patients with adolescent idiopathic scoliosis, who had undergone spinal fusion using Harrington rods to the lower lumbar spine with one or two unfused discs below the fusion, were re-examined 25 years after the fusion. The re-examinations included validated questionnaires, clinical examination, full standing frontal and lateral radiographs and MR examination of the lower lumbar region. Curve size and degenerative findings on MR images were evaluated by two unbiased radiologists, blinded to the clinical findings. A matched control group of 32 persons without scoliosis was subjected to the same examinations. Results and conclusion: There were significantly more degenerative disc changes (p<0.0001), disc height reduction (p=0.0010) and end-plate changes (p<0.0001 for both upper and lower end-plates) in the lowest unfused disc in the patient group compared with the control group. The MR findings in the lowest unfused disc, but not the one above, in the patient group correlated to lumbar pain intensity as well as to the diminished lumbar lordosis

  20. Immediate occlusal loading of NanoTite PREVAIL implants: a prospective 1-year clinical and radiographic study.

    Science.gov (United States)

    Ostman, Pär-Olov; Wennerberg, Ann; Albrektsson, Tomas

    2010-03-01

    Recently, a new implant surface texture, featuring application of nanometer-scale calcium phosphate has been shown to enhance early bone fixation and formation in preclinical studies and in human histomorphometric studies, which may be beneficial in immediate loading situations. The purpose of the present prospective clinical study was to, during 1 year, clinically and radiographically evaluate a nanometer scale surface modified implant placed for immediate loading of fixed prostheses in both maxillary and mandibular regions. Thirty-five out of 38 patients who needed implant treatment and met inclusion criteria agreed to participate in the study and were consecutively enrolled. Surgical implant placement requirements consisted of a final torque of a least 25 Ncm prior to final seating and an implant stability quotient above 55. A total of 102 NanoTite PREVAIL (NTP) implants (BIOMET 3i, Palm Beach Gardens, FL, USA) (66 maxillary and 36 mandibular) were placed by one investigator, and the majority of these were placed in posterior regions (65%) and in soft bone (69%). A total of 44 prosthetic constructions were evaluated consisting of 14 single-tooth restorations, 26 fixed partial dentures, and four complete fixed restorations. All provisional constructions were delivered within 1 hour, and the final constructions placed after 4 months. Implants were monitored for clinical and radiographic outcomes at follow-up examinations scheduled for 3, 6, and 12 months. Of the 102 study implants, one implant failed. The simple cumulative survival rate value at 1 year was 99.2%. The average marginal bone resorption was 0.37 mm (SD 0.39) during the first year in function. According to the success criteria of Albrektsson and Zarb, success grade 1 was found with 93% of the implants. Although limited to the short follow-up, immediate loading of NanoTite Prevail implants seems to be a viable option in implant rehabilitation, at least when a good initial fixation is achieved.

  1. Closed Versus Open Supracondylar Fractures of the Humerus in Children: A Comparison of Clinical and Radiographic Presentation and Results.

    Science.gov (United States)

    Lewine, Eliza; Kim, Jaehon M; Miller, Patricia E; Waters, Peter M; Mahan, Susan T; Snyder, Brian; Hedequist, Daniel; Bae, Donald S

    2018-02-01

    The purpose of this investigation was to compare the presentation and postoperative results of children treated for open and closed, completely displaced type III supracondylar humerus fractures (SCFs). Thirty patients with open and 66 patients with closed, completely displaced type III SCFs were evaluated. Open fractures underwent irrigation and debridement, and all patients were treated by open or closed reduction and pin fixation. Medical records were reviewed to obtain demographic information as well as preoperative and postoperative clinical data regarding mechanism of injury, neurovascular status, associated injuries, postoperative range of motion, infections, and pain. Radiographs were evaluated to quantify displacement, Baumann's angle, humeral capitellar angle, position of the anterior humeral line, and adequacy of reduction. Outcomes were assessed using Flynn criteria. Mean clinical follow-up for the open and closed fracture groups was 8.9 and 5.7 months, respectively. Both groups were similar with respect to age, sex distribution, weight and body mass index, laterality of involvement, and mechanism of injury. At presentation, 35% of closed SCFs and 23% of open SCFs presented with abnormal neurovascular status. There was a higher prevalence of diminished/absent pulses or distal limb ischemia in patients with open injuries (27%) compared with closed fractures (18%). Conversely, severely displaced closed fractures were more commonly associated with nerve injury/palsy at presentation (35%) than those with open fractures (23%). Spontaneous nerve recovery was seen in 87% within 3 to 6 months. Postoperative loss of reduction and malunion were more common in the closed fracture group. However, 84% of patients achieved good-to-excellent results by Flynn criteria, with no appreciable difference based upon open versus closed fractures. With timely wound and fracture treatment, the clinical and radiographic results of children treated for open SCFs is similar to

  2. Influence of Cobb Angle and ISIS2 Surface Topography Volumetric Asymmetry on Scoliosis Research Society-22 Outcome Scores in Scoliosis.

    Science.gov (United States)

    Brewer, Paul; Berryman, Fiona; Baker, De; Pynsent, Paul; Gardner, Adrian

    2013-11-01

    Retrospective sequential patient series. To establish the relationship between the magnitude of the deformity in scoliosis and patients' perception of their condition, as measured with Scoliosis Research Society-22 scores. A total of 93 untreated patients with adolescent idiopathic scoliosis were included retrospectively. The Cobb angle was measured from a plain radiograph, and volumetric asymmetry was measured by ISIS2 surface topography. The association between Scoliosis Research Society scores for function, pain, self-image, and mental health against Cobb angle and volumetric asymmetry was investigated using the Pearson correlation coefficient. Correlation of both Cobb angle and volumetric asymmetry with function and pain was weak (all self-image, was higher, although still moderate (-.37 for Cobb angle and -.44 for volumetric asymmetry). Both were statistically significant (Cobb angle, p = .0002; volumetric asymmetry; p = .00001). Cobb angle contributed 13.8% to the linear relationship with self-image, whereas volumetric asymmetry contributed 19.3%. For mental health, correlation was statistically significant with Cobb angle (p = .011) and volumetric asymmetry (p = .0005), but the correlation was low to moderate (-.26 and -.35, respectively). Cobb angle contributed 6.9% to the linear relationship with mental health, whereas volumetric asymmetry contributed 12.4%. Volumetric asymmetry correlates better with both mental health and self-image compared with Cobb angle, but the correlation was only moderate. This study suggests that a patient's own perception of self-image and mental health is multifactorial and not completely explained through present objective measurements of the size of the deformity. This helps to explain the difficulties in any objective analysis of a problem with multifactorial perception issues. Further study is required to investigate other physical aspects of the deformity that may have a role in how patients view themselves. Copyright

  3. Prediction of renal mass aggressiveness using clinical and radiographic features: a global, multicentre prospective study

    NARCIS (Netherlands)

    Golan, Shay; Eggener, Scott; Subotic, Svetozar; Barret, Eric; Cormio, Luigi; Naito, Seiji; Tefekli, Ahmet; Pilar Laguna Pes, M.

    2016-01-01

    To examine the ability of preoperative clinical characteristics to predict histological features of renal masses (RMs). Data from consecutive patients with clinical stage I RMs treated surgically between 2010 and 2011 in the Clinical Research Office of Endourology Society (CROES) Renal Mass Registry

  4. Does PACS improve diagnostic accuracy in chest radiograph interpretations in clinical practice?

    International Nuclear Information System (INIS)

    Hurlen, Petter; Borthne, Arne; Dahl, Fredrik A.; Østbye, Truls; Gulbrandsen, Pål

    2012-01-01

    Objectives: To assess the impact of a Picture Archiving and Communication System (PACS) on the diagnostic accuracy of the interpretation of chest radiology examinations in a “real life” radiology setting. Materials and methods: During a period before PACS was introduced to radiologists, when images were still interpreted on film and reported on paper, images and reports were also digitally stored in an image database. The same database was used after the PACS introduction. This provided a unique opportunity to conduct a blinded retrospective study, comparing sensitivity (the main outcome parameter) in the pre and post-PACS periods. We selected 56 digitally stored chest radiograph examinations that were originally read and reported on film, and 66 examinations that were read and reported on screen 2 years after the PACS introduction. Each examination was assigned a random number, and both reports and images were scored independently for pathological findings. The blinded retrospective score for the original reports were then compared with the score for the images (the gold standard). Results: Sensitivity was improved after the PACS introduction. When both certain and uncertain findings were included, this improvement was statistically significant. There were no other statistically significant changes. Conclusion: The result is consistent with prospective studies concluding that diagnostic accuracy is at least not reduced after PACS introduction. The sensitivity may even be improved.

  5. Upper gastrointestinal examinations: a radiographic study of clinically normal Beagle puppies

    International Nuclear Information System (INIS)

    Miyabayashi, T.; Morgan, J.P.

    1991-01-01

    A total of 24 upper gastrointestinal examinations were performed on four weanling beagle puppies over six weeks, using liquid barium (10 ml/kg body weight of 60 per cent w/v barium sulphate suspension] and barium food (8 g/kg of crushed kibble dog food and 7 ml/kg body weight of 60 per cent w/v barium sulphate suspension) as contrast media. The radiographic appearance was similar to that noted in adult dogs except for the consistent location of the pylorus on or near the midline. Duodenal pseudoulcers were seen more often with liquid barium and the caecal shadows were identified more often with the longer examination time with barium food. The stomach of the puppies appeared to have discriminatory emptying function; that is, semi-solid food was emptied from the stomach at a slower rate (210 to 450 minutes) than liquid (60 to 90 minutes). Solid meals emptied faster in puppies than in adult dogs. Dosages of 13 to 15 mg/kg body weight for the liquid barium examination and 14 g of ground kibble and 16 ml of barium sulphate suspension per m2 of body surface area for the barium food examination are suggested as more appropriate for contrast studies in puppies

  6. Relationship of Radiographic and Clinical Parameters With Hallux Valgus and Second Ray Pathology.

    Science.gov (United States)

    Gribbin, Caitlin K; Ellis, Scott J; Nguyen, Joseph; Williamson, Emilie; Cody, Elizabeth A

    2017-01-01

    Hallux valgus is frequently associated with additional forefoot pathologies, including hammertoes and midfoot osteoarthritis (OA). However, the pathogenesis of these concurrent pathologies remains to be elucidated. We sought to determine whether there is a relationship between demographic and radiographic parameters and the incidence of secondary pathologies in the setting of a bunion, with an emphasis on second tarsometatarsal (TMT) OA and hammertoes. A total of 153 patients (172 feet) who underwent reconstruction for hallux valgus were divided into 3 groups: (1) bunion only (61 patients), (2) bunion with hammertoe without second TMT joint OA (78 patients), and (3) bunion with second TMT joint OA (14 patients). Preoperative age, sex, and body mass index (BMI) as well as hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsus adductus angle (MAA), ratio of second to first metatarsal length, and Meary's angle were recorded. One-way analysis of variance (normality demonstrated) and Kruskal-Wallis (normality not demonstrated) tests were used to assess differences in continuous variables. Post hoc tests were conducted with the Bonferroni technique. Associations between discrete variables and the study groups were analyzed using χ 2 tests. Following the univariate analysis, multinomial logistic regression models were built to determine potential risk factors for hammertoe or TMT OA group placement. Patients in the hammertoe and TMT OA groups were significantly older than patients in the bunion only group ( P hallux valgus who are at greater risk for developing secondary pathologies. Level III, retrospective comparative series.

  7. Ogilvie′s syndrome following posterior spinal arthrodesis for scoliosis

    Directory of Open Access Journals (Sweden)

    Athanasios I Tsirikos

    2013-01-01

    Full Text Available We report Ogilvie′s syndrome following posterior spinal arthrodesis on a patient with thoracic and lumbar scoliosis associated with intraspinal anomalies. Postoperative paralytic ileus can commonly complicate scoliosis surgery. Ogilvie′s syndrome as a cause of abdominal distension and pain has not been reported following spinal deformity correction and can mimic post-surgical ileus. 12 year old female patient with double thoracic and lumbar scoliosis associated with Arnold-Chiari 1 malformation and syringomyelia. The patient underwent posterior spinal fusion from T 4 to L 3 with segmental pedicle screw instrumentation and autogenous iliac crest grafting. She developed abdominal distension and pain postoperatively and this deteriorated despite conservative management. Repeat ultrasounds and abdominal computer tomography scans ruled out mechanical obstruction. The clinical presentation and blood parameters excluded toxic megacolon and cecal volvulus. As the symptoms persisted, a laparotomy was performed on postoperative day 16, which demonstrated ragged tears of the colon and cecum. A right hemi-colectomy followed by ileocecal anastomosis was required. The pathological examination of surgical specimens excluded inflammatory bowel disease and vascular abnormalities. The patient made a good recovery following bowel surgery and at latest followup 3.2 years later she had no abdominal complaints and an excellent scoliosis correction. Ogilvie′s syndrome should be included in the differential diagnosis of postoperative ileus in patients developing prolonged unexplained abdominal distension and pain after scoliosis correction. Early diagnosis and instigation of conservative management can prevent major morbidity and mortality due to bowel ischemia and perforation.

  8. New bacterial composition in primary and persistent/secondary endodontic infections with respect to clinical and radiographic findings.

    Science.gov (United States)

    Tennert, Christian; Fuhrmann, Maximilian; Wittmer, Annette; Karygianni, Lamprini; Altenburger, Markus J; Pelz, Klaus; Hellwig, Elmar; Al-Ahmad, Ali

    2014-05-01

    The aim of the present study was to analyze the microbiota of primary and secondary/persistent endodontic infections of patients undergoing endodontic treatment with respect to clinical and radiographic findings. Samples from the root canals of 21 German patients were taken using 3 sequential sterile paper points. In the case of a root canal filling, gutta-percha was removed with sterile files, and samples were taken using sterile paper points. The samples were plated, and microorganisms were then isolated and identified morphologically by biochemical analysis and sequencing the 16S rRNA genes of isolated microorganisms. In 12 of 21 root canals, 33 different species could be isolated. Six (50%) of the cases with isolated microorganisms were primary, and 6 (50%) cases were endodontic infections associated with root-filled teeth. Twelve of the isolated species were facultative anaerobic and 21 obligate anaerobic. Monomicrobial infections were found for Enterococcus faecalis and Actinomyces viscosus. E. faecalis was most frequently isolated in secondary endodontic infections (33%). Moraxella osloensis was isolated from a secondary endodontic infection that had an insufficient root canal filling accompanied by a mild sensation of pain. A new bacterial composition compromising Atopobium rimae, Anaerococcus prevotii, Pseudoramibacter alactolyticus, Dialister invisus, and Fusobacterium nucleatum was recovered from teeth with chronic apical abscesses. New bacterial combinations were found and correlated to clinical and radiographic findings, particularly to chronic apical abscesses. M. osloensis was detected in root canals for the second time and only in German patients. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  9. [Effects of surgery on muscles on clinical and radiographic findings in the hip joint region in cerebral palsy patients].

    Science.gov (United States)

    Schejbalová, A; Havlas, V

    2008-10-01

    PURPOSE OF THE STUDY Isolated or combined surgical procedures on muscles around the hip joint are currently indicated by many authors. In cerebral palsy patients they are regarded as essential intervention. MATERIAL In the years 2005-2007, surgery in the hip joint region was essential for 150 children between 3 and 18 years of age. At the time of surgery, the patients' locomotion ranged from stage 1 to stage 7 of the Vojta system. METHODS The outcome was evaluated by clinical and radiographic examination at 2 and 6 months post-operatively and hip migration percentage and Wiberg's CE angle were measured. RESULTS The best clinical and radiographic outcomes were achieved in children younger than 6 years of age. On the other hand, isolated transfer of the distal rectus femoris muscle significantly affected pelvis anteflexion in adolescent patients. The most marked decrease in migration percentage was found after adductor tenotomy combined with surgery on the iliopsoas muscle (55.6 %) or when the two procedures were combined with distal rectus femoris transfer. DISCUSSION Combined surigical procedures, i.e., adductor tenotomy, surgery on the iliopsoas muscle or rectus femoris muscle and medial hamstrings, with fixation using an abduction modified Atlanta brace, are effective in patients with marked lateral hip migration who are younger that 6 years. Isolated adductor tenotomy and distal transfer of the rectus femoris muscle markedly improve standing position in walking patients. CONCLUSION An appropriate combination of surgical procedures on muscles in the hip region and on medial hamstrings can significantly improve the patient's locomotion and, if lateral migration is present, help to avoid surgery on bones.

  10. APPLICABILITY OF THE COBB ANGLE MEASUREMENT IN IDIOPATHIC SCOLIOSIS USING SCANNED IMAGING

    Directory of Open Access Journals (Sweden)

    ERASMO DE ABREU ZARDO

    Full Text Available ABSTRACT Objectives: To compare the measurement of the Cobb angle on printed radiographs and on scanned radiographs viewed through the software "PixViewer". Methods: Preoperative radiographs of 23 patients were evaluated on printed films and through the software "PixViewer". The same evaluator, a spine surgeon, chose the proximal and distal limiting vertebrae of the main curve on printed radiographs, without identification of patients, and measured the Cobb angle based on these parameters. The same parameters and measurements were applied to scanned radiographs. The measurements were compared, as well as the choice of limiting vertebrae. Results: The average variation of the Cobb angle between methods was 1.48 ± 1.73°. The intraclass correlation coefficient (ICC was 0.99, demonstrating excellent reproducibility. Conclusion: The Cobb method can be used to evaluate scoliosis through the "PixViewer" tool with the same reliability as the classic method on printed radiographs.

  11. Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in dogs with fatal acute pancreatitis: 70 cases (1986-1995)

    International Nuclear Information System (INIS)

    Hess, R.S.; Saunders, H.M.; Van Winkle, T.J.; Shofer, F.S.; Washabau, R.J.

    1998-01-01

    To determine clinical, clinicopathologic, radiographic, ultrasonographic, and coagulation abnormalities in dogs in which acute pancreatitis was fatal. Retrospective study. 70 dogs. History, clinical signs, and physical examination findings at the time of initial evaluation at the veterinary teaching hospital; results of pretreatment laboratory tests, abdominal radiography, and ultrasonography; and histologic abnormalities were obtained from medical records. Clinical signs included anorexia, vomiting, Weakness, diarrhea, polyuria and polydipsia, neurologic abnormalities, melena, weight loss, hematemesis, and passage of frank blood in feces. At the time of initial examination at the veterinary teaching hospital, 68 (97%) dogs were dehydrated, 18 (26%) were icteric, 22 (32%) were febrile, 40 (58%) had signs of abdominal pain, and 30 (43%) were classified as overweight or obese. Most dogs had leukocytosis, neutrophilia with a left shift, and thrombocytopenia. Various serum biochemical abnormalities were identified, including hypoglycemia, azotemia, hypercalcemia and other electrolyte abnormalities, hypoalbuminemia, high hepatic and pancreatic enzyme activities, hypercholesterolemia, and lipemia. For 17 of 28 (61%) dogs, results of coagulation function tests were abnormal. Results of abdominal ultrasonography and radiography were consistent with a diagnosis of acute pancreatitis in 23 of 34 (68%) and 10 of 41 (24%) dogs, respectively. For 2 dogs, results of abdominal ultrasonography were not suggestive of acute pancreatitis, but results of abdominal radiography were. Clinical signs and results of clinicopathologic tests are inconsistent. Abdominal ultrasonography may be valuable in the diagnostic evaluation of dogs suspected to have acute pancreatitis

  12. Radiographic testing

    International Nuclear Information System (INIS)

    Kuster, J.

    1978-01-01

    In view of great differencies in X-ray transmission it is more difficult to get optimum radiographs of plastics and especially of reinforced plastics than for example of metals. A procedure will be reported how to get with little effort optimum radiographs especially also in the range of long wave-length radiation corresponding 10 to 25 kV.P. (orig.) [de

  13. Empty polyetheretherketone (PEEK) cages in anterior cervical diskectomy and fusion (ACDF) show slow radiographic fusion that reduces clinical improvement: results from the prospective multicenter "PIERCE-PEEK" study.

    Science.gov (United States)

    Suess, Olaf; Schomaker, Martin; Cabraja, Mario; Danne, Marco; Kombos, Theodoros; Hanna, Michael

    2017-01-01

    Anterior cervical diskectomy and fusion (ACDF) is a well-established surgical treatment for radiculopathy and myelopathy. Previous studies showed that empty PEEK cages have lower radiographic fusion rates, but the clinical relevance remains unclear. This paper's aim is to provide high-quality evidence on the outcomes of ACDF with empty PEEK cages and on the relevance of radiographic fusion for clinical outcomes. This large prospective multicenter clinical trial performed single-level ACDF with empty PEEK cages on patients with cervical radiculopathy or myelopathy. The main clinical outcomes were VAS (0-10) for pain and NDI (0-100) for functioning. Radiographic fusion was evaluated by two investigators for three different aspects. The median (range) improvement of the VAS pain score was: 3 (1-6) at 6 months, 3 (2-8) at 12 months, and 4 (2-8) at 18 months. The median (range) improvement of the NDI score was: 12 (2-34) at 6 months, 18 (4-46) at 12 months, and 22 (2-44) at 18 months. Complete radiographic fusion was reached by 126 patients (43%) at 6 months, 214 patients (73%) at 12 months, and 241 patients (83%) at 18 months. Radiographic fusion was a highly significant ( p  PEEK cages is slow and insufficient. Lack of complete radiographic fusion leads to less improvement of pain and disability. We recommend against using empty uncoated pure PEEK cages in ACDF. ISRCTN42774128. Retrospectively registered 14 April 2009.

  14. Radiographic manifestations of hypochondroplasia

    Energy Technology Data Exchange (ETDEWEB)

    Heselson, N G; Cremin, B J [Groote Schuur Hospital, Cape Town (South Africa); Beighton, P

    1979-01-01

    Hypochrondroplasia is an inherited skeletal dysplasia that resembles achondroplasia in mild degree. Radiographic manifestations encountered in 12 affected individuals in South Africa include slight shortening of all segments of the tubular bones, moderate caudal diminution of the lumbar interpedicular distances, increased lumbar lordosis with cacral tilt and distal prolongation of the fibular. Hypochondroplasia can be distinguished from other osteochondrodystrophies such as achondroplasia, pseudo-achondroplasia and metaphyseal chondroplasia by the recognition of it clinical and radiographic manifestations.

  15. Clinical, echocardiographic, and radiographic findings of peritoneopericardial diaphragmatic hernia in two dogs and a cat

    International Nuclear Information System (INIS)

    Hay, W.H.; Woodfield, J.A.; Moon, M.A.

    1989-01-01

    Peritoneopericardial diaphragmatic hernia was diagnosed in 2 dogs and a cat. One dog was referred because of clinical signs of cardiac tamponade and acute decompensation from liver entrapment within the hernia. Surgical correction of the hernia alleviated clinical signs in all 3 animals. Echocardiography was used in combination with radiography to provide a rapid and accurate diagnosis

  16. Evaluation of Patient Outcome and Satisfaction after Surgical Treatment of Adolescent Idiopathic Scoliosis Using Scoliosis Research Society-30.

    Science.gov (United States)

    Ghandehari, Hasan; Mahabadi, Maryam Ameri; Mahdavi, Seyed Mani; Shahsavaripour, Ali; Seyed Tari, Hossein Vahid; Safdari, Farshad

    2015-04-01

    Adolescent idiopathic scoliosis (AIS) may lead to physical and mental problems. It also can adversely affect patient satisfaction and the quality of life. In this study, we assessed the outcomes and satisfaction rate after surgical treatment of AIS using scoliosis research society-30 questionnaire (SRS-30). We enrolled 135 patients with AIS undergoing corrective surgery. Patients were followed for at least 2 years. We compared pre- and post-operative x-rays in terms of Cobb's angles and coronal balance. At the last visit, patients completed the SRS-30 questionnaire. We then assessed the correlation between radiographic measures, SRS-30 total score, and patient satisfaction. Cobb's angle and coronal balance improved significantly after surgery (Pself-image/cosmesis, mental health, and satisfaction were 27±4.3, 26±2.5, 33±5.2, 23±3.5, and 13±1.8, respectively. The total SRS-30 score was 127±13. Radiographic measures showed significant positive correlation with satisfaction and SRS-30 total scores. There was also a positive correlation between satisfaction and self-image/cosmesis domain scores. The greater the radiographic angles were corrected the higher the SRS-30 total score and patient satisfaction were. It is intuitive that the appearance and cosmesis is of most important factor associated with patient satisfaction.

  17. Incidence of periapical lesions and clinical symptoms after pulpectomy--a clinical and radiographic evaluation of 1- versus 2-session treatment.

    Science.gov (United States)

    Gesi, Andrea; Hakeberg, Magnus; Warfvinge, Johan; Bergenholtz, Gunnar

    2006-03-01

    Outcome of pulpectomy in 2 treatment sessions with calcium hydroxide as an intracanal dressing was compared to a procedure comprising instrumentation and root-filling in 1 session. Subjects with a vital pulp condition (N = 256) were recruited to a randomized clinical trial. Outcome parameters included radiographic signs of apical periodontitis and painful symptoms at clinical follow-ups 1 week and 1-3 years after treatment. Of 244 subjects available for final recall, 17 presented with periapical radiolucency. Lesions were evenly distributed among the 2 treatment groups. Postoperative pain recorded 1 week after permanent filling was significantly associated with overfilling (P = .001), with no difference between treatment groups. There was no association with presence of overfilling and radiographic lesion at end point of recall. Study confirms that pulpectomy may be carried out at a high rate of success if due attention is given to aseptic operating procedures, proper instrumentation and filling. Under these conditions an interappointment dressing with calcium hydroxide does not seem to influence outcome.

  18. Hemivertebra of the cervical spine: an uncommon background for neck pain, cervical scoliosis, and torticollis.

    Science.gov (United States)

    Kapetanakis, Stylianos; Gkasdaris, Grigorios; Nastoulis, Evangelos; Stavrev, Vladimir

    2017-10-01

    A 15-year-old female patient presented with neck pain accompanied by cervical scoliosis, on the existence of torticollis. Although rare, hemivertebra of the cervical spine is a congenital deformation associated with these three clinical features.

  19. Interpreting radiographs. 4. The carpus

    International Nuclear Information System (INIS)

    Burguez, P.N.

    1984-01-01

    The complexity of the carpus which has three major joints, seven or eight carpal bones and five adjacent bones, each of which articulates with one or more of the carpal elements, necessitates good quality radiographs for definitive radiographic interpretation may be extremely difficult because of the disparity between radiographic changes and obvious clinical signs and, therefore, must be discussed in the light of a thorough clinical assessment

  20. Discriminative and predictive validity of the scoliosis research society-22 questionnaire in management and curve-severity subgroups of adolescents with idiopathic scoliosis.

    Science.gov (United States)

    Parent, Eric C; Hill, Doug; Mahood, Jim; Moreau, Marc; Raso, Jim; Lou, Edmond

    2009-10-15

    Prospective cross-sectional measurement study. To determine the ability of the Scoliosis Research Society (SRS)-22 questionnaire to discriminate among management and scoliosis severity subgroups and to correlate with internal and external measures of curve severity. In earlier studies of the SRS-22 discriminative ability, age was not a controlled factor. The ability of the SRS-22 to predict curve severity has not been thoroughly examined. The SRS-22 was completed by 227 females with adolescent idiopathic scoliosis. Using Analysis of covariance analyses controlling for age, the SRS-22 scores were compared among management subgroups (observation, brace, presurgery, and postsurgery) and curve-severity subgroups (in nonoperated subjects: Cobb angles of 50 degrees). A stepwise discriminant analysis was used to identify the SRS-22 domains most discriminative for curve-severity categories. Correlation between SRS-22 scores and radiographic or surface topography measurements was used to determine the predictive ability of the questionnaire. Pain was better for subjects treated with braces than for those planning surgery. Self-image was better for subjects under observation or postsurgery than for those planning surgery. Satisfaction was better for the brace and postsurgery subgroups than for the observation or presurgery subgroups. Statistically significant mean differences between subgroups were all larger than 0.5, which is within the range of minimal clinically important differences recommended for each of the 5-point SRS-22 domain scoring scales. Pain and mental health were worse for those with Cobb angles of >50 degrees than with Cobb angles of 30 degrees to 50 degrees. Self-image and total scores were worse for those with Cobb angles of >50 degrees than both other subgroups. Using discriminant analysis, self-image was the only SRS-22 domain score selected to classify subjects within curve severity subgroups. The percentage of patients accurately classified was 54

  1. Clinical and Radiographic Evaluation of the Effectiveness of Formocresol, Mineral Trioxide Aggregate, Portland Cement, and Enamel Matrix Derivative in Primary Teeth Pulpotomies: A Two Year Follow-Up.

    Science.gov (United States)

    Yildirim, Ceren; Basak, Feridun; Akgun, Ozlem Marti; Polat, Gunseli Guven; Altun, Ceyhan

    2016-01-01

    The aim of this study was to evaluate and to compare clinical and radiographic outcomes of 4 materials (formocresol, mineral trioxide aggregate (MTA), Portland cement and enamel matrix derivative) using in primary teeth pulpotomies. Sixty-five patients aged 5-9 years (32 female, 33 male) were included in this study. A total of 140 primary first and second molars with deep caries were treated with pulpotomy. All teeth were then restored with stainless steel crowns. The treated teeth were evaluated clinically and radiographically at 3, 6, 12, 18 and 24 months. At 24 months, the clinical success rates of formocresol, MTA, Portland cement, and enamel matrix derivative were 96.9%, 100%, 93.9%, and 93.3%, respectively. The corresponding radiographic success rates were 84.4%, 93.9%, 86.7% and 78.1%, respectively. Although there were no statistically significant differences in clinical and radiographic success rates among the 4 groups, MTA appears to be superior to formocresol, Portland cement, and enamel matrix derivative as a pulpotomy agent in primary teeth.

  2. TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity: results from the Swiss Clinical Quality Management cohort.

    Science.gov (United States)

    Molnar, Christoph; Scherer, Almut; Baraliakos, Xenofon; de Hooge, Manouk; Micheroli, Raphael; Exer, Pascale; Kissling, Rudolf O; Tamborrini, Giorgio; Wildi, Lukas M; Nissen, Michael J; Zufferey, Pascal; Bernhard, Jürg; Weber, Ulrich; Landewé, Robert B M; van der Heijde, Désirée; Ciurea, Adrian

    2018-01-01

    To analyse the impact of tumour necrosis factor inhibitors (TNFis) on spinal radiographic progression in ankylosing spondylitis (AS). Patients with AS in the Swiss Clinical Quality Management cohort with up to 10 years of follow-up and radiographic assessments every 2 years were included. Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. The relationship between TNFi use before a 2-year radiographic interval and progression within the interval was investigated using binomial generalised estimating equation models with adjustment for potential confounding and multiple imputation of missing values. Ankylosing Spondylitis Disease Activity Score (ASDAS) was regarded as mediating the effect of TNFi on progression and added to the model in a sensitivity analysis. A total of 432 patients with AS contributed to data for 616 radiographic intervals. Radiographic progression was defined as an increase in ≥2 mSASSS units in 2 years. Mean (SD) mSASSS increase was 0.9 (2.6) units in 2 years. Prior use of TNFi reduced the odds of progression by 50% (OR 0.50, 95% CI 0.28 to 0.88) in the multivariable analysis. While no direct effect of TNFi on progression was present in an analysis including time-varying ASDAS (OR 0.61, 95% CI 0.34 to 1.08), the indirect effect, via a reduction in ASDAS, was statistically significant (OR 0.75, 95% CI 0.59 to 0.97). TNFis are associated with a reduction of spinal radiographic progression in patients with AS. This effect seems mediated through the inhibiting effect of TNFi on disease activity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Adolescent Idiopathic Scoliosis and Eating Disorders: Is There a Relation? Results of a Cross-Sectional Study

    Science.gov (United States)

    Zaina, Fabio; Donzelli, Sabrina; Lusini, Monia; Vismara, Luca; Capodaglio, Paolo; Neri, Laura; Negrini, Stefano

    2013-01-01

    A recent study suggests a correlation between idiopathic scoliosis in adolescence and eating disorders. However, this does not correspond with our clinical experience in the same population. The aim of this study was to verify the correlation between scoliosis and eating disorders in adolescence. A cross-sectional study was designed including 187…

  4. Physiotherapy scoliosis-specific exercises - a comprehensive review of seven major schools.

    Science.gov (United States)

    Berdishevsky, Hagit; Lebel, Victoria Ashley; Bettany-Saltikov, Josette; Rigo, Manuel; Lebel, Andrea; Hennes, Axel; Romano, Michele; Białek, Marianna; M'hango, Andrzej; Betts, Tony; de Mauroy, Jean Claude; Durmala, Jacek

    2016-01-01

    In recent decades, there has been a call for change among all stakeholders involved in scoliosis management. Parents of children with scoliosis have complained about the so-called "wait and see" approach that far too many doctors use when evaluating children's scoliosis curves between 10° and 25°. Observation, Physiotherapy Scoliosis Specific Exercises (PSSE) and bracing for idiopathic scoliosis during growth are all therapeutic interventions accepted by the 2011 International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT). The standard features of these interventions are: 1) 3-dimension self-correction; 2) Training activities of daily living (ADL); and 3) Stabilization of the corrected posture. PSSE is part of a scoliosis care model that includes scoliosis specific education, scoliosis specific physical therapy exercises, observation or surveillance, psychological support and intervention, bracing and surgery. The model is oriented to the patient. Diagnosis and patient evaluation is essential in this model looking at a patient-oriented decision according to clinical experience, scientific evidence and patient's preference. Thus, specific exercises are not considered as an alternative to bracing or surgery but as a therapeutic intervention, which can be used alone or in combination with bracing or surgery according to individual indication. In the PSSE model it is recommended that the physical therapist work as part of a multidisciplinary team including the orthopeadic doctor, the orthotist, and the mental health care provider - all are according to the SOSORT guidelines and Scoliosis Research Society (SRS) philosophy. From clinical experiences, PSSE can temporarily stabilize progressive scoliosis curves during the secondary period of progression, more than a year after passing the peak of growth. In non-progressive scoliosis, the regular practice of PSSE could produce a temporary and significant reduction of the Cobb angle. PSSE can also

  5. Immediate occlusal loading of implants in the partially edentate mandible: a prospective 1-year radiographic and 4-year clinical study.

    Science.gov (United States)

    Ostman, Pär-Olov; Hellman, Mats; Sennerby, Lars

    2008-01-01

    The purpose of the present prospective clinical study was to evaluate the radiographic and clinical outcome of immediately loaded implants in the partial edentulous mandible over a 4-year follow-up period using a modified surgical protocol, primary implant stability criteria, and splinting for inclusion. Patients in need of implant treatment in the partial edentate mandible were consecutively included in the study. The implant sites were underprepared to obtain maximal stability. Inclusion criteria for the study were torque of a least 30 Ncm before final seating of the implant and an ISQ greater than 60. A provisional fixed partial denture was delivered within 24 hours and a definitive fixed partial denture within 3 months. The patients were monitored with clinical and radiographic follow-up examinations for up to 4 years. Stability of the implants was measured with resonance frequency analysis at placement and after 6 months. Ninety-six patients were evaluated, and 77 patients who met the inclusion criteria were included. A total of 111 fixed partial dentures supported by 257 Brånemark System implants (77 turned and 180 TiUnite implants) were delivered. Four (1.6%) of the 257 implants did not osseointegrate, giving an overall survival rate of 98.4% after 4 years. Three turned (3.9%) implants and 1 oxidized implant (0.6%) failed after 4 to 13 months. The average marginal bone resorption was 0.7 mm (SD 0.78) during the first year in function. Turned implants showed an average bone loss of 0.5 mm (SD 0.8) and oxidized implants an average of 0.7 mm (SD 0.8). Resonance frequency analysis showed a mean implant stability quotient of 72.2 (SD 7.5) at placement and 72.5 (SD 5.7) after 6 months of loading. It is concluded that immediate loading of implants with firm primary stability in partially edentulous areas of the mandible appears to be a viable procedure with predictable outcome.

  6. Clinical case review: a method to improve identification of true clinical and radiographic pneumonia in children meeting the World Health Organization definition for pneumonia.

    Science.gov (United States)

    Puumalainen, Taneli; Quiambao, Beatriz; Abucejo-Ladesma, Erma; Lupisan, Socorro; Heiskanen-Kosma, Tarja; Ruutu, Petri; Lucero, Marilla G; Nohynek, Hanna; Simoes, Eric A F; Riley, Ian

    2008-07-21

    The World Health Organization's (WHO) case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies. A group of paediatricians conducted a retrospective review of clinical and laboratory data including C-reactive protein concentration and chest radiograph findings among Filipino children hospitalised in the Bohol Regional Hospital who were enrolled in a pneumococcal vaccine efficacy study and had an episode of respiratory disease fulfilling the WHO case definition for clinical pneumonia. Our aim was to evaluate which disease entities the WHO definition actually captures and what is the probable aetiology of respiratory infections among these episodes diagnosed in this population. Among the 12,194 children enrolled to the vaccine study we recorded 1,195 disease episodes leading to hospitalisation which fulfilled the WHO criteria for pneumonia. In total, 34% of these episodes showed radiographic evidence of pneumonia and 11% were classified as definitive or probable bacterial pneumonia. Over 95% of episodes of WHO-defined severe pneumonia (with chest indrawing) had an acute lower respiratory infection as final diagnosis whereas 34% of those with non-severe clinical pneumonia had gastroenteritis or other non-respiratory infection as main cause of hospitalisation. The WHO definition for severe pneumonia shows high specificity for acute lower respiratory infection and provides a tool to compare the total burden of lower respiratory infections in different settings. ISRCTN62323832.

  7. Clinical case review: A method to improve identification of true clinical and radiographic pneumonia in children meeting the World Health Organization definition for pneumonia

    Directory of Open Access Journals (Sweden)

    Ruutu Petri

    2008-07-01

    Full Text Available Abstract Background The World Health Organization's (WHO case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies. Methods A group of paediatricians conducted a retrospective review of clinical and laboratory data including C-reactive protein concentration and chest radiograph findings among Filipino children hospitalised in the Bohol Regional Hospital who were enrolled in a pneumococcal vaccine efficacy study and had an episode of respiratory disease fulfilling the WHO case definition for clinical pneumonia. Our aim was to evaluate which disease entities the WHO definition actually captures and what is the probable aetiology of respiratory infections among these episodes diagnosed in this population. Results Among the 12,194 children enrolled to the vaccine study we recorded 1,195 disease episodes leading to hospitalisation which fulfilled the WHO criteria for pneumonia. In total, 34% of these episodes showed radiographic evidence of pneumonia and 11% were classified as definitive or probable bacterial pneumonia. Over 95% of episodes of WHO-defined severe pneumonia (with chest indrawing had an acute lower respiratory infection as final diagnosis whereas 34% of those with non-severe clinical pneumonia had gastroenteritis or other non-respiratory infection as main cause of hospitalisation. Conclusion The WHO definition for severe pneumonia shows high specificity for acute lower respiratory infection and provides a tool to compare the total burden of lower respiratory infections in different settings. Trial registration ISRCTN62323832

  8. Radiographic Progression-Free Survival as a Clinically Meaningful End Point in Metastatic Castration-Resistant Prostate Cancer: The PREVAIL Randomized Clinical Trial.

    Science.gov (United States)

    Rathkopf, Dana E; Beer, Tomasz M; Loriot, Yohann; Higano, Celestia S; Armstrong, Andrew J; Sternberg, Cora N; de Bono, Johann S; Tombal, Bertrand; Parli, Teresa; Bhattacharya, Suman; Phung, De; Krivoshik, Andrew; Scher, Howard I; Morris, Michael J

    2018-05-01

    Drug development for metastatic castration-resistant prostate cancer has been limited by a lack of clinically relevant trial end points short of overall survival (OS). Radiographic progression-free survival (rPFS) as defined by the Prostate Cancer Clinical Trials Working Group 2 (PCWG2) is a candidate end point that represents a clinically meaningful benefit to patients. To demonstrate the robustness of the PCWG2 definition and to examine the relationship between rPFS and OS. PREVAIL was a phase 3, randomized, double-blind, placebo-controlled multinational study that enrolled 1717 chemotherapy-naive men with metastatic castration-resistant prostate cancer from September 2010 through September 2012. The data were analyzed in November 2016. Patients were randomized 1:1 to enzalutamide 160 mg or placebo until confirmed radiographic disease progression or a skeletal-related event and initiation of either cytotoxic chemotherapy or an investigational agent for prostate cancer treatment. Sensitivity analyses (SAs) of investigator-assessed rPFS were performed using the final rPFS data cutoff (May 6, 2012; 439 events; SA1) and the interim OS data cutoff (September 16, 2013; 540 events; SA2). Additional SAs using investigator-assessed rPFS from the final rPFS data cutoff assessed the impact of skeletal-related events (SA3), clinical progression (SA4), a confirmatory scan for soft-tissue disease progression (SA5), and all deaths regardless of time after study drug discontinuation (SA6). Correlations between investigator-assessed rPFS (SA2) and OS were calculated using Spearman ρ and Kendall τ via Clayton copula. In the 1717 men (mean age, 72.0 [range, 43.0-93.0] years in enzalutamide arm and 71.0 [range, 42.0-93.0] years in placebo arm), enzalutamide significantly reduced risk of radiographic progression or death in all SAs, with hazard ratios of 0.22 (SA1; 95% CI, 0.18-0.27), 0.31 (SA2; 95% CI, 0.27-0.35), 0.21 (SA3; 95% CI, 0.18-0.26), 0.21 (SA4; 95% CI, 0.17-0.26), 0

  9. Aggressive combination therapy with intraarticular glucocorticoid injections and conventional DMARDs in early rheumatoid arthritis Two Year Clinical and Radiographic Results From The CIMESTRA Study

    DEFF Research Database (Denmark)

    Hetland, Merete; Stengaard-Pedersen, Kristian; Junker, Peter

    2008-01-01

    of the 2nd year of the randomized, controlled double-blind CIMESTRA study. METHODS: 160 patients with early RA (any swollen joint in combination with step-up treatment with either methotrexate and placebo...... years, and the radiographic erosive progression was minimal. Addition of cyclosporine during the first 76 weeks resulted in significantly better ACR20 and ACR50 responses, but did not have any additional effect on remission rate and radiographic outcome.......OBJECTIVE: To investigate whether clinical and radiographic disease control can be achieved and maintained in patients with early, active rheumatoid arthritis (RA) during the 2nd year of aggressive treatment with conventional DMARD and intraarticular corticosteroid. This paper presents the results...

  10. Zirconia dental implants : a clinical, radiographic, and microbiologic evaluation up to 3 years

    NARCIS (Netherlands)

    Brüll, Felix; van Winkelhoff, Arie Jan; Cune, Marco S.

    2014-01-01

    PURPOSE: To retrospectively evaluate the clinical performance of zirconia endosseous implants. MATERIALS AND METHODS: Partially edentulous patients with adequate bone volume to fit yttria tetragonal zirconia polycrystal (Y-TZP) implants at least 3.5 mm wide and 8.0 mm long were included. Full-mouth

  11. Difference of achalasia subtypes based on clinical symptoms, radiographic findings, and stasis scores

    Directory of Open Access Journals (Sweden)

    A. Meillier

    2018-01-01

    Conclusions: Achalasia subtypes had similar clinical symptoms, except for increased vomiting severity in subtype i. The maximum esophageal diameter in subtype ii was significantly greater than in subtype iii. Esophageal stasis scores were similar. Thus, high-resolution esophageal manometry remains essential in assessing achalasia subtypes.

  12. Radiographer Level of Simulation Training, Critical Thinking Skills, Self-Efficacy, and Clinical Competence

    Science.gov (United States)

    Chiu, Jennifer G.

    2013-01-01

    Radiography is an essential part of the healthcare continuum and ensuring the competency of each technologist is essential. A clinically competent technologist is vital in achieving quality diagnostic images to accurate diagnosis disease and pathology to develop treatment plans leading to improved patient outcomes. The purpose of this study was…

  13. Reliability and validity of the photogrammetry for scoliosis evaluation: a cross-sectional prospective study.

    Science.gov (United States)

    Saad, Karen Ruggeri; Colombo, Alexandra S; João, Silvia M Amado

    2009-01-01

    The purpose of this study was to investigate the reliability and validity of photogrammetry in measuring the lateral spinal inclination angles. Forty subjects (32 female and 8 males) with a mean age of 23.4 +/- 11.2 years had their scoliosis evaluated by radiographs of their trunk, determined by the Cobb angle method, and by photogrammetry. The statistical methods used included Cronbach alpha, Pearson/Spearman correlation coefficients, and regression analyses. The Cronbach alpha values showed that the photogrammetric measures showed high internal consistency, which indicated that the sample was bias free. The radiograph method showed to be more precise with intrarater reliabilities of 0.936, 0.975, and 0.945 for the thoracic, lumbar, and thoracolumbar curves, respectively, and interrater reliabilities of 0.942 and 0.879 for the angular measures of the thoracic and thoracolumbar segments, respectively. The regression analyses revealed a high determination coefficient although limited to the adjusted linear model between the radiographic and photographic measures. It was found that with more severe scoliosis, the lateral curve measures obtained with the photogrammetry were for the thoracic and lumbar regions (R = 0.619 and 0.551). The photogrammetric measures were found to be reproducible in this study and could be used as supplementary information to decrease the number of radiographs necessary for the monitoring of scoliosis.

  14. Radiographic positioning

    International Nuclear Information System (INIS)

    Eisenberg, R.L.; Dennis, C.A.; May, C.

    1989-01-01

    This book concentrates on the routine radiographic examinations commonly performed. It details the wide variety of examinations possible and their place in initial learning and in the radiology department as references for those occasions when an unusual examination is requested. This book provides information ranging from basic terminology to skeletal positioning to special procedures. Positions are discussed and supplemented with a picture of a patient, the resulting radiograph, and a labeled diagram. Immobilization and proper shielding of the patient are also shown

  15. Radiographic Test

    Energy Technology Data Exchange (ETDEWEB)

    Lee, H.J; Yang, S.H. [Korea Electric Power Research Institute, Taejon (Korea)

    2002-07-01

    This report contains theory, procedure technique and interpretation of radiographic examination and written for whom preparing radiographic test Level II. To determine this baseline of technical competence in the examination, the individual must demonstrate a knowledge of radiography physics, radiation safety, technique development, radiation detection and measurement, facility design, and the characteristics of radiation-producing devices and their principles of operation. (author) 98 figs., 23 tabs.

  16. Statistical analysis of general, clinical and radiographic parameters of navicular disease in the horse

    International Nuclear Information System (INIS)

    Langfeldt, N.; Hertsch, B.

    1988-01-01

    With 20,4 % the syndrome navicular disease has a remarkable part of lameness in the equine fore limb. Although intensive investigations of the last years, there is no uniform opinion in the clinical diagnosis of navicular disease. At first there is a differential description of the diagnosis of navicular disease and a presentation of the importance of this disease from the whole patients of the equine hospital of the Tierärztliche Hochschule Hannover about five years (1980-1984). After that, the importance of the identification of pain with pain provocation test and the elimination of pain by anesthetic nerve blocking are described. The result of the anesthetic block of the ''Ramus pulvinus'' of the medial and lateral palmar digital nerves is a necessary part in clinical diagnosis of navicular disease [de

  17. Male-female differences in Scoliosis Research Society-30 scores in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Roberts, David W; Savage, Jason W; Schwartz, Daniel G; Carreon, Leah Y; Sucato, Daniel J; Sanders, James O; Richards, Benjamin Stephens; Lenke, Lawrence G; Emans, John B; Parent, Stefan; Sarwark, John F

    2011-01-01

    Longitudinal cohort study. To compare functional outcomes between male and female patients before and after surgery for adolescent idiopathic scoliosis (AIS). There is no clear consensus in the existing literature with respect to sex differences in functional outcomes in the surgical treatment of AIS. A prospective, consecutive, multicenter database of patients who underwent surgical correction for adolescent idiopathic scoliosis was analyzed retrospectively. All patients completed Scoliosis Research Society-30 (SRS-30) questionnaires before and 2 years after surgery. Patients with previous spine surgery were excluded. Data were collected for sex, age, Risser grade, previous bracing history, maximum preoperative Cobb angle, curve correction at 2 years, and SRS-30 domain scores. Paired sample t tests were used to compare preoperative and postoperative scores within each sex. Independent sample t tests were used to compare scores between sexes. A P value of Self-image/appearance had the greatest relative improvement. Males had better self-image/appearance scores preoperatively, better pain scores at 2 years, and better mental health and total scores both preoperatively and at 2 years. Both males and females were similarly satisfied with surgery. Males treated with surgery for AIS report better preoperative self-image, less postoperative pain, and better mental health than females. These differences may be clinically significant. For both males and females, the most beneficial effect of surgery is improved self-image/appearance. Overall, the benefits of surgery for AIS are similar for both sexes.

  18. CLINICAL-RADIOGRAPHIC CORRELATION OF DEGENERATIVE CHANGES OF THE SPINE - SYSTEMATIC REVIEW

    Directory of Open Access Journals (Sweden)

    Emiliano Neves Vialle

    Full Text Available ABSTRACT Systematic review of the literature on the evaluation of images of degenerative changes of the spine and its clinical correlation. A systematic literature review was conducted, and the results evaluated for the presence of clinical correlation, as well as the type of imaging method used. The search terms were "Intervertebral Disc Degeneration", "Intervertebral disc", "Classification", "Anulus fibrosus", "Nucleus pulposus", "Lumbar spine", "Degenerative disc disease", "Degeneration", "Zygapophyseal Joint". We also assessed whether there were inter- and intraobserver agreement in the selected works and possible guidelines regarding the treatment and prognosis of patients. Of the 91 reviewed abstracts, 31 articles were selected that met the inclusion criteria. Six articles were related to the cervical spine, 13 to the lumbar spine and 12 were about changes not related specifically to a single segment of the spine. Articles that determined limiting values considered normal were also included, since variations were considered signs of degeneration or pathology. It was not possible to establish the relationship between the changes identified in imaging and the clinical history of patients, either define treatment and prognosis guidelines.

  19. Immediate occlusal loading of NanoTite™ tapered implants: a prospective 1-year clinical and radiographic study.

    Science.gov (United States)

    Östman, Pär-Olov; Wennerberg, Ann; Ekestubbe, Annika; Albrektsson, Tomas

    2013-12-01

    During the last decade, high success rates have been reported for implants placed with immediate loading procedures, especially when bone quality and quantity provide good implant stability. In many of these studies, straight-walled implants with moderately rough surfaces were employed. Tapered implants are becoming increasingly more popular due to standardized drilling protocols and reports of high initial primary stability. The aim of the present prospective, single center clinical study was to evaluate surface topographical analysis and the clinical and radiographic outcomes of the NanoTite™ (BIOMET 3i, Palm Beach Gardens, FL, USA) Tapered Implant when used for immediate loading of fixed prostheses and single-tooth restorations. Forty-two patients who needed implant treatment and met admission criteria agreed to participate in the study and were consecutively enrolled. Surgical implant placement requirements consisted of a final torque of a least 30 Ncm prior to final seating and an implant stability quotient above 55. A total of 139 NanoTite Tapered implants (112 maxillary and 27 mandibular) were placed by one investigator, and the majority of these implants (n = 77/55%) were placed in posterior regions, and in soft bone (n = 90/65%). A total of 57 prosthetic constructions were evaluated consisting of 20 single-tooth restorations, 30 fixed partial dentures, and 7 complete, fixed maxillary restorations. Radiographs were taken at baseline and at 12 months of follow-up. Of the 139 study implants, one implant failure was declared. The overall cumulative survival rate at 1 year is 99.4%. Mean marginal bone resorption is 1.01 mm (SD 0.85) during the first year of function. Although limited to the short follow-up, immediate loading of NanoTite Tapered implants seems to be a viable option in implant rehabilitation, when insertion torque of at least 30 Ncm is achieved. Further studies are needed to authenticate the finding of this study. © 2012 Wiley

  20. The relation between electromyography and growth velocity of the spine in the evaluation of curve progression in idiopathic scoliosis

    NARCIS (Netherlands)

    Cheung, J.; Veldhuizen, A.G.; Halbertsma, J.P.; Maurits, N.M.; Sluiter, W.J.; Cool, J.C.; van Horn, J.R.

    2004-01-01

    Study Design. A prospective study in which patients with idiopathic scoliosis were examined longitudinally by radiographic and electromyographic measurements according to a protocol. Objectives. To measure the growth velocity of the spine and the electromyographic ratio of the paraspinal muscles to

  1. Correlation of clinical, radiographic, and surgical localization of intervertebral disc extrusion in small-breed dogs: a prospective study of 50 cases

    International Nuclear Information System (INIS)

    Schulz, K.S.; Walker, M.; Moon, M.; Waldron, D.; Slater, M.; McDonald, D.E.

    1998-01-01

    Objective-To compare prospectively clinical, radiographic, and surgical findings of intervertebral disc extrusion (IDE) localization in small-breed dogs and to determine the best means of lesion localization for the purpose of hemilaminectomy. Study Design-Clinical, radiographic, and surgical findings of small-breed dogs with thoracolumbar IDE were prospectively compared for agreement on lesion localization. Sample Population-50 small-breed dogs with IDE treated at the three participating veterinary hospitals were included in the study if no other confounding diseases were identified and if the owner gave permission for diagnostic tests and surgery. Methods-Clinical and surgical findings were recorded by the surgeon assigned to the case. Radiographic studies were evaluated independently by two radiologists blinded as to the clinical and surgical findings. K values and 95% confidence intervals were calculated for agreement on lesion localization by clinical, radiographic, and surgical means and for agreement between radiologists. Results-K values for agreement of lesion localization were as follows: clinical versus surgical, 0.595; radiologist A versus radiologist B, 0.81; radiologist A versus surgical findings, 0.60; radiologist B versus surgical findings, 0.71. Both radiologists interpretation of IDE localization agreed with surgical localization in 60% of cases. Conclusions-Clinical lateralization of IDE was found to be the least reliable factor of those studied for determining on which side the hemilaminectomy should be performed. Results of this study differ from those of previous studies examining the reliability of myelography to localize the site of IDE accurately. The results of this study further suggest that surgery may not be an absolute standard for determination of the localization of IDE in small-breed dogs. Clinical Relevance-Intervertebral disc extrusion in small-breed dogs frequently results in bilateral distribution of extruded material. Computed

  2. Triplanar correction of adolescent idiopathic scoliosis by asymmetrically shaped and simultaneously applied rods associated with direct vertebral rotation: clinical and radiological analysis of 36 patients.

    Science.gov (United States)

    Faldini, Cesare; Perna, Fabrizio; Geraci, Giuseppe; Pardo, Francesco; Mazzotti, Antonio; Pilla, Federico; Ruffilli, Alberto

    2018-04-17

    Aim of this study was to investigate the effectiveness of a new surgical corrective manoeuvre for adolescent idiopathic scoliosis (AIS) by asymmetrically shaped and simultaneously applied rods and in combination with direct vertebral rotation, to control both the triplanar deformity and the kyphosis apex location. We retrospectively reviewed 36 patients who undergo surgical treatment using simultaneous translation on two differently contoured rods, in combination with direct vertebral rotation. Patients were divided into three main groups according to the scoliotic curve type. The average follow-up was 1.8 years (range 1-3 years). Mean thoracic Cobb angle decreased from 64.6° to 17.0 (p < 0.05). Mean lumbar Cobb angle decreased from 54.9 to 13°. T5-T12 kyphosis values improved from 16.2 to 22.8° (p < 0.05). Apical vertebral rotation decreased from 25.3 to 9.7°. Mean total SRS-22 score values improved from 2.3 on pre-operative to 3.8 at the last available follow-up. Two major and two minor perioperative complications were recorded. Nor deformity progression or screw pull-out or non-union was recorded at the last available follow-up. The corrective manoeuvre using two differently contoured rods simultaneously in combination with direct vertebral rotation can provide a good triplanar deformity correction and improve patient's quality of life and self-image perception in mild-to-moderate AIS. Moreover, the described technique allows the positioning of the desired kyphosis apex at a different level from the scoliosis apex. This procedure allows a better sagittal contour restoration while maintaining a comparable amount of correction on the frontal and axial plane of the already available techniques. These slides can be retrieved under Electronic Supplementary Material.

  3. Congenital bipartite atlas with hypodactyly in a dog: clinical, radiographic and CT findings.

    Science.gov (United States)

    Wrzosek, M; Płonek, M; Zeira, O; Bieżyński, J; Kinda, W; Guziński, M

    2014-07-01

    A three-year-old Border collie was diagnosed with a bipartite atlas and bilateral forelimb hypodactyly. The dog showed signs of acute, non-progressive neck pain, general stiffness and right thoracic limb non-weight-bearing lameness. Computed tomography imaging revealed a bipartite atlas with abaxial vertical bone proliferation, which was the cause of the clinical signs. In addition, bilateral hypodactyly of the second and fifth digits was incidentally found. This report suggests that hypodactyly may be associated with atlas malformations. © 2014 British Small Animal Veterinary Association.

  4. Clinical, Radiographic, and Microbiologic Features of Infective Endocarditis in Patients With Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    Sims, Jason R; Anavekar, Nandan S; Bhatia, Subir; O'Horo, John C; Geske, Jeffrey B; Chandrasekaran, Krishnaswamy; Wilson, Walter R; Baddour, Larry M; Gersh, Bernard J; DeSimone, Daniel C

    2018-02-15

    Infective endocarditis (IE) is an infection of the inner lining of the heart with high morbidity and mortality despite medical and surgical advancements in recent decades. Hypertrophic cardiomyopathy (HC) is one of several medical conditions that have been linked to an increased risk of IE, but there is a paucity of data on this association. We therefore sought to define the clinical phenotype of IE in patients with HC at a single tertiary care center. A retrospective cohort of 30 adult patients with HC diagnosed with IE between January 1, 2006 and December 31, 2016 at Mayo Clinic Rochester were identified. Similar rates of aortic (n = 14) and mitral (n = 16) valve involvement by IE were noted (47% vs 53%). This finding persisted even in patients with left-ventricular outflow tract obstruction and systolic anterior motion of the mitral valve. Symptomatic embolic complications occurred in 10 cases (33%). Surgical intervention was performed in 11 cases (37%). One-year mortality was remarkably low at 7%. In conclusion, in the largest single-center cohort of IE complicating HC, there were similar rates of both mitral and aortic valve involvement regardless of the presence of left ventricular outflow tract obstruction, which is contrary to a long-standing tenet regarding the association of HC and IE. Moreover, no "high risk" IE subset was identified based on HC-related parameters. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. The clinical value of daily routine chest radiographs in a mixed medical-surgical intensive care unit is low.

    Science.gov (United States)

    Graat, Marleen E; Choi, Goda; Wolthuis, Esther K; Korevaar, Johanna C; Spronk, Peter E; Stoker, Jaap; Vroom, Margreeth B; Schultz, Marcus J

    2006-02-01

    The clinical value of daily routine chest radiographs (CXRs) in critically ill patients is unknown. We conducted this study to evaluate how frequently unexpected predefined major abnormalities are identified with daily routine CXRs, and how often these findings lead to a change in care for intensive care unit (ICU) patients. This was a prospective observational study conducted in a 28-bed, mixed medical-surgical ICU of a university hospital. Over a 5-month period, 2,457 daily routine CXRs were done in 754 consecutive ICU patients. The majority of these CXRs did not reveal any new predefined major finding. In only 5.8% of daily routine CXRs (14.3% of patients) was one or more new and unexpected abnormality encountered, including large atelectases (24 times in 20 patients), large infiltrates (23 in 22), severe pulmonary congestion (29 in 25), severe pleural effusion (13 in 13), pneumothorax/pneumomediastinum (14 in 13), and malposition of the orotracheal tube (32 in 26). Fewer than half of the CXRs with a new and unexpected finding were ultimately clinically relevant; in only 2.2% of all daily routine CXRs (6.4% of patients) did these radiologic abnormalities result in a change to therapy. Subgroup analysis revealed no differences between medical and surgical patients with regard to the incidence of new and unexpected findings on daily routine CXRs and the effect of new and unexpected CXR findings on daily care. In the ICU, daily routine CXRs seldom reveal unexpected, clinically relevant abnormalities, and they rarely prompt action. We propose that this diagnostic examination be abandoned in ICU patients.

  6. Comparison of low density and high density pedicle screw instrumentation in Lenke 1 adolescent idiopathic scoliosis.

    Science.gov (United States)

    Shen, Mingkui; Jiang, Honghui; Luo, Ming; Wang, Wengang; Li, Ning; Wang, Lulu; Xia, Lei

    2017-08-02

    The correlation between implant density and deformity correction has not yet led to a precise conclusion in adolescent idiopathic scoliosis (AIS). The aim of this study was to evaluate the effects of low density (LD) and high density (HD) pedicle screw instrumentation in terms of the clinical, radiological and Scoliosis Research Society (SRS)-22 outcomes in Lenke 1 AIS. We retrospectively reviewed 62 consecutive Lenke 1 AIS patients who underwent posterior spinal arthrodesis using all-pedicle screw instrumentation with a minimum follow-up of 24 months. The implant density was defined as the number of screws per spinal level fused. Patients were then divided into two groups according to the average implant density for the entire study. The LD group (n = 28) had fewer than 1.61 screws per level, while the HD group (n = 34) had more than 1.61 screws per level. The radiographs were analysed preoperatively, postoperatively and at final follow-up. The perioperative and SRS-22 outcomes were also assessed. Independent sample t tests were used between the two groups. Comparisons between the two groups showed no significant differences in the correction of the main thoracic curve and thoracic kyphosis, blood transfusion, hospital stay, and SRS-22 scores. Compared with the HD group, there was a decreased operating time (278.4 vs. 331.0 min, p = 0.004) and decreased blood loss (823.6 vs. 1010.9 ml, p = 0.048), pedicle screws needed (15.1 vs. 19.6, p density and high density pedicle screw instrumentation achieved satisfactory deformity correction in Lenke 1 AIS patients. However, the operating time and blood loss were reduced, and the implant costs were decreased with the use of low screw density constructs.

  7. Treatment planning in severe scoliosis: the role of MRI

    Energy Technology Data Exchange (ETDEWEB)

    Freund, M. [Dept. of Clinical Radiology, Univ. of Muenster (Germany); Dept. of Neuroradiology, Univ. of Heidelberg Medical School (Germany); Haehnel, S.; Sartor, K. [Dept. of Neuroradiology, Univ. of Heidelberg Medical School (Germany); Thomsen, M. [Dept. of Orthopaedic Surgery, University of Heidelberg, Medical School (Germany)

    2001-06-01

    The use of magnetic resonance imaging (MRI) in the preoperative investigation of children with idiopathic scoliosis is controversial. Syringomyelia and other intraspinal lesions may be risk factors for neurological injury during surgical correction. Our purpose was to investigate whether pathology of the neuraxis is associated with scoliosis and to detect lesions which may threaten neurological sequelae during distraction and instrumented correction. We obtained T1- and T2-weighted images of 40 children (28 girls, 12 boys), mean age 12.7 years with severe idiopathic scoliosis (Cobb angle 50-70 ) obtained in coronal, sagittal and axial planes from the posterior cranial fossa to the sacrum, and these were assessed by two neuroradiologists and an orthopaedic surgeon prior to further treatment planning. Abnormalities of the neuraxis were found in 24 patients (60 %); five (12 %) had two or more lesions. No abnormalities of the neuraxis were found in 16 patients (40 %). There were 15 patients (38 %) with intraspinal abnormalities who deteriorated clinically and nine (22 %) who showed no clinical changes. We transferred 16 patients (40 %) from the orthopaedic to the neurosurgical department for further assessment. Our results suggest that one should investigate the neuraxis with MRI before contemplating orthopaedic surgical correction of severe idiopathic scoliosis, because the findings may lead to a change of procedure. (orig.)

  8. Two-dimensional fusion imaging of planar bone scintigraphy and radiographs in patients with clinical scaphoid fracture: an imaging study

    DEFF Research Database (Denmark)

    Henriksen, Otto Mølby; Lonsdale, Markus Georg; Jensen, T D

    2009-01-01

    . Bone scintigraphy is highly sensitive for the detection of fractures, but exact localization of scintigraphic lesions may be difficult and can negatively affect diagnostic accuracy. PURPOSE: To investigate the influence of image fusion of planar bone scintigraphy and radiographs on image interpretation......BACKGROUND: Although magnetic resonance imaging (MRI) is now considered the gold standard in second-line imaging of patients with suspected scaphoid fracture and negative radiographs, bone scintigraphy can be used in patients with pacemakers, metallic implants, or other contraindications to MRI....... CONCLUSION: Image fusion of planar bone scintigrams and radiographs has a significant influence on image interpretation and increases both diagnostic confidence and interobserver agreement....

  9. Alveolar Bone Morphology Following Periodontally Accelerated Osteogenic Orthodontics: A Clinical and Radiographic Analysis.

    Science.gov (United States)

    Chackartchi, Tali; Barkana, Idit; Klinger, Avigdor

    The aim of this study was to analyze alveolar bone morphology following periodontally accelerated osteogenic orthodontics. Treated patients were called for a full periodontal examination and a cone beam computed tomography scan. Mean treatment time was 6.08 months. Mean probing pocket depth was 2.7 mm. No gingival recessions were noted. In the maxilla, buccal plate thickness was 0.48 to 2.14 mm. In the mandible, bone thickness was 0.2 to 1.82 mm. Root fenestrations and dehiscences were present in up to 40% of the anterior teeth. Although clinical outcomes were favorable, due to the presence of multiple posttreatment bone fenestrations and dehiscences, a revision of the treatment protocol might be considered.

  10. Clinical utility of magnetic resonance imaging radiographs for suspected organic syndromes in adult psychiatry.

    Science.gov (United States)

    Erhart, Stephen M; Young, Alexander S; Marder, Stephen R; Mintz, Jim

    2005-08-01

    In psychiatric practice, adult patients are most commonly referred for magnetic resonance imaging (MRI) to screen for suspected organic medical diseases of the central nervous system that can mimic psychiatric syndromes. We identified the most common signs and symptoms prompting MRIs to establish the predictive value of these signs and symptoms for clinically pertinent organic syndromes. This study was a retrospective chart review of psychiatric patients at the Veterans Affairs Greater Los Angeles Health Care Center (Los Angeles, Calif.) who were referred for MRI of the brain between 1996 and 2002. Patients referred for evaluation of dementia were excluded. The specific indications leading clinicians to obtain MRI were identified and grouped. In order to offset the uncertain significance of many MRI findings, for this study, the predictive value of each indication was calculated based on the percentage of patients in whom clinical management changed in response to MRI findings rather than on the percentage with any abnormal MRI results. Of 253 patients who had MRIs, 38 (15%) incurred some degree of treatment modification as a result of MRI findings, including 6 patients in whom MRI identified a medical condition that became the focus of treatment. Six indications appeared most likely to prompt clinicians to obtain MRIs. Because pertinent results were associated with each of these indications, statistical evaluation did not reveal significant differences in their predictive values (chi(2) = 4.32, df = 5, p = .505). Unlike prior studies showing no value to screening radioimaging, this study shows MRI can be a useful screening test among patients suspected of having organic psychiatric disorders and that the common indications for MRI employed at one institution were predictive.

  11. Clinical and radiographic evaluation of one- and two-visit endodontic treatment of asymptomatic necrotic teeth with apical periodontitis: a randomized clinical trial.

    Science.gov (United States)

    Molander, Anders; Warfvinge, Johan; Reit, Claes; Kvist, Thomas

    2007-10-01

    The present investigation recorded the 2-year clinical and radiographic outcome of one- and two visit endodontic treatment and studied the significance of the bacteriologic sampling results on the outcome. A randomization procedure allocated 53 teeth to one-visit treatment and 48 teeth to two-visit treatment. At the end of the study period, 32 teeth (65%) in the one-visit group and 30 teeth (75%) in the two-visit group were classified as healed. The statistical analysis of the healing results did not show any significant difference between the groups (p = 0.75). Forty-nine (80%) of the 61 teeth that were obturated after a negative micobiologic sample were classified as healed. Teeth sealed after positive samples healed in 44%. The present study gave evidence that similar healing results might be obtained through one- and two-visit antimicrobial treatment.

  12. Concordance Rates of Adolescent Idiopathic Scoliosis in a Danish Twin Population

    DEFF Research Database (Denmark)

    Simony, Ane; Carreon, Leah Y; Højmark, Karen

    2016-01-01

    STUDY DESIGN: Clinical, radiological and genetic determination of zygosity of twin pairs from the Danish Twin Registry who self-reported having Adolescent Idiopathic Scoliosis (AIS). OBJECTIVE: To establish concordance rates of AIS. SUMMARY OF BACKGROUND DATA: The aetiology of and the true mode...... reported. METHODS: All 46,418 twins registered in the Danish Twin Registry born from 1931 to 1982 were sent a survey, which included questions about scoliosis. The survey was returned by 34,944 individuals (75.3%) representing 23,204 pairs. From this study, 548 individuals representing 274 complete twin...... pairs where at least one twin self-reported having scoliosis were invited to a clinical and radiological examination. Zygosity was established by genetic testing. RESULTS: 182 individuals (33.2%) of the original cohort agreed to participate, 128 of whom had scoliosis by self-report. There were 91 twin...

  13. Clinical e radiographic sucess of indirect pulp capping with partial excavation of demineralization dentin in primary posterior teeth

    Directory of Open Access Journals (Sweden)

    Roberta Francisca Martins de Castro

    2009-10-01

    Full Text Available Objective: To assess the outcome of the indirect pulp capping technique after incomplete excavation of the demineralized dentin in primary molars of patients treated in the period from 2004 to 2006.Methods: Sample consisted of 81 teeth of 36 patients aged from 1-to-8 year-old. Clinical and radiographic inclusion criteria, as well as criteria of the success of the evaluated treatments were established.Results: There were four (4.9% failures and 77 (95.1% successful treatments. Treatment failure occurred in three girls and in one boy, and no statistically significant difference (p=0.341 was found. Twenty three teeth were treated with resin-modified glass-ionomer cement and 58 with composite resin, of which 22 and 55, respectively, showed successful results. There was no statistically significant difference between restorative materials used (p=0.877. As regards the studied age group, patients aged from 1 to 4 years showed a significantly lower success rate when compared with 5-8 year-old children (p = 0.0428. Conclusion: The results suggest that the indirect pulp capping technique after incomplete excavation of demineralized dentin is a reliable technique to be adopted in deep lesions of primary teeth.

  14. Characteristics and determinants of clinical symptoms in radiographic lumbar spinal stenosis in a tertiary health care centre in sub-Saharan Africa.

    Science.gov (United States)

    Doualla-Bija, Marie; Takang, Mbeng Ashu; Mankaa, Emmanuella; Moutchia, Jude; Ongolo-Zogo, Pierre; Luma-Namme, Henry

    2017-11-28

    Lumbar spinal stenosis (LSS) refers to narrowing of the lumbar central spinal canal, lateral recess, and/or neuro-foramina. Radiographic LSS plays an important role in clinical LSS but is not solely accountable for the presence of symptoms. We sought to characterise clinical LSS and to determine factors associated with presence of symptoms of LSS in patients with radiographic LSS in a sub Saharan Africa setting. After prior ethical clearance, a case control study was done in a tertiary hospital in Douala-Cameroon, including 105 patients with radiographic LSS: 57 with symptoms of LSS (cases) and 58 with no symptoms (controls). Spinal stenosis was assessed using computed tomography (CT) scans. Data were analysed using SPSS version 23. The mean age of our study participants was 53.4 ± 13.1 years. The mean age of onset of symptoms of LSS was 50.3 ± 11.6 years and the most common symptoms were Low back pain (100.0%), radicular symptoms (98.2%) and neurogenic claudication (98.2%). Obesity (p history of low back pain (p = 0.004), vertebra lesion at L2 (p = 0.034), L3 (p = 0.002), L4 (p = 0.025) and multiple (p = 0.008) levels, degenerative disc protrusion (p = 0.044), disc lesion at L3-L4 (p = 0.001), L4-L5 (p = 0.011) and multiple (p = 0.046) levels were significantly associated with presence of symptoms of LSS in persons with radiographic LSS. Characteristics of clinical LSS have been described in this sub-Saharan Africa population. Obesity, a high waist circumference and a positive family history of low back pain are significantly associated with presence of symptoms of LSS in persons with radiographic LSS.

  15. FIRST METATARSOPHALANGEAL JOINT OSTEOARTHRITIS: PERCUTANEOUS SURGERY, CHOICE OF A SURGICAL PROCEDURE, CLINICAL AND RADIOGRAPHIC CLASSIFICATION

    Directory of Open Access Journals (Sweden)

    S. Yu. Berezhnoy

    2017-01-01

    Full Text Available Introduction. Hallux rigidus is observed in approximately 2.5% of the adult population. Until now neither a unified classification of hallux rigidus appears to exist nor any clear principles to choose the surgical method. The variety of clinical and radiological signs explains the difficulties in establishing a comprehensive classification system and in selection of the criteria for surgical procedure. There are few published reports about hallux rigidus percutaneous surgical treatment. Existing papers are dedicated to a limited number of percutaneous techniques.The purpose of this study was to evaluate the efficacy of percutaneous techniques for surgical treatment of the first metatarsophalangeal joint osteoarthritis; to specify factors determining the choice of procedure; to develop a grading system of the hallux rigidus severity which will help in selection of surgery. Materials and methods. Based on 156 surgeries (107 patients the author demonstrated the possibilities of percutaneous techniques in the surgical treatment of hallux rigidus of different stages as well as provided a brief description of used surgical techniques.Results. The mean age of patients was 48.8 years (ranged from 18 to 73. The mean follow-up was 7 months (ranged from 3 to 54. At the specified time the treatment outcomes of 103 patients (150 feet were analyzed. Mean hospital stay was 0.78 days (ranged from 0 to 1. No infectious or wound-healing problems were observed. Overall, the patients were completely satisfied with the outcomes of 89 surgical treatment, qualified satisfaction was reported with patients in respect of outcomes of 57 surgeries. Four unsatisfactory outcomes were observed. The role of the relatively long first metatarsal in the development of hallux rigidus was confirmed. Conclusion. Percutaneous techniques provide successful treatment for all stages of hallux rigidus. The choice of a specific surgical technique may be challenging and requires

  16. Clinical relevance and prognostic value of radiographic findings in Zenker's diverticulum.

    Science.gov (United States)

    Mantsopoulos, Konstantinos; Psychogios, Georgios; Karatzanis, Alexander; Künzel, Julian; Lell, Michael; Zenk, Johannes; Koch, Michael

    2014-03-01

    The aim of this study was to evaluate the clinical relevance and prognostic value of preoperative and postoperative oesophagography in patients with Zenker's diverticulum. The medical records of 155 patients who underwent surgical treatment (with an endoscopic or transcervical approach) for Zenker's diverticulum between 1992 and 2010 in a tertiary referral centre were retrospectively evaluated. The size of the diverticula on oesophagography, recognizable muscular septum, and protection of the diverticulum were assessed relative to the surgical procedures performed. The incidence of diverticular remnants on postoperative oesophagography was also assessed relative to the surgical procedure. It was investigated whether the detection of a residual pharyngeal pouch and filling of it with contrast medium were related to the patients' immediate postoperative symptoms and the development of symptomatic recurrence. Larger diverticula (Brombart III-IV) were manageable significantly more often with endoscopic procedures (P = 0.007). Residual diverticulum and filling with contrast medium were strongly associated with prolonged dysphagia immediately postoperatively (P = 0.005 and P = 0.009, respectively). However, these parameters failed to correlate significantly with a symptomatic recurrence. Preoperative oesophagography proved to be extremely important for surgical planning, with the surgeon's personal preference seeming to be the driving indicator in many cases. Postoperative oesophagography is only useful for excluding postoperative complications in the immediate postoperative phase and did not have a prognostic value as to a recurrence of the disease.

  17. A Novel Proforma for Clinical and Radiographic Evaluation of Impacted Third Molars Prior to Surgical Removal

    Directory of Open Access Journals (Sweden)

    Dhuvad Jigar M

    2017-02-01

    Full Text Available Background: Dental surgeons and resident doctors of oral surgery who encounter the complex situation during the third molar removal, such as those in unexpected areas, often have limited resources to provide a structured care. Therefore, there is always a need for simple, easy to memorize, situate into practice, comprehensive and cost-effective “Proforma of third molar evaluation” required. Objective: The purpose of this paper was to facilitate the residents of oral and maxillofacial surgery and the dentists throughout their preliminary phase, by organizing the comprehensive proforma for evaluating upper and lower wisdom tooth impactions, access and anticipate the difficulty, judge intraoperative tribulations they might encounter and hence, prepare an appropriate treatment plan. Materials and methods: The available literature relevant to oral and maxillofacial surgery in online database of the United States National Library of Medicine: PubMed (http://www. ncbi.nlm.nih.gov/pubmed/ was investigated. The inclusion criterion was to review the published clinical papers, abstracts, and evidence based reviews on “Preoperative Evaluation of Impacted Third Molar”. Results: Thirty-six articles found with the search term “Preoperative Evaluation of Impacted Third Molar” in the literature were searched. Thirteen articles met the inclusion criteria for the study. The relevant data extracted and discussed. Conclusion: The advantages of the proforma uses were reported for inpatient care with correct diagnosis, treatment, follow up and prevention of the any superfluous complications further and improved the quality of patient care.

  18. A Retrospective Analysis of the Clinical Impact of 939 Chest Radiographs Using the Medical Records

    International Nuclear Information System (INIS)

    Geijer, M.; Ivarsson, L.; Gothlin, J.H.

    2012-01-01

    Objective. Between one-third and half of all radiology examinations worldwide are probably chest studies. The aim of the current study was to retrospectively evaluate the clinical influence of chest radiography. Methods. In a tertiary referral hospital, 939 consecutive daytime chest radiography examinations were evaluated. The outcome was classified as normal, incidental, or pathologic. The referring physicians reaction to radiologic outcome was classified as highly expected, moderately expected, or unexpected. The influence on the patients' treatment was divided into four groups from major to no influence. Results. In all, 71.6% of the studies had a highly expected outcome. Moderately expected or unexpected outcomes were noted in 36.6% of 500 pathologic examinations. Unexpected outcome was noted in 11.6% of all studies. The radiologic outcome influenced treatment in 65.4% of patients where pathology was demonstrated. Patients with normal or incidental findings had treatment influenced in 1/3 of the cases. Unexpected findings influenced treatment more than moderately expected findings. When radiological findings were highly expected, treatment was influenced in less than half of the cases. Surprisingly few chest radiology examinations were commented upon in the medical records

  19. A meta-analysis of clinical and radiographic outcomes of posterior horn medial meniscus root repairs.

    Science.gov (United States)

    Chung, Kyu Sung; Ha, Jeong Ku; Ra, Ho Jong; Kim, Jin Goo

    2016-05-01

    Although interest in medial meniscus posterior root tear (MMPRT) repair has increased, few case series have been reported. This meta-analysis aimed to examine the clinical and radiological effects of MMPRT repair by pooling pre- and post-operative data from case-series reports. A literature search was performed using MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE databases. Pre- and post-operative data were pooled to investigate the effects of MMPRT repair, including the Lysholm score improvement, meniscal extrusion (mm) reduction, progression of the Kellgren-Lawrence (K-L) grade, and cartilage status according to the Outerbridge classification. Treatment effects included paired standardized mean differences (difference in the pre- and post-operative mean outcomes divided by the standard deviation) for the Lysholm score and meniscal extrusion, as well as the pooled event rates of progression of K-L grade and cartilage status. As treatment effects, the Lysholm score increased by as much as 3.675 (P meniscus extrusion was not reduced (n.s.). The overall pooled event rates of progression of K-L grade and cartilage status were 10.6 and 17.3 % (P meniscus extrusion was not reduced. Considering the occurrence of progression of K-L grade and cartilage status, it did not prevent the progression of arthrosis completely. Based on these results, repair results in favourable outcomes for MMPRT. Meta-analysis, Level IV.

  20. Adolescent idiopathic scoliosis patients report increased pain at five years compared with two years after surgical treatment.

    Science.gov (United States)

    Upasani, Vidyadhar V; Caltoum, Christine; Petcharaporn, Maty; Bastrom, Tracey P; Pawelek, Jeff B; Betz, Randal R; Clements, David H; Lenke, Lawrence G; Lowe, Thomas G; Newton, Peter O

    2008-05-01

    A multicenter study of changes in Scoliosis Research Society (SRS) outcome measures after surgical treatment of adolescent idiopathic scoliosis (AIS). To evaluate changes in patient determined outcome measures between 2 and 5 years after AIS surgery. Current surgical procedures have been shown to improve subjective measures in patients with AIS. At 2-year follow-up, AIS patients reported significant improvement in all 4 preoperative domains of the SRS questionnaire. In addition, the major Cobb angle was shown to be negatively correlated with preoperative scores in the pain, general self-image, and general function domains. Five-year SRS scores have not been evaluated previously. A multicenter, prospectively generated database was used to obtain perioperative, radiographic, and SRS-24 outcomes data. The inclusion criteria were: a diagnosis of AIS, surgical treatment (anterior, posterior, or combined), a comprehensive set of radiographic measures, and completed preoperative, 2-year, and 5-year SRS questionnaires. Repeated measures analysis of variance was used to compare changes in patient responses for each of the 7 outcome domains. Univariate analysis of variance was used to compare the change in pain score at 5 years to the level of the lowest instrumented vertebrae and surgical approach. A correlation analysis was used to determine the association between changes in any of the radiographic variables and changes in SRS scores. The data were checked for normality and equal variances, and the level of significance was set at P < 0.01. Forty-nine patients (42 women, 7 men; 14.2 +/- 2.1 year old; 5.4 +/- 0.6 years follow-up) met the inclusion criteria for this study. Thirty-seven of 49 (76%) of these patients underwent an open or thoracoscopic anterior procedure. SRS-24 scores improved significantly in 3 of the 4 preoperative domains at the 2-year visit. At 5 years postop, a statistically significant decrease in the pain score (4.2 +/- 0.6 to 3.9 +/- 0.9, P = 0

  1. The use of guided tissue regeneration principles in endodontic surgery for induced chronic periodontic-endodontic lesions: a clinical, radiographic, and histologic evaluation.

    Science.gov (United States)

    Britain, Steven K; Arx, Thomas von; Schenk, Robert K; Buser, Daniel; Nummikoski, Pirkka; Cochran, David L

    2005-03-01

    Chronic periodontic-endodontic lesions are not uncommon in clinical practice and their regenerative capacity has long been questioned. However, there are no published studies investigating the application of guided tissue regeneration techniques in combination with endodontic surgery using an induced perio-endo defect model. This study evaluated the clinical, radiographic, and histologic outcomes of three surgical procedures used to treat induced perio-endo lesions. Pulpal necrosis was induced in foxhounds along with surgical removal of radicular buccal bone. After 4 weeks, chronic lesions were clinically and radiographically assessed. Treatment surgery consisted of apicoectomy, root canal instrumentation, and retrofilling with mineral trioxide aggregate. Teeth were then assigned to one of the following treatment groups: open flap debridement only (OFD), OFD with bioabsorbable porcine-derived collagen membrane (BG), or OFD with BG and anorganic bovine bone matrix (BO/BG). Clinical parameters and standardized radiographs were assessed at defect creation; treatment surgery; and at 1, 2, 4, and 6 months. Animals were sacrificed at 6 months and specimens prepared for histometric analysis. Clinical and radiographic conditions improved during the study period. Mean epithelial attachment was similar between all groups. Mean connective tissue attachment for groups OFD, BG, and BO/BG was 3.79 mm, 2.63 mm, and 1.75 mm, respectively, and mean radicular bone height was 2.16 mm, 3.24 mm, and 3.45 mm, respectively. Statistically significant increases in the amount of new cementum were observed in groups BG and BO/BG when compared with OFD (P periodontal ligament, and significant increases in the amount of new cementum when compared to open flap debridement in a canine model.

  2. Bone marrow edema pattern in advanced hip osteoarthritis: quantitative assessment with magnetic resonance imaging and correlation with clinical examination, radiographic findings, and histopathology

    International Nuclear Information System (INIS)

    Taljanovic, Mihra S.; Schwartz, Stephanie A.; Graham, Anna R.; Benjamin, James B.; Gmitro, Arthur F.; Krupinski, Elizabeth A.; Hunter, Tim B.; Resnick, Donald L.

    2008-01-01

    To correlate the amount of bone marrow edema (BME) calculated by magnetic resonance imaging(MRI) with clinical findings, histopathology, and radiographic findings, in patients with advanced hip osteoarthritis(OA). The study was approved by The Institutional Human Subject Protection Committee. Coronal MRI of hips was acquired in 19 patients who underwent hip replacement. A spin echo (SE) sequence with four echoes and separate fast spin echo (FSE) proton density (PD)-weighted SE sequences of fat (F) and water (W) were acquired with water and fat suppression, respectively. T2 and water:fat ratio calculations were made for the outlined regions of interest. The calculated MRI values were correlated with the clinical, radiographic, and histopathologic findings. Analyses of variance were done on the MRI data for W/(W + F) and for T2 values (total and focal values) for the symptomatic and contralateral hips. The values were significantly higher in the study group. Statistically significant correlations were found between pain and total W/(W + F), pain and focal T2 values, and the number of microfractures and calculated BME for the focal W/(W + F) in the proximal femora. Statistically significant correlations were found between the radiographic findings and MRI values for total W/(W + F), focal W/(W + F) and focal T2 and among the radiographic findings, pain, and hip movement. On histopathology, only a small amount of BME was seen in eight proximal femora. The amount of BME in the OA hip, as measured by MRI, correlates with the severity of pain, radiographic findings, and number of microfractures. (orig.)

  3. Idiopathic Scoliosis from Psychopathological and Mind-Body Medicine Perspectives.

    Science.gov (United States)

    Talić, Goran; Ostojić, Ljerka; Bursać, Snježana Novaković; Nožica-Radulović, Tatjana; Stevanović-Papić, Đurđica

    2016-12-01

    Idiopathic scoliosis, defined as a three-dimensional spine and trunk deformity, which appears in otherwise healthy subjects, exhibits complex relations with various forms of personal well-being and psychopathology. Most research studies have documented a higher proportion of psychological disturbances (e.g., self-criticism, negative body image, low self-esteem) and mental disorders (e.g., anxiety and depressive disorders, personality disorders) among idiopathc scoliosis patients compared to healthy controls. In addition, there are some reports, although more systematic research is warranted, on the role of mental health and personality traits in relation to the adherence to conservative treatment. Given the increasing role of surgical treatment in the management of scoliosis, as well as several reports on negative psychological outcomes of such interventions, there is a growing need for ongoing screening and mental health care in this population. It seems this also holds true for non-operative treatments, particularly bracing therapy. One should keep in mind that these scoliosis-psychopathology relations are deduced from a limited number of empirical studies, usually conducted on small sample sizes, suggesting the need for further large-scale investigations, preferrably those with longitudinal research designs. Understanding the complex interplay between personality/psychopathology and spinal deformities within the framework of personalized mind-body medicine, should help clinicians tailor more individualized and specific treatments and predict therapeutic outcomes in this clinical population.

  4. Animal radiographs

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    This chapter presents historical x rays of a wide variety of animals taken within 5 years of the discovery of x radiation. Such photos were used as tests or as illustrations for radiographic publications. Numerous historical photographs are included. 10 refs

  5. Prevalence, Characteristics, and Complications of Supernumerary Teeth in Nonsyndromic Pediatric Population of South India: A Clinical and Radiographic Study.

    Science.gov (United States)

    Syriac, Gibi; Joseph, Elizabeth; Rupesh, S; Philip, John; Cherian, Sunu Alice; Mathew, Josey

    2017-11-01

    Supernumerary teeth are the presence of more number of teeth over the normal dental formula and may occur in permanent as well as early mixed dentition. This study determined the prevalence, characteristics, and complications caused by supernumerary teeth in nonsyndromic South Indian pediatric population. Characteristics of supernumerary teeth determined by clinical and radiographic examination were recorded. The age, sex, number of supernumerary teeth, eruption status, morphology, position, orientation, and complications (if any) associated with supernumerary teeth were recorded for each patient who had supernumerary teeth. The data collected were statistically analyzed. Supernumerary teeth were detected in 45 subjects (1.1%), of which 34 (75.6%) were male and 11 (24.4%) were female. There was no association between the number of supernumerary teeth and the gender of the patient. The total number of supernumerary teeth among the affected 45 patients was 54. The average number of supernumerary teeth per person was 1.2. The number of supernumerary teeth was one in 35 cases, two in 8 cases, and 3 in 1 case. Of the 45 patients, 8 patients with supernumerary teeth were in deciduous dentition stage, 29 patients were in mixed dentition stage, and 8 patients were in permanent dentition stage. Most supernumerary teeth presented in the anterior maxilla. Morphologically, conical-shaped supernumerary teeth were the most common finding. 68.5% of supernumerary teeth presented with straight orientation and inverted orientation was seen in 24.1%. Complications seen in patients with supernumerary teeth were delayed or noneruption of adjacent tooth malposition or rotation of adjacent teeth, diastema formation, and formation of dentigerous cyst. Supernumerary teeth have an incidence of 1.1% in South Indian population and can cause many complications that can harm the developing occlusion. Knowledge about supernumerary teeth may help the dentist in early diagnosis and early

  6. Clinical, radiographic, and histological observation of a human immature permanent tooth with chronic apical abscess after revitalization treatment.

    Science.gov (United States)

    Shimizu, Emi; Ricucci, Domenico; Albert, Jeffrey; Alobaid, Adel S; Gibbs, Jennifer L; Huang, George T-J; Lin, Louis M

    2013-08-01

    Revitalization procedures have been widely used for the treatment of immature permanent teeth with apical periodontitis. The treatment procedures appear to be capable of encouraging continued root development and thickening of the canal walls. The nature of tissues formed in the canal space and at the root apex after revitalization has been shown histologically in several animal studies; similar studies in humans were recently reported. A 9-year-old boy had a traumatic injury to his upper anterior teeth. Tooth #9 suffered a complicated crown fracture with a pulp exposure, which was restored with a composite resin. The tooth developed a chronic apical abscess. Revitalization procedures were performed on tooth #9 because it was an immature permanent tooth with an open apex and thin canal walls. Twenty-six months after revitalization, the tooth had a horizontal crown fracture at the cervical level and could not be restored. The tooth was extracted and processed for routine histological and immunohistochemical examination to identify the nature of tissues formed in the canal space. Clinically and radiographically, the revitalization of the present case was successful because of the absence of signs and symptoms and the resolution of periapical lesion as well as thickening of the canal walls and continued root development. The tissue formed in the canal was well-mineralized cementum- or bone-like tissue identified by routine histology and immunohistochemistry. No pulp-like tissue characterized by the presence of polarized odontoblast-like cells aligning dentin-like hard tissue was observed. The tissues formed in the canal of revitalized human tooth are similar to cementum- or bone-like tissue and fibrous connective tissue. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  7. Evaluation of 316 narrow diameter implants followed for 5-10 years: a clinical and radiographic retrospective study.

    Science.gov (United States)

    Arisan, Volkan; Bölükbaşi, Nilüfer; Ersanli, Selim; Ozdemir, Tayfun

    2010-03-01

    Narrow diameter implants (NDIs; diameter >3.75 mm) are useful in replacement of missing incisor teeth and when the bucco-lingual width of the edentulous crest is insufficient. The present study evaluated the success and survival rates, peri-implant parameters, mechanical and prosthetic post-loading complications of NDIs followed over a 10-year period. Three hundred and sixteen NDIs were inserted into 139 patients and restored with 120 prostheses. Clinical and radiographic assessment data were collected during recall visits. Implant success (SC), cumulative survival rate (CSR), marginal bone loss (MBL), peri-implant conditions and prosthetic complications were assessed. Cox proportional hazards regression analysis, Kaplan-Meier survival curves with the log-rank test and life table analysis were used to evaluate the outcome of NDIs within comparable subgroups. MBL and peri-implant parameters measured annually were further analyzed. The mean follow-up time was 9.1 years (range: 60-124 months). Twelve implants were lost in the healing phase and two during function. The mean MBL in the maxilla and the mandible was 1.32 +/- 0.13 and 1.28 +/- 0.3 mm, respectively, after 10 years. SC and CSR were 91.4% and 92.3%, respectively, after 124 months. Smoking and posterior localization were associated with an increased risk of failure. Cement loosening (16.8%) was the most common prosthetic complication. No implants were fractured. NDIs can be used with confidence where a regular diameter implant is not suitable. MBL around NDIs occurred predominantly within 2 years of loading and was minimal thereafter. Further studies are required to clarify the possible risks associated with smoking and posterior placement.

  8. Clinical results of free-hand pedicle screw placement by the palpation of lateral wall of pedicle (PLP) method for scoliosis surgery

    International Nuclear Information System (INIS)

    Oyama, Motohiko; Shimizu, Takachika; Fueki, Keisuke; Ino, Masatake; Toda, Naofumi; Tanouti, Tetu; Tatara, Yasunori; Manabe, Nodoka

    2011-01-01

    The purpose of this study was to evaluate the accuracy of thoracic pedicle screw (TPS) placement by the palpation of the lateral wall of the pedicle (PLP) method. The subjects of this study were 45 scoliosis patients. The accuracy of TPS placement was evaluated by postoperative CT. Of the 348 TPSs inserted, 26 (7.5%) breached the pedicle wall. Of the 26 misplaced screws, 20 were inserted on the wrong trajectory, and 6 were inserted at the wrong insertion point. The preoperative major Cobb angle averaged 70.4 deg in the group with pedicle perforation by the TPS, and 54.1 deg in the group with correct placement of the TPS (p=0.006). No intra- or post-operative complications developed as a result of the pedicle perforation. The PLP method is useful in deciding on the correct insertion point, but it is of no assistance in inserting screws along the correct trajectory. This, it will be necessary to improve the technique of determining the correct trajectory for the TPS. (author)

  9. Computed tomography for radiographers

    International Nuclear Information System (INIS)

    Brooker, M.J.

    1986-01-01

    This book is directed towards giving radiographers an introduction to and basic knowledge of computerized tomography. The technical section discusses gantries and x-ray production, computer and disc drive image display, storage, artefacts quality assurance and design of departments. The clinical section includes patient preparation, radiotherapy planning, and interpretation of images from various areas of the anatomy. (U.K.)

  10. Development and assessment of a digital X-ray software tool to determine vertebral rotation in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Eijgenraam, Susanne M; Boselie, Toon F M; Sieben, Judith M; Bastiaenen, Caroline H G; Willems, Paul C; Arts, Jacobus J; Lataster, Arno

    2017-02-01

    The amount of vertebral rotation in the axial plane is of key importance in the prognosis and treatment of adolescent idiopathic scoliosis (AIS). Current methods to determine vertebral rotation are either designed for use in analogue plain radiographs and not useful in digital images, or lack measurement precision and are therefore less suitable for the follow-up of rotation in AIS patients. This study aimed to develop a digital X-ray software tool with high measurement precision to determine vertebral rotation in AIS, and to assess its (concurrent) validity and reliability. In this study a combination of basic science and reliability methodology applied in both laboratory and clinical settings was used. Software was developed using the algorithm of the Perdriolle torsion meter for analogue AP plain radiographs of the spine. Software was then assessed for (1) concurrent validity and (2) intra- and interobserver reliability. Plain radiographs of both human cadaver vertebrae and outpatient AIS patients were used. Concurrent validity was measured by two independent observers, both experienced in the assessment of plain radiographs. Reliability-measurements were performed by three independent spine surgeons. Pearson correlation of the software compared with the analogue Perdriolle torsion meter for mid-thoracic vertebrae was 0.98, for low-thoracic vertebrae 0.97 and for lumbar vertebrae 0.97. Measurement exactness of the software was within 5° in 62% of cases and within 10° in 97% of cases. Intraclass correlation coefficient (ICC) for inter-observer reliability was 0.92 (0.91-0.95), ICC for intra-observer reliability was 0.96 (0.94-0.97). We developed a digital X-ray software tool to determine vertebral rotation in AIS with a substantial concurrent validity and reliability, which may be useful for the follow-up of vertebral rotation in AIS patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. What's New in Congenital Scoliosis?

    Science.gov (United States)

    Pahys, Joshua M; Guille, James T

    2018-03-01

    Congenital scoliosis is a failure of vertebral formation, segmentation, or a combination of the 2 arising from abnormal vertebral development during weeks 4 to 6 of gestation. The associated spinal deformity can be of varying severity and result in a stable or progressive deformity based on the type and location of the anomalous vertebra(e). Bracing for congenital scoliosis is rarely indicated, while recent reports have demonstrated the utility of serial derotational casting for longer curves with multiple anomalous vertebrae as an effective "time buying strategy" to delay the need for surgery. Earlier hemivertebra excision and short-segment posterior spinal fusion have been advocated to prevent future curve progression of the deformity and/or the development of large compensatory curves. It has been shown in recent long-term follow-up studies that growth rates of the vertebral body and spinal canal are not as dramatically affected by pedicle screw instrumentation at a young age as once thought. Growth friendly surgery with either spine-based or rib-based anchors has demonstrated good results with curve correction while maintaining spinal growth. Rib-based anchors are typically more commonly indicated in the setting of chest wall abnormalities and/or when spinal anatomy precludes placement of spinal instrumentation. Recently, magnetically controlled growing rods have shown promising results in several studies that include a small subset of congenital scoliosis cases. A literature search was performed to identify existing studies related to the treatment of congenital scoliosis published from January 1, 2005 to June 1, 2016. Databases included PubMed, Medline, and the Cochrane Library. The search was limited to English articles and yielded 36 papers. This project was initiated by the Pediatric Orthopaedic Society of North America Publications Committee and was reviewed and approved by the Pediatric Orthopaedic Society of North America Presidential Line. A total of

  12. Congenital scoliosis in monozygotic twins: case report and review of possible factors contributing to its development

    Directory of Open Access Journals (Sweden)

    Weiss Hans-Rudolf

    2008-11-01

    Full Text Available Abstract Background The exact etiology of congenital scoliosis remains unknown as yet. It seems that its development may be influenced by both genetic predisposition and environmental factors, at varying degrees. International bibliography features few cases of monozygotic twins with congenital scoliosis. The aim of this study is to report a case in monozygotic twins and review the literature relating to the description of similar cases as well as the pathophysiological mechanism involved in its development. Methods Clinical examination and simple X-rays revealed scoliosis of differing degrees and types in male monozygotic twins with moderate mental retardation and dyslalia. Results Congenital scoliosis identified in both twins. In the first, this was manifested as left thoracic scoliosis, with Cobb angle of 34 degrees while in the second as left thoracolumbar scoliosis with Cobb angle of 10 degrees. Both were found to suffer from incarcerated hemivertebrae. Conclusion According to both its clinical identification and severity and to its course, not only the genetic but the environmental factors seem to play a leading role in the appearance of the condition.

  13. Total spine and posterior fossa MRI screening in adolescent idiopathic scoliosis (177 cases

    Directory of Open Access Journals (Sweden)

    MR Etemadifar

    2005-05-01

    Full Text Available Background: MRI screening for idiopathic scoliosis is controversial. Considering our clinical experiences, the results of MRI in all patients with idiopathic scoliosis were evaluated. Methods: In a prospective clinical study, all neurologically normal patients with idiopathic scoliosis screened by posterior fossa and total spine MRI. Results: After excluding 9 patients for mild neurological findings, in other 177 patients (132 female, 45 male, the average age and curve angle was 15±2 years and 59±17º (30 to 135º, respectively. Convexity was to right in 146 and to left in 31 cases. MRI was positive in 12 cases (6.8%. In 5 cases (2.8%, neurosurgical intervention was necessary prior to scoliosis surgery. There was no relation between age, sex, presence of pain or curve angle and positive MRI findings (P>0.05. Left convexity was significantly related to positive MRI findings (P=0.013. In males with left convex curves, the probability of positive MRI findings was 8.8 folds other patients. Conclusion: Considering our results and other reported articles, it seems that routine MRI screening of all patients presenting as idiopathic scoliosis is necessary for detection of underlying pathologies. Key words: Idiopathic Scoliosis, MRI, Spine Syrinx, Chiari

  14. Pre- and postoperative photographs and surgical outcomes in patients with Lenke type 1 adolescent idiopathic scoliosis.

    Science.gov (United States)

    Albayrak, Akif; Buyuk, Abdul Fettah; Ucpunar, Hanifi; Balioglu, Mehmet Bulent; Kargin, Deniz; Kaygusuz, Mehmet Akif

    2015-04-01

    Clinical study with pre- and postoperative back photographs and postoperative Scoliosis Research Society-22 survey in patients who had undergone surgery for idiopathic scoliosis. To determine the effect of showing patients their photographs before and after surgery for idiopathic scoliosis on postoperative patient satisfaction. After scoliosis surgery, patient satisfaction may be limited because the patients cannot directly see their back and may forget the preoperative appearance. In 60 patients who had undergone surgery for correction of idiopathic scoliosis (Lenke type 1), pre- and postoperative photographs were taken from the anterior, posterior, and right and left lateral views. After surgery, patients in group 1 (30 patients) were shown the preoperative and most recent follow-up photographs, and patients in group 2 (30 patients) had routine evaluation but were not shown their photographs. All patients completed the Scoliosis Research Society-22 survey. Patients in both groups had similar age, sex, distribution of Lenke type and Risser sign, follow-up, and pre- and postoperative Cobb angles and balance (coronal and sagittal). A significant difference was observed between the groups for survey question 10 (which was about self-image), question 18 (which was about function and activity), and question 21 (which was about satisfaction) (P ≤ 0.05). There were no differences between patients in groups 1 and 2 in Scoliosis Research Society-22 domain or total scores. By showing patients the pre- and postoperative clinical photographs, patient satisfaction may be greater, as measured with some SRS-22 scores. This method may enable clinicians to positively change the patients' self-image perception after surgery for correction of scoliosis. 4.

  15. Two-Dimensional Image Fusion of Planar Bone Scintigraphy and Radiographs in Patients with Clinical Scaphoid Fracture: An Imaging Study

    DEFF Research Database (Denmark)

    Henriksen, O.M.; Lonsdale, M.N.; Jensen, T.D.

    2008-01-01

    . Bone scintigraphy is highly sensitive for the detection of fractures, but exact localization of scintigraphic lesions may be difficult and can negatively affect diagnostic accuracy. Purpose: To investigate the influence of image fusion of planar bone scintigraphy and radiographs on image interpretation......Background: Although magnetic resonance imaging (MRI) is now considered the gold standard in second-line imaging of patients with suspected scaphoid fracture and negative radiographs, bone scintigraphy can be used in patients with pacemakers, metallic implants, or other contraindications to MRI....... Conclusion: Image fusion of planar bone scintigrams and radiographs has a significant influence on image interpretation and increases both diagnostic confidence and interobserver agreement Udgivelsesdato: 2008/12/3...

  16. Development of a non-fusion scoliosis correction device. Numerical modelling of scoliosis correction.

    NARCIS (Netherlands)

    Meijer, Gerdine

    2011-01-01

    Scoliosis is a three-dimensional deformity of the spine and trunk, comprising of a lateral deviation and an axial rotation. Severe scoliosis is mostly seen in girls and is often detected during adolescence. Without treatment, scoliosis progression can lead to a life-threatening situation because the

  17. Systematic review and meta-analysis of the value of clinical features to exclude radiographic pneumonia in febrile neutropenic episodes in children and young people.

    Science.gov (United States)

    Phillips, Bob; Wade, Ros; Westwood, Marie; Riley, Richard; Sutton, Alex J

    2012-08-01

      Children and young people who present with febrile neutropenia (FNP) secondary to malignancies or their treatment frequently do not undergo routine chest radiography. With shorter courses of antibiotic therapy, failure to recognise pneumonia and consequent under-treatment could produce significant problems.   The review was conducted determine the value of the absence of clinical features of lower respiratory tract infection in excluding radiographic pneumonia at presentation of FNP using Centre for Reviews and Dissemination methods. It was registered with the HTA Registry of systematic reviews, CRD32009100453. Ten bibliographic databases, conference proceedings, reference lists and citations were searched. Cohort studies which compared clinical examination to radiographic findings were included. Results were summarised by random-effects meta-analysis.   Four studies were included. Synthesis of the three higher-quality studies gave imprecise estimates of the average sensitivity (75%; 95% CI 52% to 89%) and average specificity (69%; 95% CI 57% to 78%) for clinical examination in the detection of radiographic pneumonia. If the prevalence of pneumonia is 5%, these estimates produce a negative predictive value of 98% (95% CI 96% to 99%). Alternatively, there remains a 1.9% probability of pneumonia (95% CI 0.7% to 4.2%).   Signs and symptoms of lower respiratory infection have only moderate sensitivity and specificity for pneumonia; the low prevalence of the condition justifies the routine withholding of chest radiographs. However, for those with a predisposition to pneumonia, or re-presenting after a short course of antibiotic therapy, a chest X-ray should be performed despite an absence of signs. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  18. Cardiopulmonary Exercise Testing in Patients with Idiopathic Scoliosis.

    Science.gov (United States)

    Shen, Jianxiong; Lin, Youxi; Luo, Jinmei; Xiao, Yi

    2016-10-05

    Scoliosis causes impairment of the respiratory and cardiovascular systems. Traditional pulmonary function tests only examine patients under static conditions. The aim of our study was to investigate the correlation between radiographic parameters and dynamic cardiopulmonary capacity in patients with idiopathic scoliosis. Forty patients with idiopathic scoliosis were included in this prospective study from January 2014 to February 2016. The patients underwent full radiographic assessment of deformity, pulmonary function testing, and cardiopulmonary bicycle ergometer testing. The impact of the severity of thoracic curvature and kyphosis on pulmonary function and physical capacity was investigated. Thirty-three female patients with a mean age of 15.5 years (range, 11 to 35 years) and coronal thoracic curvature of 49.4° (range, 24° to 76°) and 7 male subjects with a mean age of 15.9 years (range, 13 to 18 years) and coronal thoracic curvature of 47.1°(range, 22° to 80°) were included. No correlation was found between coronal thoracic curvature and pulmonary function test results in the female patients. Female patients with a thoracic curve of ≥60° had lower blood oxygen saturation at maximal exercise in the cardiopulmonary exercise test (p = 0.032). Female patients with a thoracic curve of ≥50° had a higher respiratory rate (p = 0.041) and ventilation volume per minute (p = 0.046) and lower breathing reserve at maximal exercise (p = 0.038). Thoracic kyphosis in female patients was positively correlated with pulmonary function, as shown by the forced expiratory volume in 1 second (r = 0.456, p = 0.01), forced vital capacity (r = 0.366, p = 0.043), vital capacity (r = 0.525, p = 0.006), and total lung capacity (r = 0.388, p = 0.031), as well as with tidal volume (r = 0.401, p = 0.025) in cardiopulmonary exercise testing. Female patients who engaged in regular exercise had better peak oxygen intake normalized by body weight (p rate (p = 0.020), and heart rate

  19. ISSLS PRIZE IN BIOENGINEERING SCIENCE 2018: dynamic imaging of degenerative spondylolisthesis reveals mid-range dynamic lumbar instability not evident on static clinical radiographs.

    Science.gov (United States)

    Dombrowski, Malcolm E; Rynearson, Bryan; LeVasseur, Clarissa; Adgate, Zach; Donaldson, William F; Lee, Joon Y; Aiyangar, Ameet; Anderst, William J

    2018-04-01

    Degenerative spondylolisthesis (DS) in the setting of symptomatic lumbar spinal stenosis is commonly treated with spinal fusion in addition to decompression with laminectomy. However, recent studies have shown similar clinical outcomes after decompression alone, suggesting that a subset of DS patients may not require spinal fusion. Identification of dynamic instability could prove useful for predicting which patients are at higher risk of post-laminectomy destabilization necessitating fusion. The goal of this study was to determine if static clinical radiographs adequately characterize dynamic instability in patients with lumbar degenerative spondylolisthesis (DS) and to compare the rotational and translational kinematics in vivo during continuous dynamic flexion activity in DS versus asymptomatic age-matched controls. Seven patients with symptomatic single level lumbar DS (6 M, 1 F; 66 ± 5.0 years) and seven age-matched asymptomatic controls (5 M, 2 F age 63.9 ± 6.4 years) underwent biplane radiographic imaging during continuous torso flexion. A volumetric model-based tracking system was used to track each vertebra in the radiographic images using subject-specific 3D bone models from high-resolution computed tomography (CT). In vivo continuous dynamic sagittal rotation (flexion/extension) and AP translation (slip) were calculated and compared to clinical measures of intervertebral flexion/extension and AP translation obtained from standard lateral flexion/extension radiographs. Static clinical radiographs underestimate the degree of AP translation seen on dynamic in vivo imaging (1.0 vs 3.1 mm; p = 0.03). DS patients demonstrated three primary motion patterns compared to a single kinematic pattern in asymptomatic controls when analyzing continuous dynamic in vivo imaging. 3/7 (42%) of patients with DS demonstrated aberrant mid-range motion. Continuous in vivo dynamic imaging in DS reveals a spectrum of aberrant motion with significantly greater

  20. Posterior Surgery for Adolescent Idiopathic Scoliosis With Pedicle Screws and Ultrahigh-Molecular Weight Polyethylene Tape: Achieving the Ideal Thoracic Kyphosis.

    Science.gov (United States)

    Imagama, Shiro; Ito, Zenya; Wakao, Norimitsu; Ando, Kei; Hirano, Kenichi; Tauchi, Ryoji; Muramoto, Akio; Matsui, Hiroki; Matsumoto, Tomohiro; Sakai, Yoshihito; Katayama, Yoshito; Matsuyama, Yukihiro; Ishiguro, Naoki

    2016-10-01

    Prospective clinical case series. To describe our surgical procedure and results for posterior correction and fusion with a hybrid approach using pedicle screws, hooks, and ultrahigh-molecular weight polyethylene tape with direct vertebral rotation (DVR) (the PSTH-DVR procedure) for treatment of adolescent idiopathic scoliosis (AIS) with satisfactory correction in the coronal and sagittal planes. Introduction of segmental pedicle screws in posterior surgery for AIS has facilitated good correction and fusion. However, procedures using only pedicle screws have risks during screw insertion, higher costs, and decreased postoperative thoracic kyphosis. We have obtained good outcomes compared with segmental pedicle screw fixation in surgery for AIS using a relatively simple operative procedure (PSTH-DVR) that uses fewer pedicle screws. The subjects were 30 consecutive patients with AIS who underwent the PSTH-DVR procedure and were followed for a minimum of 2 years. Preoperative flexibility, preoperative and postoperative Cobb angles, correction rates, loss of correction, thoracic kyphotic angles (T5-T12), coronal balance, sagittal balance, and shoulder balance were measured on plain radiographs. Rib hump, operation time, estimated blood loss, spinal cord monitoring findings, complications, and scoliosis research society (SRS)-22 scores were also examined. The mean preoperative curve of 58.0 degrees (range, 40-96 degrees) was corrected to a mean of 9.9 degrees postoperatively, and the correction rate was 83.6%. Fusion was obtained in all patients without loss of correction. In 10 cases with preoperative kyphosis angles (T5-T12) correction of deformity with PSTH-DVR is equivalent to that of all-pedicle screw constructs. The procedure gives favorable correction, is advantageous for kyphosis compared with segmental screw fixation, and uses the minimum number of pedicle screws. Therefore, the PSTH-DVR procedure may be useful for treatment of idiopathic scoliosis.

  1. EOS microdose protocol for the radiological follow-up of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Ilharreborde, Brice; Ferrero, Emmanuelle; Alison, Marianne; Mazda, Keyvan

    2016-02-01

    Imaging plays a key role in adolescent idiopathic scoliosis (AIS) to determine the prognosis and accordingly define the best therapeutic strategy to follow. Conventional radiographs with ionizing radiation have been associated with 1-2 % increased lifetime risk of developing cancer in children, and physicians, therefore, need a sensitive but harmless way to explore patients at risk, according to the "as low as reasonably achievable" concept. The EOS system (EOS imaging, Paris, France) is available in routine clinical use since 2007, and allows 3D reconstructions of the trunk in standing position with significant radiation reduction. With recent technical advances, further dose reduction can be obtained, but at the cost of image quality that might alter the reliability of 3D reconstructions. The aim of the present study was to analyze the reproducibility of a "microdose" protocol, and evaluate its use in clinical practice. 32 consecutive patients followed for AIS were prospectively included. Biplanar radiographs were obtained with the EOS system according to the new microdose protocol. From the microdose images obtained, three experienced operators performed 3D reconstructions, two times for each subject in a random order (total, 192 reconstructions). The intraoperator repeatability and interoperator reproducibility were evaluated, as recommended by the International Organization for Standardization, for the most clinically relevant 3D radiological parameters. The identification of the required anatomical landmarks for the "fast spine" reconstruction process was possible in all cases. None of the patients required a second acquisition for 3D analysis. Mean time for reconstruction was 5 ± 2 min. The intraoperator repeatability was better than interoperator reproducibility for all parameters, with values ranging between 3° and 8° for frontal and sagittal spinal parameters, and between 1° and 8° for pelvic measurements. The agreement was very good for all clinical

  2. The Scoliosis Research Society-22 questionnaire adapted for adolescent idiopathic scoliosis patients in China: reliability and validity analysis.

    Science.gov (United States)

    Zhao, Li; Zhang, Yong; Sun, Xiaotang; Du, Qing; Shang, Lei

    2007-12-01

    Outcome investigation to verify the internal consistency, reproducibility and validity of the adapted Chinese version of the Scoliosis Research Society-22 (SRS-22) questionnaire for measuring health-related quality of life (HRQoL) in children with idiopathic scoliosis. To develop this questionnaire for the outcome measurement in treating Chinese adolescents with idiopathic scoliosis and evaluate its metric qualities. The SRS-22 questionnaire has proven to be a valid instrument for clinical assessment of patients with idiopathic scoliosis and has been successfully translated into Spanish and Turkish. In most developing countries, however, quality of life and psychological health have been poorly described when treating children with idiopathic scoliosis. Trans-cultural adaptation of the SRS-22 questionnaire was carried out according to the International Quality of Life Assessment Project guidelines. The final version was approved by a committee of experts. The questionnaire was completed by 86 adolescents with idiopathic scoliosis who had been treated with a brace; this included 11 males and 75 females, aged from 10 to 18 years (mean 13.9 years). Curve magnitude ranged from 25 degrees to 45 degrees (mean 35.6 degrees ). A subgroup of 30 patients completed the questionnaire again in 3 or 4 weeks. Five common factors were acquired from factorial analysis, and the cumulative contribution ratio was 67.66%. The overall alpha coefficient of the questionnaire was 0.88. Coefficients for individual domains were as follows: function/activity, 0.70; pain, 0.80; self-image, 0.80; mental health, 0.88; and satisfaction, 0.81. The questionnaire as a whole had a test-retest correlation coefficient of 0.97. Test-retest correlation coefficients for individual domains were as follows: function, 0.85; pain, 0.96; self-image, 0.96; mental health, 0.95; and satisfaction, 0.91. The Chinese version of the SRS-22 questionnaire is eligible in terms of reliability and validity, and can be

  3. Adolescent Idiopathic Scoliosis Surgery by a Neurosurgeon: Learning Curve for Neurosurgeons.

    Science.gov (United States)

    Hyun, Seung-Jae; Han, Sanghyun; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Yongjung J; Rhim, Seung-Chul; Kim, Hyun-Jib

    2018-02-01

    To determine a neurosurgeon's learning curve of surgical treatment for adolescent idiopathic scoliosis (AIS) patients. This study is a retrospective analysis. Forty-six patients were treated by a single neurosurgeon between 2011 and 2017 using posterior segmental instrumentation and fusion. According to the time period, the former and latter 23 patients were divided into group 1 and group 2, respectively. Patients' demographic data, curve magnitude, number of levels treated, amount of correction achieved, radiographic/clinical outcomes, and complications were compared between the groups. The majority were females (34 vs. 12) with average ages of 15.0 versus 15.6, respectively. The mean follow-up period was 24.6 months. The average number of fusion levels was similar with 10.3 and 11.5 vertebral bodies in groups 1 and 2, respectively. The average Cobb angle of major curvature was 59.8° and 58.5° in groups 1 and 2, respectively. There observed significant reductions of operative time (324.4 vs. 224.7 minutes, P = 0.007) and estimated blood loss (648.3 vs. 438.0 mL, P = 0.027) in group 2. The correction rate of the major structural curve was greater in group 2 (70.7% vs. 81.0%, P = 0.001). There was no case of neurologic deficit, infection, and revision for screw malposition. One patient of group 1 underwent fusion extension surgery for shoulder asymmetry. Radiographic and clinical outcomes of AIS patients treated by a neurosurgeon were acceptable. AIS surgery may be performed with an acceptable rate of complications after about 20 surgeries. With acquisition of surgical experiences, neurosurgeons could perform deformity surgery for AIS effectively and safely. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Adolescent Idiopathic Scoliosis Treatment by a Korean Neurosurgeon: The Changing Role for Neurosurgeons.

    Science.gov (United States)

    Hyun, Seung-Jae; Kim, Woong-Beom; Park, Young-Seop; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Yongjung J

    2015-07-01

    The purpose of this study was to evaluate radiographic/clinical outcomes of adolescent idiopathic scoliosis (AIS) patients treated by a Korean neurosurgeon. Ten AIS patients were treated by a single neurosurgeon between January 2011 and September 2013 utilizing segmental instrumentation with pedicle screws. Basic demographic information, curve pattern by Lenke classification, number of levels treated, amount of correction achieved, radiographic/clinical outcomes [by Scolisis Resarch Society (SRS-22r) questionnaire] and complications were evaluated to determine the surgical results. Pulmonary function test was utilized to assess forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) before and after surgery. The average percentage of correction of the major structural curve was 73.6% (ranged from 64% to 81.5%). Preoperative and final postoperative absolute FVC averaged 3.03 L and 3.76 L (0.73 L increase, p=0.046), and absolute FEV1 averaged 2.63 L and 3.49 L (0.86 L increase, p=0.021). Preoperative and final postoperative average self-image and function scores of SRS-22r were, 2.6±0.5, 3.3±0.1, 4.0±0.5, and 4.6±0.0, respectively. There was a significant improvement of the self-image and function scores of SRS-22r questionnaires before and after surgery (pneurosurgeon were acceptable. Fundamental understanding of pediatric spinal deformity is essential for the practice of AIS surgery.

  5. A histologic, histomorphometric, and radiographic comparison between two complexes of CenoBoen/CenoMembrane and Bio-Oss/Bio-Gide in lateral ridge augmentation: A clinical trial.

    Science.gov (United States)

    Amoian, Babak; Moudi, Ehsan; Majidi, Maryam Seyed; Ali Tabatabaei, S M

    2016-09-01

    Several grafting materials have been used for alveolar ridge augmentation. The literature lacks researches to compare CenoBone to other grafting materials. The aim of this study was to compare CenoBone/CenoMembrane complex to Bio-Oss/Bio-Gide complex in lateral alveolar bone augmentation in terms of radiographic, histologic, and histomorphometric parameters. In this randomized controlled trial, ten patients who needed lateral ridge augmentation were selected and augmentations were done using either of CenoBone/CenoMembrane or Bio-Oss/Bio-Gide complexes. In the re-entry surgery in 6 months following augmentation, core biopsies were taken and clinical, radiographic, histologic, and histomorphometric evaluations were performed. No statistically significant difference was seen between groups except for the number of blood vessels and percentage of residual graft materials. CenoBone seems to present a comparable lateral ridge augmentation to Bio-Oss in.

  6. Predictors of emotional functioning in youth after surgical correction of idiopathic scoliosis.

    Science.gov (United States)

    Zebracki, Kathy; Thawrani, Dinesh; Oswald, Timothy S; Anadio, Jennifer M; Sturm, Peter F

    2013-09-01

    Patients with idiopathic scoliosis, although otherwise healthy, often have significant concerns about their self-image and appearance. In a group of juveniles and adolescents, this can impact adjustment in school, functioning in peer groups, and general sense of well-being. There are limited data to help physicians reliably and precisely identify those who are at higher risk of poor emotional adjustment even after spine deformity correction. The purpose of this study was to determine the predictors of emotional maladjustment in juvenile and adolescent patients after surgical correction of idiopathic scoliosis. A total of 233 juveniles, mean age 11.26 ± 1.02 (range, 8 to 12) years and 909 adolescents, mean age 14.91 ± 1.61 (range, 13 to 21) years, who underwent surgical correction for idiopathic scoliosis and who were participating in a prospective longitudinal multicenter database, were enrolled in the study. Participants completed the Scoliosis Research Society-22 (SRS-22) questionnaire before surgery and 2 years postoperatively. Radiographs were used to measure Cobb angle and surface measurements were used to determine decompensation and trunk shift. Adolescents reported poorer mental health preoperatively (Pself-image (Pself-image (Padolescent group, mental health 2 years postoperatively was predicted by preoperative mental health (Pself-image 2 years postoperatively was predicted by preoperative mental health (Pself-image (PSelf-image and mental health are significantly improved after spine deformity correction in juveniles and adolescents with idiopathic scoliosis. However, consistent with normative development, adolescents are at higher risk for emotional maladjustment than juveniles. Surgical decision making in scoliosis correction should take the emotional status of the patient into consideration.

  7. Stress fractures of the humerus, radius, and tibia in horses: clinical features and radiographic and/or scintigraphic appearance

    International Nuclear Information System (INIS)

    Mackey, V.S.; Trout, D.R.; Meagher, D.M.; Hornof, W.J.

    1987-01-01

    The medical records, radiographic and nuclear scintigraphic findings of 26 racing horses with 27 stress fracture episodes of the humerus, radius, or tibia were reviewed. The purposes of this study were to describe the radiographic and/or scintigraphic features of stress fractures of the humerus, radius, or tibia, and to evaluate the signalment and history of horses in which stress fracture occurred. Stress fractures of the three long bones examined were primarily seen in 2- and 3-year-old male Thoroughbred horses; commonly, the onset of lameness was immediately following training gallops or racing. There were 13 humeral stress fracture episodes in 12 horses. Ten were in the proximal caudolateral cortex, and three were in the distal craniomedial cortex. Radical stress fractures were seen in three horses, all in the midshaft radius. Tibial stress fractures were diagnosed in 11 horses. They were located in the proximal lateral tibia in six horses, the distal caudolateral tibia in three horses, and the midshaft tibia in three horses. Fifteen stress fractures were diagnosed with radiography alone, one was diagnosed with scintigraphy alone, nine were diagnosed with radiographs and scintigraphy, and, in two horses, radiographs were negative, but the scintigraphic findings were consistent with stress fracture

  8. Neurologic dysfunction in patients with rheumatoid arthritis of the cervical spine. Predictive value of clinical, radiographic and MR imaging parameters

    International Nuclear Information System (INIS)

    Reijnierse, M.; Kroon, H.M.; Holscher, H.C.; Bloem, J.L.; Dijkmans, B.A.C.; Breedveld, F.C.; Hansen, B.; Pope, T.L.

    2001-01-01

    The aim of this study was to evaluate if subjective symptoms, radiographic and especially MR parameters of cervical spine involvement, can predict neurologic dysfunction in patients with severe rheumatoid arthritis (RA). Sequential radiographs, MR imaging, and neurologic examination were performed yearly in 46 consecutive RA patients with symptoms indicative of cervical spine involvement. Radiographic parameters were erosions of the dens or intervertebral joints, disc-space narrowing, horizontal and vertical atlantoaxial subluxation, subluxations below C2, and the diameter of the spinal canal. The MR features evaluated were presence of dens and atlas erosion, brainstem compression, subarachnoid space encroachment, pannus around the dens, abnormal fat body caudal to the clivus, cervicomedullary angle, and distance of the dens to the line of McRae. Muscle weakness was associated with a tenfold increased risk of neurologic dysfunction. Radiographic parameters were not associated. On MR images atlas erosion and a decreased distance of the dens to the line of McRae showed a fivefold increased risk of neurologic dysfunction. Subarachnoid space encroachment was associated with a 12-fold increased risk. Rheumatoid arthritis patients with muscle weakness and subarachnoid space encroachment of the entire cervical spine have a highly increased risk of developing neurologic dysfunction. (orig.)

  9. Neurologic dysfunction in patients with rheumatoid arthritis of the cervical spine. Predictive value of clinical, radiographic and MR imaging parameters

    Energy Technology Data Exchange (ETDEWEB)

    Reijnierse, M.; Kroon, H.M.; Holscher, H.C.; Bloem, J.L. [Dept. of Radiology, University Hospital Leiden (Netherlands); Dijkmans, B.A.C.; Breedveld, F.C. [Dept. of Rheumatology, University Hospital Leiden (Netherlands); Hansen, B. [Dept. of Medical Statistics, University Hospital Leiden (Netherlands); Pope, T.L. [Dept. of Diagnostic Radiology, Univ. of South Carolina (United States)

    2001-03-01

    The aim of this study was to evaluate if subjective symptoms, radiographic and especially MR parameters of cervical spine involvement, can predict neurologic dysfunction in patients with severe rheumatoid arthritis (RA). Sequential radiographs, MR imaging, and neurologic examination were performed yearly in 46 consecutive RA patients with symptoms indicative of cervical spine involvement. Radiographic parameters were erosions of the dens or intervertebral joints, disc-space narrowing, horizontal and vertical atlantoaxial subluxation, subluxations below C2, and the diameter of the spinal canal. The MR features evaluated were presence of dens and atlas erosion, brainstem compression, subarachnoid space encroachment, pannus around the dens, abnormal fat body caudal to the clivus, cervicomedullary angle, and distance of the dens to the line of McRae. Muscle weakness was associated with a tenfold increased risk of neurologic dysfunction. Radiographic parameters were not associated. On MR images atlas erosion and a decreased distance of the dens to the line of McRae showed a fivefold increased risk of neurologic dysfunction. Subarachnoid space encroachment was associated with a 12-fold increased risk. Rheumatoid arthritis patients with muscle weakness and subarachnoid space encroachment of the entire cervical spine have a highly increased risk of developing neurologic dysfunction. (orig.)

  10. Clinical results and radiographic appearance of the Rashkind double umbrella device in patients with occlusion of the ductus arteriosus

    International Nuclear Information System (INIS)

    Galal, O.; Sinner, W. von; Azhari, N.; Al-Fadley, F.; De Moor, M.; Boecker, J.; Fawzy, M.E..; Al-Halees, Z.

    1997-01-01

    Background. The Rashkind double umbrella device for patent arterial duct occlusion has been used in many patients. Its radiographic appearance has not been sufficiently described. Objective. To present the varying radiographic appearances of the Rashkind double umbrella device on the chest X-ray. Materials and methods. The chest radiographs of 69 patients (median age 60 months; median weight 17 kg), who underwent closure of their patent arterial duct between March 1990 and August 1994, were reviewed. The following parameters were evaluated: (1) the size of the heart (cardio-thoracic ratio) and pulmonary vessels, (2) the position of the device in AP/PA and lateral projections. The results of occlusion of the patent arterial duct were also reviewed. Results. Sixty-two of 69 (90 %) pa- tients had complete occlusion after a follow-up between 2 months and 3 1 / 2 years. The cardio-thoracic ratio showed significant reduction at follow-up (P < 0.001). The two different size devices could be well differentiated in the AP and the lateral projection. In 14 patients (20 %) the device was in an asymmetrical position. There was no significant correlation between position of the device and success of occlusion in our material. Conclusion. Complete occlusion of the arterial duct using Rashkind double umbrella devices can be achieved in 90 % of our population. In 20 % the device will have an asymmetrical position. There is no correlation between asymmetrical position of the device in the chest radiograph and residual shunting. (orig.)

  11. Clinical and Radiographic Evaluation of Procedural Errors during Preparation of Curved Root Canals with Hand and Rotary Instruments: A Randomized Clinical Study

    Science.gov (United States)

    Khanna, Rajesh; Handa, Aashish; Virk, Rupam Kaur; Ghai, Deepika; Handa, Rajni Sharma; Goel, Asim

    2017-01-01

    Background: The process of cleaning and shaping the canal is not an easy goal to obtain, as canal curvature played a significant role during the instrumentation of the curved canals. Aim: The present in vivo study was conducted to evaluate procedural errors during the preparation of curved root canals using hand Nitiflex and rotary K3XF instruments. Materials and Methods: Procedural errors such as ledge formation, instrument separation, and perforation (apical, furcal, strip) were determined in sixty patients, divided into two groups. In Group I, thirty teeth in thirty patients were prepared using hand Nitiflex system, and in Group II, thirty teeth in thirty patients were prepared using K3XF rotary system. The evaluation was done clinically as well as radiographically. The results recorded from both groups were compiled and put to statistical analysis. Statistical Analysis: Chi-square test was used to compare the procedural errors (instrument separation, ledge formation, and perforation). Results: In the present study, both hand Nitiflex and rotary K3XF showed ledge formation and instrument separation. Although ledge formation and instrument separation by rotary K3XF file system was less as compared to hand Nitiflex. No perforation was seen in both the instrument groups. Conclusion: Canal curvature played a significant role during the instrumentation of the curved canals. Procedural errors such as ledge formation and instrument separation by rotary K3XF file system were less as compared to hand Nitiflex. PMID:29042727

  12. Radiographer interpretation of trauma radiographs: Issues for radiography education providers

    International Nuclear Information System (INIS)

    Hardy, Maryann; Snaith, Beverly

    2009-01-01

    Background: The role of radiographers with respect to image interpretation within clinical practice is well recognised. It is the expectation of the professional, regulatory and academic bodies that upon qualification, radiographers will possess image interpretation skills. Additionally, The College of Radiographers has asserted that its aspiration is for all radiographers to be able to provide an immediate written interpretation on skeletal trauma radiographs by 2010. This paper explores the readiness of radiography education programmes in the UK to deliver this expectation. Method: A postal questionnaire was distributed to 25 Higher Education Institutions in the UK (including Northern Ireland) that provided pre-registration radiography education as identified from the Society and College of Radiographers register. Information was sought relating to the type of image interpretation education delivered at pre- and post-registration levels; the anatomical range of image interpretation education; and education delivery styles. Results: A total of 19 responses (n = 19/25; 76.0%) were received. Image interpretation education was included as part of all radiographer pre-registration programmes and offered at post-registration level at 12 academic centres (n = 12/19; 63.2%). The anatomical areas and educational delivery methods varied across institutions. Conclusion: Radiography education providers have embraced the need for image interpretation education within both pre- and post-registration radiography programmes. As a result, UK education programmes are able to meet the 2010 College of Radiographers aspiration.

  13. A Human Clinical, Histological, Histomorphometrical, and Radiographical Study on Biphasic HA-Beta-TCP 30/70 in Maxillary Sinus Augmentation.

    Science.gov (United States)

    Mangano, Carlo; Sinjari, Bruna; Shibli, Jamil A; Mangano, Francesco; Hamisch, Sabine; Piattelli, Adriano; Perrotti, Vittoria; Iezzi, Giovanna

    2015-06-01

    By mixing hydroxyapatite (HA) and tricalcium phosphate (TCP), biphasic calcium phosphate ceramics can be obtained, and by varying their ratio it is possible to tailor the characteristics of the biomaterial. The aim of the present human study was to evaluate the histological and radiographical aspects of bone formation in maxillary sinus augmentation using a 30/70 HA-beta-TCP with a reticular structure. A total of 12 patients, undergoing two-stage sinus augmentation procedure using HA-beta-TCP at a ratio of 30/70, were included in the present study. After a 6-month healing period, during implant insertion, radiographical analysis was performed, and then the bone core biopsies were harvested and processed for histology. At radiographic evaluation, the bone gain was on average 6.85 ± 0.60 mm. HA-beta-TCP 30/70 appeared to be lined by newly formed bone, with no gaps at the interface. The histomorphometric analysis revealed 26 ± 2% of residual grafted biomaterial, 29 ± 3% of newly formed bone, and 45 ± 2% of marrow spaces. The present results indicate histologically the high biocompatibility and osteoconductivity of HA-beta-TCP 30/70, and clinically its successful use for sinus augmentation procedures. © 2013 Wiley Periodicals, Inc.

  14. [Scoliosis: review of types, aetiology, diagnostics, and treatment 1

    NARCIS (Netherlands)

    de Baat, P.; van Biezen, E.C.; de Baat, C.

    2012-01-01

    A scoliosis is a flexible or rigid deformity of the spine in the frontal plane. There are several types of scoliosis, each with specific characteristics. The most prevalent types are idiopathic, congenital, and neuromuscular scoliosis and scoliosis in adults. The aetiology is varied and largely

  15. Radiographic element

    International Nuclear Information System (INIS)

    Abbott, T.I.; Jones, C.G.

    1984-01-01

    Radiographic elements are disclosed comprised of first and second silver halide emulsion layers separated by an interposed support capable of transmitting radiation to which the second image portion is responsive. At least the first imaging portion contains a silver halide emulsion in which thin tubular silver halide grains of intermediate aspect ratios (from 5:1 to 8:1) are present. Spectral sensitizing dye is adsorbed to the surface of the tubular grains. Increased photographic speeds can be realized at comparable levels of crossover. (author)

  16. Clinical and radiographic evaluation of Bio-Gen with biocollagen compared with Bio-Gen with connective tissue in the treatment of class II furcation defects: a randomized clinical trial

    Science.gov (United States)

    JENABIAN, Niloofar; HAGHANIFAR, Sina; MABOUDI, Avideh; BIJANI, Ali

    2013-01-01

    Objective Treatment of furcation defects are thought to be challenging. The purpose of this study was to evaluate the clinical and radiographic parameters of Bio-Gen with Biocollagen compared with Bio-Gen with connective tissue in the treatment of Class II furcation defects. Material and Methods In this clinical trial, 24 patients with Class II furcation defect on a buccal or lingual mandibular molar were recruited. After oral hygiene instruction, scaling and root planing and achievement of acceptable plaque control, the patients were randomly chosen to receive either connective tissue and Bio-Gen (case group) or Biocollagen and Bio-Gen (control group). The following parameters were recorded before the first and re-entry surgery (six months later): vertical clinical attachment level (VCAL), gingival index (GI), plaque index (PI), horizontal probing depth (HPD), vertical probing depth (VPD), gingival recession (GR), furcation vertical component (FVC), furcation to alveolar crest (FAC), fornix to base of defect (FBD), and furcation horizontal component (FHC) were calculated at the time of first surgery and during re-entry. A digital periapical radiograph was taken in parallel before first surgery and re-entry. The radiographs were then analyzed by digital subtraction. The differences with p value <0.05 were considered significant. Results Only the mean changes of FAC, FHC, mean of FHC, FBD in re-entry revealed statistically significant differences between the two groups. HPD, VPD, FBD, FAC, and FHC showed statistically significant differences after 6 months in the case group. However, in the control group, statistically significant differences were found in GR and HPD. We did not observe any significant difference in radiographic changes among the two groups. Conclusion The results of this trial indicate that better clinical outcomes can be obtained with connective tissue grafts in combination with bone material compared with a resorbable barrier with bone material

  17. Clinical and radiographic evaluation of Bio-Gen with biocollagen compared with Bio-Gen with connective tissue in the treatment of class II furcation defects: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Niloofar Jenabian

    2013-09-01

    Full Text Available OBJECTIVE: Treatment of furcation defects are thought to be challenging. The purpose of this study was to evaluate the clinical and radiographic parameters of Bio-Gen with Biocollagen compared with Bio-Gen with connective tissue in the treatment of Class II furcation defects. MATERIAL AND METHODS: In this clinical trial, 24 patients with Class II furcation defect on a buccal or lingual mandibular molar were recruited. After oral hygiene instruction, scaling and root planing and achievement of acceptable plaque control, the patients were randomly chosen to receive either connective tissue and Bio-Gen (case group or Biocollagen and Bio-Gen (control group. The following parameters were recorded before the first and re-entry surgery (six months later: vertical clinical attachment level (VCAL, gingival index (GI, plaque index (PI, horizontal probing depth (HPD, vertical probing depth (VPD, gingival recession (GR, furcation vertical component (FVC, furcation to alveolar crest (FAC, fornix to base of defect (FBD, and furcation horizontal component (FHC were calculated at the time of first surgery and during re-entry. A digital periapical radiograph was taken in parallel before first surgery and re-entry. The radiographs were then analyzed by digital subtraction. The differences with p value <0.05 were considered significant. RESULTS: Only the mean changes of FAC, FHC, mean of FHC, FBD in re-entry revealed statistically significant differences between the two groups. HPD, VPD, FBD, FAC, and FHC showed statistically significant differences after 6 months in the case group. However, in the control group, statistically significant differences were found in GR and HPD. We did not observe any significant difference in radiographic changes among the two groups. CONCLUSION: The results of this trial indicate that better clinical outcomes can be obtained with connective tissue grafts in combination with bone material compared with a resorbable barrier with bone

  18. Nutritional secondary hyperparathyroidism in a white lion cub (Panthera leo, with concomitant radiographic double cortical line : clinical communication

    Directory of Open Access Journals (Sweden)

    V. Herz

    2004-06-01

    Full Text Available A captive-bred white lion cub was presented with hindquarter pain, lameness and reluctance to move. Radiographs revealed generalised osteoapenia, multiple fractures, a severely collapsed pelvic girdle, bilateral lateral bowing of the scapulae and mild kyphosis of the caudal vertebrae.Adouble cortical line, a distinct sign of osteopaenia, was repeatedly seen on the pelvic limbs, most strikingly along both femurs. Based on radiographic findings and a history of an exclusive meat diet since weaning, a diagnosis of nutritional secondary hyperparathyroidism was made. The diet was changed to a commercial kitten food and the cub was given cage rest for 6 weeks. Signs of pain abated and the cub became more active.A guarded prognosis was given for full recovery, as changes to the pelvis were considered potentially irreversible.

  19. Clinical results and radiographic appearance of the Rashkind double umbrella device in patients with occlusion of the ductus arteriosus

    Energy Technology Data Exchange (ETDEWEB)

    Galal, O [King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); [Department of Cardiovascular Diseases, MBC 16, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211 (Saudi Arabia); Sinner, W von; Azhari, N; Al-Fadley, F; De Moor, M; Boecker, J; Fawzy, M E; Al-Halees, Z [King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)

    1997-12-01

    Background. The Rashkind double umbrella device for patent arterial duct occlusion has been used in many patients. Its radiographic appearance has not been sufficiently described. Objective. To present the varying radiographic appearances of the Rashkind double umbrella device on the chest X-ray. Materials and methods. The chest radiographs of 69 patients (median age 60 months; median weight 17 kg), who underwent closure of their patent arterial duct between March 1990 and August 1994, were reviewed. The following parameters were evaluated: (1) the size of the heart (cardio-thoracic ratio) and pulmonary vessels, (2) the position of the device in AP/PA and lateral projections. The results of occlusion of the patent arterial duct were also reviewed. Results. Sixty-two of 69 (90 %) pa- tients had complete occlusion after a follow-up between 2 months and 3{sup 1}/{sub 2} years. The cardio-thoracic ratio showed significant reduction at follow-up (P < 0.001). The two different size devices could be well differentiated in the AP and the lateral projection. In 14 patients (20 %) the device was in an asymmetrical position. There was no significant correlation between position of the device and success of occlusion in our material. Conclusion. Complete occlusion of the arterial duct using Rashkind double umbrella devices can be achieved in 90 % of our population. In 20 % the device will have an asymmetrical position. There is no correlation between asymmetrical position of the device in the chest radiograph and residual shunting. (orig.) With 7 figs., 12 refs.

  20. WE-G-204-07: Automated Characterization of Perceptual Quality of Clinical Chest Radiographs: Improvements in Lung, Spine, and Hardware Detection

    International Nuclear Information System (INIS)

    Wells, J; Zhang, L; Samei, E

    2015-01-01

    Purpose: To develop and validate more robust methods for automated lung, spine, and hardware detection in AP/PA chest images. This work is part of a continuing effort to automatically characterize the perceptual image quality of clinical radiographs. [Y. Lin et al. Med. Phys. 39, 7019–7031 (2012)] Methods: Our previous implementation of lung/spine identification was applicable to only one vendor. A more generalized routine was devised based on three primary components: lung boundary detection, fuzzy c-means (FCM) clustering, and a clinically-derived lung pixel probability map. Boundary detection was used to constrain the lung segmentations. FCM clustering produced grayscale- and neighborhood-based pixel classification probabilities which are weighted by the clinically-derived probability maps to generate a final lung segmentation. Lung centerlines were set along the left-right lung midpoints. Spine centerlines were estimated as a weighted average of body contour, lateral lung contour, and intensity-based centerline estimates. Centerline estimation was tested on 900 clinical AP/PA chest radiographs which included inpatient/outpatient, upright/bedside, men/women, and adult/pediatric images from multiple imaging systems. Our previous implementation further did not account for the presence of medical hardware (pacemakers, wires, implants, staples, stents, etc.) potentially biasing image quality analysis. A hardware detection algorithm was developed using a gradient-based thresholding method. The training and testing paradigm used a set of 48 images from which 1920 51×51 pixel"2 ROIs with and 1920 ROIs without hardware were manually selected. Results: Acceptable lung centerlines were generated in 98.7% of radiographs while spine centerlines were acceptable in 99.1% of radiographs. Following threshold optimization, the hardware detection software yielded average true positive and true negative rates of 92.7% and 96.9%, respectively. Conclusion: Updated segmentation

  1. The influence of dental implants in periapical and panoramic radiographs and cone beam computed tomography images: a clinical study.

    Science.gov (United States)

    Felix, Rafael Perdomo; Shinkai, Rosemary Sadami Arai; Rockenbach, Maria Ivete Bolzan

    2018-01-01

    The aim of this study was to analyze the influence of dental implants on the radiographic density of the peri-implant region in tomographic and radiographic examinations. A sample of 21 dental implants from 10 patients with Brånemark-protocol prostheses was evaluated based on postoperative control images, including periapical radiography (paralleling technique), panoramic radiography, and cone beam computed tomography (CBCT). The density means of 6 defined areas near dental implants were calculated and compared considering their locations and the different imaging examinations. The CBCT examinations showed significantly different densities among the measured areas (P implants in all the examinations: CBCT (127.88 and 120.71), panoramic (106.51 and 106.09), and periapical (120.32). The sagittal CBCT images were measured in 2 different sections, and in both sections those areas closer to implants showed mean densities that were significantly higher than means from more distant areas (P implant region confirmed the interference of dental implants in radiographic and tomographic images. CBCT images suffered the greatest interference from dental implants.

  2. EOS suspension test for the assessment of spinal flexibility in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Hirsch, Caroline; Ilharreborde, Brice; Mazda, Keyvan

    2015-07-01

    The assessment of spinal flexibility is essential for the planning of adolescent idiopathic scoliosis (AIS) surgery. Various radiographic methods have been used but none of them has shown any superiority. The new low-dose stereography system EOS (EOS imaging, Paris, France) captures whole body images in a single scan without vertical distortion. EOS is now used in routine clinical use for AIS follow-up. The aim of this study was to prospectively evaluate the feasibility and the reproducibility of a new suspension test during the EOS imaging for the assessment of spinal flexibility in AIS. Fifty AIS patients scheduled for surgery were prospectively included. For each patient, a standard EOS radiograph was obtained, then a suspension test in the EOS and a classic traction test on the cotrel frame were performed. The examinations were compared in terms of radiation exposure, tolerance, mean traction force, and Cobb angle reduction for each curve. Axial and sagittal reductions during suspension were analyzed on three-dimensional EOS reconstructions. The tolerance of the suspension test was lower than the traction test but it was less operator dependent. Radiation exposure was 7 times lower during the suspension test. Cobb angle reductions achieved in the proximal and main curves by the two tests were similar. The traction test achieved greater reduction of the distal curve. Flexibility in the axial plane and in the sagittal plane was analyzed with the suspension test. The reduction in apical rotation was not correlated with the reduction in Cobb angle. The EOS suspension test can be used for the assessment of spinal flexibility in AIS. It gives a global vision of the deformity with new flexibility indices in the axial and sagittal planes.

  3. Scoliosis in osteogenesis imperfecta caused by COL1A1/COL1A2 mutations - genotype-phenotype correlations and effect of bisphosphonate treatment.

    Science.gov (United States)

    Sato, Atsuko; Ouellet, Jean; Muneta, Takeshi; Glorieux, Francis H; Rauch, Frank

    2016-05-01

    Bisphosphonates are widely used to treat children with osteogenesis imperfecta (OI), a bone fragility disorder that is most often caused by mutations in COL1A1 or COL1A2. However, it is unclear whether this treatment decreases the risk of developing scoliosis. We retrospectively evaluated spine radiographs and charts of 437 patients (227 female) with OI caused by mutations in COL1A1 or COL1A2 and compared the relationship between scoliosis, genotype and bisphosphonate treatment history. At the last follow-up (mean age 11.9 [SD: 5.9] years), 242 (55%) patients had scoliosis. The prevalence of scoliosis was highest in OI type III (89%), followed by OI type IV (61%) and OI type I (36%). Moderate to severe scoliosis (Cobb angle ≥25°) was rare in individuals with COL1A1 haploinsufficiency mutations but was present in about two fifth of patients with triple helical glycine substitutions or C-propeptide mutations. During the first 2 to 4years of bisphosphonate therapy, patients with OI type III had lower Cobb angle progression rates than before bisphosphonate treatment, whereas in OI types I and IV bisphosphonate treatment was not associated with a change in Cobb angle progression rates. At skeletal maturity, the prevalence of scoliosis (Cobb angle >10°) was similar in patients who had started bisphosphonate treatment early in life (before 5.0years of age) and in patients who had started therapy later (after the age of 10.0years) or had never received bisphosphonate therapy. Bisphosphonate treatment decreased progression rate of scoliosis in OI type III but there was no evidence of a positive effect on scoliosis in OI types I and IV. The prevalence of scoliosis at maturity was not influenced by the bisphosphonate treatment history in any OI type. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Scoliosis secondary to an unusual rib lesion.

    LENUS (Irish Health Repository)

    Burke, N G

    2012-04-01

    Tumours of the chest wall are uncommon and are usually malignant. A bone haemangioma is a rare benign vascular neoplasm, which more commonly occurs in middle-aged patients. We present the case of a scoliosis caused by a rib haemangioma in an adolescent male. Other causes of scoliosis secondary to rib lesions are discussed.

  5. Effects of living environment on the postoperative Scoliosis Research Society-24 results in females with adolescent idiopathic scoliosis.

    Science.gov (United States)

    Misterska, Ewa; Głowacki, Maciej; Panek, Sławomir; Ignyś-O'Byrne, Anna; Głowacki, Jakub; Ignyś, Iwona; Krauss, Hanna; Piątek, Jacek

    2012-08-01

    There are many factors influencing postoperative health-related quality of life of adolescent idiopathic scoliosis patients, including the degree of the deformity, culture, differences in geography, rural versus urban living environments, and social factors. The objective of this study was to analyze the significance of geographic factors and their differences influencing the postoperative quality of life in females with adolescent idiopathic scoliosis residing in urban and rural environments, by use of the Polish version of the SRS-24 questionnaire. Forty urban and 20 rural postoperative patients with adolescent scoliosis with a minimum 2-year follow-up period after surgery were included in the study. The process of cross-cultural adaptation was performed according to the IQOLA Project. General results of the Polish SRS-24 equalled 4.1 (SD 0.5) and 4.0 (SD.0.5) in the rural and urban groups of patients, respectively. The 2 groups do not differ in incidence of floor and ceiling effects. The Cronbach's alpha values are excellent for the general result of SRS-24 in urban and rural groups (0.85 and 0.85, respectively). The sub-groups differed significantly in the self-image after surgery domain (p=0.048). Patients from the rural group scored higher in the self-image after surgery domain but reported higher pain levels when compared to urban patients. The associations between SRS-24 results and radiographic parameters in the rural group of patients were strong, compared with moderate relations reported in the urban group.

  6. Synovial tissue rank ligand expression and radiographic progression in rheumatoid arthritis: observations from a proof-of-concept randomized clinical trial of cytokine blockade.

    LENUS (Irish Health Repository)

    Rooney, Terence

    2012-02-01

    The objective of the study was to evaluate synovial tissue receptor activator of nuclear factor-kappabeta ligand (RANKL) and osteoprotegerin (OPG) as biomarkers of disease activity, progressive joint damage, and therapeutic response, during cytokine blockade in rheumatoid arthritis (RA). Patients with active RA entered a randomized open-label 12-month study of anakinra 100 mg\\/day, administered as monotherapy or in combination with pegsunercept 800 mug\\/kg twice weekly. Arthroscopic synovial tissue biopsies were obtained at baseline, at 4 weeks and at the final time point. Following immunohistochemical staining, RANKL and OPG expression was quantified using digital image analysis. Radiographic damage was evaluated using the van der Heijde modification of the Sharp scoring system. Twenty-two patients were randomized. Baseline expression of RANKL, but not OPG, correlated significantly with baseline CRP levels (r = 0.61, P < 0.01). While a significant reduction in OPG expression following treatment was observed in clinical responders at the final time point (P < 0.05 vs. baseline), RANKL levels did not change, and the RANKL:OPG ratio remained unaltered, even at the highest levels of clinical response. When potential predictors of radiographic outcome were evaluated, baseline RANKL expression correlated with erosive progression at 1 year (r = 0.71, P < 0.01). Distinct, though related, pathophysiologic processes mediate joint inflammation and destruction in RA. Elevated synovial tissue RANKL expression is associated with progressive joint erosion, and may be independent of the clinical response to targeted therapy. The potential therapeutic importance of modulating RANKL in RA is highlighted, if radiographic arrest is to be achieved.

  7. Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes: 1-year follow-up outcomes.

    Science.gov (United States)

    Al Amri, Mohammad D; Abduljabbar, Tariq S; Al-Kheraif, Abdulaziz A; Romanos, Georgios E; Javed, Fawad

    2017-02-01

    We hypothesized that peri-implant soft tissue inflammation is worse and peri-implant marginal bone loss (MBL) is higher around dental implants placed in patients with prediabetes compared to healthy subjects. The aim of the present 12-month follow-up study was to compare the clinical and radiographic status around dental implants placed in patients with and without prediabetes. Twelve patients with medically diagnosed prediabetes (Group-1) and 12 controls (Group-2) were included. All patients were indicated for single tooth maxillary or mandibular premolar replacement with the adjacent teeth intact. Success of the restored implants was assessed by comparing clinical (peri-implant bleeding on probing [BOP], and probing pocket depth [PPD]) and radiographic (peri-implant MBL) parameters at baseline and at 12-months follow-up. Statistical analysis was performed using one-way analysis of variance, and P-values implant pockets with PPD ≥ 4 mm in both groups. At 12-month follow-up, the mean MBL among implants placed in groups 1 and 2 were 0.2 ± 0.1 mm and 0.1 ± 0.01 mm, respectively. Overall, the periodontal status (PI, BOP and PPD ≥ 4 mm) at 12-month follow-up was comparable among patients in both groups. Within the limitations of this study, it is concluded that dental implants inserted in prediabetic and healthy patients have similar success rates and remain clinically and radiographically stable after 1-year follow-up. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms.

    Science.gov (United States)

    Wiese, Mie; Svensson, Peter; Bakke, Merete; List, Thomas; Hintze, Hanne; Petersson, Arne; Knutsson, Kerstin; Wenzel, Ann

    2008-01-01

    To identify associations between clinical symptoms of temporomandibular joint disorders and radiographic findings. Two hundred four adult patients (156 women, 48 men, mean age 40 years) with temporomandibular joint (TMJ) pain/sounds or changes in mandibular motion were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bilateral sagittal corrected TMJ tomograms in closed and open positions were assessed for the presence of flattening, erosion, osteophytes, and sclerosis in the joint components and the range of mandibular motion. Logistic regression analyses were performed with the radiographic findings as the dependent variables and the following clinical variables as independent variables: opening pattern, maximal jaw opening, TMJ sounds, number of painful muscle/TMJ sites, duration of pain, presence of arthritic disease, depression and somatization scores, graded chronic pain, and age and gender. Coarse crepitus on opening/closing (odds ratio [OR] > or = 3.12), on lateral excursions (odds ratio > or = 4.06), and on protrusion (OR > or = 5.30) was associated with increased risk of degenerative findings in tomograms. A clinical diagnosis of osteoarthritis increased the risk of radiographic findings (OR > or = 2.95) and so did increasing age (OR > or = 1.03 per year) and the female gender (OR > or = 2.36). Maximal assisted opening and maximal opening without pain (position (OR > or = 2.60). No other significant associations were observed. Age, gender, and coarse crepitus, but no pain-related variables, were associated with increased risk of degenerative findings in TMJ tomograms. Maximal opening < 40 mm was associated with a posterior condyle-to-articular tubercle relation on opening.

  9. Expansion of Mandibular Knife-Edge Ridge and Simultaneous Implant Placement to Retain Overdentures: One-Year Clinical and Radiographic Results of a Prospective Study.

    Science.gov (United States)

    ELsyad, Moustafa Abdou; Hammouda, Nelly Ibrahim

    2017-02-01

    The aim of this study was to evaluate and compare the clinical and radiographic outcomes of two implants placed in expanded mandibular knife-edge ridge and implants placed in unexpanded ridges to retain overdentures. Fifteen completely edentulous patients with knife-edge ridges at canine areas of the mandible received two implants using the ridge expansion technique (study group, SG). Expansion was performed using piezoelectric corticotomy, and self-threading expanders. The control group (CG) comprised patients who received two-implant at canine areas without ridge expansion but were all case matched to SG and served as historical cohort. In both groups, mandibular overdentures were connected to the implants with Locator attachments 3 months after implant placement. Clinical (Plaque index; PI, Gingival index; GI, Probing depth; PD, and implant stability; ISQ) and radiographic (Vertical bone loss; VBL) parameters were recorded at time of overdenture insertion (base line, T0), 6 months (T6), and 12 months (T12) after insertion. The cumulative success rates were 100% and 96.4% for CG and SG, respectively, without significant difference between groups. All tested parameters increased significantly with advance of time in both groups. There was no significant difference in PI, GI, PD, and ISQ between groups. However, SG recorded significant higher VBL than CG at T6 and T12. Expansion of mandibular knife edge ridge and simultaneous placement of implants to retain overdentures is associated with clinic and radiographic outcomes comparable to implants placed in unexpanded ridges after 1 year. However, long term randomized controlled trials with sufficient sample size are still needed to ensure the findings of the present study. © 2016 Wiley Periodicals, Inc.

  10. Modeling dental radiographic systems

    International Nuclear Information System (INIS)

    Webber, R.L.

    1980-01-01

    The Bureau of Radiological Health has been actively collaborating with the Clinical Investigations Branch, NIDR, in applied research involving diagnostic use of ionizing radiation in dentistry. This work has centered on the search for alternatives to conventional radiographic systems in an attempt to improve diagnostic performance while reducing the required exposure. The basic approach involves analysis of factors limiting performance of properly defined diagnostic tasks and the modeling alternative systems with an eye toward increasing objective measures of performance. Previous collaborative work involved using a nonlinear model to compare various x-ray spectra. The data were expressed as brightness-contrast versus exposure for simulated tasks of clinical interest. This report supplements these findings by extending the number of parameters under investigation and modifying the mode of data display so that an actual radiographic image can be simulated on a television screen

  11. Polish adaptation of scoliosis research society-22 questionnaire.

    Science.gov (United States)

    Glowacki, Maciej; Misterska, Ewa; Laurentowska, Maria; Mankowski, Przemyslaw

    2009-05-01

    Polish adaptation of the original version of Scoliosis Research Society (SRS) instrument. The transcultural adaptation of SRS-22 and evaluation of its internal consistency. High psychometric value of the SRS-22 Questionnaire has made it an effective evaluation instrument in clinically assessing the functional status of patients with adolescent idiopathic scoliosis. First, 2 translators translated the original version into Polish. Afterwards, the translators identified differences between the translations and produced a consensus version. In the third stage, 2 native English speakers produced back translations. Finally, a team of 2 orthopedic surgeons, translators, a statistician and a psychologist reviewed all the translations to produce a prefinal version. The questionnaire was administered to 60 girls at the age of 16.6, SD 2.0 with adolescent idiopathic scoliosis treated with the Cotrel-Dubousset method in Pediatric Orthopaedics and Traumatology Clinic in Poznań. The internal consistency in the Polish version equaled 0.89 for the overall result and 0.81 for function, 0.81 for pain, 0.80 for mental health, 0.77 for self-image, and 0.69 for treatment satisfaction domains, respectively. The Polish version of SRS-22 is characterized by high internal consistency for all domains and for the overall score, which makes it an evaluation tool after surgical treatment compatible with the original SRS-22.

  12. Improvement in Scoliosis Top View: Evaluation of Vertebrae Localization in Scoliotic Spine-Spine Axial Presentation

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    Paweł Główka

    2016-11-01

    Full Text Available Morphological analysis of the scoliotic spine is based on two-dimensional X-rays: coronal and sagittal. The three-dimensional character of scoliosis has raised the necessity for analyzing scoliosis in three planes. We proposed a new user-friendly method of graphical presentation of the spine in the third plane–the Spine Axial Presentation (SAP. Eighty-five vertebrae of patients with scoliosis were analyzed. Due to different positions during X-rays (standing and computer tomography (CT (supine, the corresponding measurements cannot be directly compared. As a solution, a software creating Digital Reconstructed Radiographs (DRRs from CT scans was developed to replace regular X-rays with DRRs. Based on the measurements performed on DRRs, the coordinates of vertebral bodies central points were defined. Next, the geometrical centers of vertebral bodies were determined on CT scans. The reproducibility of measurements was tested with Intraclass Correlation Coefficient (ICC, using p = 0.05. The intra-observer reproducibility and inter-observer reliability for vertebral body central point’s coordinates (x, y, z were high for results obtained based on DRRs and CT scans, as well as for comparison results obtained based on DRR and CT scans. Based on two standard radiographs, it is possible to localize vertebral bodies in 3D space. The position of vertebral bodies can be present in the Spine Axial Presentation.

  13. Radiographic apparatus

    International Nuclear Information System (INIS)

    Lapidus, S.N.

    1979-01-01

    Raytheon Company, U.S.A. have patented an on-line electronic system of normalising the responses from the photomultiplier tubes used in conjunction with a scintillator in an X-ray radiographic camera. A problem with present cameras is that the individual photomultipliers have different intensity responses which also change in time with respect to each other. The individual responses of each photomultiplier tube are measured with a uniform sheet of radioactive material in front of the camera. The associated electronic equipment then calculates scaling factors which give all photomultiplier tubes an identical response and then places these factors in an addressable store. The store is then addressed in an on-line mode to produce a visual display of the transmitted X-rays. (U.K.)

  14. Radiographic apparatus

    International Nuclear Information System (INIS)

    Dalton, B.L.

    1984-01-01

    This patent application describes a radiographic apparatus including an array of radiation sensors, a source of radiation for projecting a beam through a body and means for moving one of said source and array relative to the body and for producing an electrical signal representative of the movement of the other of said source and array needed to bring the array into register with the beam. Drive means are arranged to move the other of said source and array in response to the electrical signal. In one embodiment, the source is rotated by an amount measured by a grating and associated electronics. The required movement of the array to maintain registration is calculated and transmitted to a driver. Alternatively, a laser may be mounted with the same and the array driven so that the laser beam continuously impinges on a photocell mounted with the array. (author)

  15. Rate of complications in scoliosis surgery – a systematic review of the Pub Med literature

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    Goodall Deborah

    2008-08-01

    Full Text Available Abstract Background Spinal fusion surgery is currently recommended when curve magnitude exceeds 40–45 degrees. Early attempts at spinal fusion surgery which were aimed to leave the patients with a mild residual deformity, failed to meet such expectations. These aims have since been revised to the more modest goals of preventing progression, restoring 'acceptability' of the clinical deformity and reducing curvature. In view of the fact that there is no evidence that health related signs and symptoms of scoliosis can be altered by spinal fusion in the long-term, a clear medical indication for this treatment cannot be derived. Knowledge concerning the rate of complications of scoliosis surgery may enable us to establish a cost/benefit relation of this intervention and to improve the standard of the information and advice given to patients. It is also hoped that this study will help to answer questions in relation to the limiting choice between the risks of surgery and the "wait and see – observation only until surgery might be recommended", strategy widely used. The purpose of this review is to present the actual data available on the rate of complications in scoliosis surgery. Materials and methods Search strategy for identification of studies; Pub Med and the SOSORT scoliosis library, limited to English language and bibliographies of all reviewed articles. The search strategy included the terms; 'scoliosis'; 'rate of complications'; 'spine surgery'; 'scoliosis surgery'; 'spondylodesis'; 'spinal instrumentation' and 'spine fusion'. Results The electronic search carried out on the 1st February 2008 with the key words "scoliosis", "surgery", "complications" revealed 2590 titles, which not necessarily attributed to our quest for the term "rate of complications". 287 titles were found when the term "rate of complications" was used as a key word. Rates of complication varied between 0 and 89% depending on the aetiology of the entity investigated

  16. A comparative evaluation of freeze dried bone allograft and decalcified freeze dried bone allograft in the treatment of intrabony defects: A clinical and radiographic study

    Directory of Open Access Journals (Sweden)

    Rajat Gothi

    2015-01-01

    Full Text Available Background: Ideal graft material for regenerative procedures is autogenous bone graft but the major disadvantage with this graft is the need for a secondary surgical site to procure donor material and the frequent lack of intraoral donor site to obtain sufficient quantities of autogenous bone for multiple or deep osseous defects. Hence, to overcome these disadvantages, bone allografts were developed as an alternative source of graft material. Materials and Methods: In 10 patients with chronic periodontitis, 20 bilateral infrabony defects were treated with freeze dried bone allograft (FDBA-Group A and decalcified freeze dried bone allograft (DFDBA-Group B. Clinical and radiographic parameters were assessed preoperatively and at 3 months and 6 months postoperatively. Data thus obtained was subjected to statistical analysis. Results: Significant improvement in the reduction in probing depth and relative attachment level (RAL from the baseline to 3 months to baseline to 6 months in group A and group B, which was statistically significant but no statistically significant reduction was seen between 3 months and 6 months. On inter-group comparison, no significant differences were observed at all-time points. In adjunct to the probing depth and RAL, the radiographic area of the defect showed a similar trend in intra-group comparison and no significant difference was seen on inter-group comparison at all-time points. Conclusions: Within the limitations of the current study, it can be concluded that DFDBA did not show any improvement in the clinical and radiographic parameters in the treatment of the intrabony defects as compared to FDBA.

  17. The radiographic manifestations of hypochondroplasia

    International Nuclear Information System (INIS)

    Heselson, N.G.; Cremin, B.J.; Beighton, P.

    1979-01-01

    Hypochrondroplasia is an inherited skeletal dysplasia that resembles achondroplasia in mild degree. Radiographic manifestations encountered in 12 affected individuals in South Africa include slight shortening of all segments of the tubular bones, moderate caudal diminution of the lumbar interpedicular distances, increased lumbar lordosis with cacral tilt and distal prolongation of the fibular. Hypochondroplasia can be distinguished from other osteochondrodystrophies such as achondroplasia, pseudo-achondroplasia and metaphyseal chondroplasia by the recognition of it clinical and radiographic manifestations. (author)

  18. Clinical and radiographic outcome of a treat-to-target strategy using methotrexate and intra-articular glucocorticoids with or without adalimumab induction

    DEFF Research Database (Denmark)

    Hørslev-Petersen, K; Hetland, M L; Ørnbjerg, L M

    2015-01-01

    OBJECTIVES: To study clinical and radiographic outcomes after withdrawing 1 year's adalimumab induction therapy for early rheumatoid arthritis (eRA) added to a methotrexate and intra-articular triamcinolone hexacetonide treat-to-target strategy (NCT00660647). METHODS: Disease-modifying antirheuma......OBJECTIVES: To study clinical and radiographic outcomes after withdrawing 1 year's adalimumab induction therapy for early rheumatoid arthritis (eRA) added to a methotrexate and intra-articular triamcinolone hexacetonide treat-to-target strategy (NCT00660647). METHODS: Disease.......12). Erosive progression (Δerosion score (ES)/year) was year 1:0.57/0.06 (p=0.02); year 2:0.38/0.05 (p=0.005). Proportion of patients without erosive progression (ΔES≤0) was year 1: 59%/76% (p=0.03); year 2:64%/79% (p=0.04). CONCLUSIONS: An aggressive triamcinolone and synthetic DMARD treat-to-target strategy...... was (re)initiated in 12/12 patients and cumulative triamcinolone dose was 160/120 mg (p=0.15). The treatment target (disease activity score, 4 variables, C-reactive protein (DAS28CRP) ≤3.2 or DAS28>3.2 without swollen joints) was achieved at all visits in ≥85% of patients in year 2; remission rates were...

  19. Are we simplifying balance evaluation in adolescent idiopathic scoliosis?

    Science.gov (United States)

    Pasha, Saba; Baldwin, Keith

    2018-01-01

    Clinical evaluation of the postural balance in adolescent idiopathic scoliosis has been measured by sagittal vertical axis and frontal balance. The impact of the scoliotic deformity in three planes on balance has not been fully investigated. 47 right thoracic and left lumbar curves adolescent idiopathic scoliosis and 10 non-scoliotic controls were registered prospectively. 13 spinopelvic postural parameters were calculated from the 3-dimantional reconstructions of X-rays. 7 balance variables describing the position and sway of the center of pressure were recorded using a pressure mat. A regression analysis was used to predict sagittal vertical axis and frontal balance from the 7 balance variables. A canonical correlation analysis was performed between all the postural parameters and balance variables and the significant associations between the postural and balance variables were determined. sagittal vertical axis and frontal balance were not significantly associated with the position or sway of the center of pressure (p>0.05). Canonical correlation analysis showed significant associations between the postural variables in the 3 planes and center of pressure position (R 2 =0.81) and sway (R 2 =0.62), pbalance contributed to the postural balance in the cohort. The compensatory role of the pelvis and distal kyphosis in sagittal plane was underlined. Multidimensional analyses between the postural and balance variables showed the alignment of the thoracic, lumbar, and pelvis in the 3 planes, in addition to the global head-pelvic position impact on adolescent idiopathic scoliosis balance. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. The "shadow sign": a radiographic differentiation of stainless steel versus titanium spinal instrumentation in spine surgery.

    Science.gov (United States)

    Jones-Quaidoo, Sean M; Novicoff, Wendy; Park, Andrew; Arlet, Vincent

    2011-12-01

    Stainless steel spinal instrumentation has been supplanted in recent years by titanium instrumentation. Knowing whether stainless steel or titanium was used in a previous surgery can guide clinical decision making processes, but frequently the clinician has no way to know what type of metal was used. We describe the radiographic "shadow sign," in which superimposed titanium rods and screws remain radiolucent enough that the contour of the underlying components can be seen on a lateral radiograph, whereas superimposed stainless steel rods and screws are completely radiopaque. This technique was evaluated using a retrospective, randomized, and blinded radiographic comparison of titanium and stainless steel spinal instrumentation. The objective was to determine whether the "shadow sign" can reliably differentiate titanium from stainless steel spinal instrumentation. Lateral radiographs from 16 cases of posterior spinal instrumentation (6 titanium, 6 stainless steel, and 2 replicates of each to assess intraobserver reliability) were randomly selected from a database of cases performed for pediatric scoliosis in a university setting from 2005 to 2009. The cases were randomized then shown to 19 orthopaedic surgery residents, 1 spine fellow, and 2 spine attendings. After the "shadow sign" was described, the surgeons were asked to determine what type of metal each implant was made of. The κ value for both stainless steel and titanium versus the gold standard was 0.83 [standard error (SE) = 0.053], indicating excellent agreement. The κ value for agreement between raters was 0.71 (SE = 0.016) and the κ value for agreement within raters was 0.70 (SE = 0.016), both of which indicated substantial agreement. The "shadow sign" can help a clinician differentiate titanium from stainless steel spinal instrumentation based on radiographic appearance alone. Furthermore, our study reveals that the level of experience in diagnosing spinal lateral radiographs also enhances the use of

  1. One stage surgical treatment for scoliosis associated with intraspinal abnormalities

    Directory of Open Access Journals (Sweden)

    Kai WANG

    2017-09-01

    Full Text Available Objective To evaluate the effectiveness and safety of one stage surgical treatment for scoliosis and coexisting intraspinal abnormalities. Methods The data of 6 patients who underwent one stage surgical treatment for scoliosis and coexisting intraspinal abnormalities from October 2016 to January 2017 were retrospectively analyzed. Treatment for intraspinal abnormalities, posterior correction, osteotomy and internal fixation were performed simultaneously. The clinical and radiologic presentations, operative details, complications and postoperative outcomes were evaluated. Results The success rate was 100%. The operating time was (470.83 ± 136.20 min and intraoperative bleeding amount was 1350 (625, 2150 ml. Total fusion segments were 11.00 ± 2.76. Both Cobb angle of scoliosis [postoperation (19.60 ± 5.94° vs. preoperation (59.40 ± 14.31°, P = 0.007] and kyphosis [postoperation (25.80 ± 10.87° vs. preoperation (62.40 ± 21.04°, P = 0.005] were improved after operation. Tethered cords were released and epidermoid cyst, ganglioglioma and lipoma were excised. Syringomyelia was left untreated. No neurological functional defect or worsening was found. Muscle strength of all patients was improved. Muscular tone of 4 patients and difficulty in urination of 5 patients were also improved. The mean hospital stay was (8.83 ± 3.31 d. No severe complications, such as infection, cerebrospinal fluid (CSF leakage, failed internal fixation, fractured pedicle screws or rods occurred after operation. None of the patients died, or experienced deterioration of neurological function, delayed infection, pseudoarthrosis, or loss correction during the (7.50 ± 1.22 months follow - up. Conclusions The one stage surgical treatment for scoliosis and intraspinal abnormalities seems to be a safe and effective approach. Neurological functional defect can be improved after operation. Osteotomy can improve correction result. DOI: 10.3969/j.issn.1672-6731.2017.09.011

  2. Pediatric spine imaging post scoliosis surgery

    Energy Technology Data Exchange (ETDEWEB)

    Alsharief, Alaa N. [IWK Children' s Health Center, Dalhousie University, Diagnostic Imaging Department, Halifax, NS (Canada); The Hospital for Sick Children, University of Toronto, Department of Diagnostic Imaging, Toronto (Canada); King Saud University, Department of Medical Imaging, King Abdul-Aziz Medical City, King Khaled National Guard Hospital-Western Region, Jeddah (Saudi Arabia); El-Hawary, Ron [Dalhousie University, Orthopedic Surgery Department, IWK Children' s Health Center, Halifax, NS (Canada); Schmit, Pierre [IWK Children' s Health Center, Dalhousie University, Diagnostic Imaging Department, Halifax, NS (Canada)

    2018-01-15

    Many orthopedic articles describe advances in surgical techniques and implants used in pediatric scoliosis surgery. However, even though postoperative spine imaging constitutes a large portion of outpatient musculoskeletal pediatric radiology, few, if any, radiology articles discuss this topic. There has been interval advancement over the last decades of the orthopedic procedures used in the treatment of spinal scoliosis in adolescents with idiopathic scoliosis. The goal of treatment in these patients is to stop the progression of the curve by blocking the spinal growth and correcting the deformity as much as possible. To that end, the authors in this paper discuss postoperative imaging findings of Harrington rods, Luque rods, Luque-Galveston implants and segmental spinal fusion systems. Regarding early onset scoliosis, the guiding principles used for adolescent idiopathic scoliosis do not apply to a growing spine because they would impede lung development. As a result, other devices have been developed to correct the curve and to allow spinal growth. These include spine-based growing rods, vertically expandable prosthetic titanium rods (requiring repetitive surgeries) and magnetically controlled growing rods (with a magnetic locking/unlocking system). Other more recent systems are Shilla and thoracoscopic anterior vertebral body tethering, which allow guided growth of the spine without repetitive interventions. In this paper, we review the radiologic appearances of different orthopedic implants and techniques used to treat adolescent idiopathic scoliosis and early onset scoliosis. Moreover, we present the imaging findings of the most frequent postoperative complications. (orig.)

  3. Pediatric spine imaging post scoliosis surgery

    International Nuclear Information System (INIS)

    Alsharief, Alaa N.; El-Hawary, Ron; Schmit, Pierre

    2018-01-01

    Many orthopedic articles describe advances in surgical techniques and implants used in pediatric scoliosis surgery. However, even though postoperative spine imaging constitutes a large portion of outpatient musculoskeletal pediatric radiology, few, if any, radiology articles discuss this topic. There has been interval advancement over the last decades of the orthopedic procedures used in the treatment of spinal scoliosis in adolescents with idiopathic scoliosis. The goal of treatment in these patients is to stop the progression of the curve by blocking the spinal growth and correcting the deformity as much as possible. To that end, the authors in this paper discuss postoperative imaging findings of Harrington rods, Luque rods, Luque-Galveston implants and segmental spinal fusion systems. Regarding early onset scoliosis, the guiding principles used for adolescent idiopathic scoliosis do not apply to a growing spine because they would impede lung development. As a result, other devices have been developed to correct the curve and to allow spinal growth. These include spine-based growing rods, vertically expandable prosthetic titanium rods (requiring repetitive surgeries) and magnetically controlled growing rods (with a magnetic locking/unlocking system). Other more recent systems are Shilla and thoracoscopic anterior vertebral body tethering, which allow guided growth of the spine without repetitive interventions. In this paper, we review the radiologic appearances of different orthopedic implants and techniques used to treat adolescent idiopathic scoliosis and early onset scoliosis. Moreover, we present the imaging findings of the most frequent postoperative complications. (orig.)

  4. Effect of Glucocorticoids on the Clinical and Radiographic Efficacy of Tofacitinib in Patients with Rheumatoid Arthritis: A Posthoc Analysis of Data from 6 Phase III Studies.

    Science.gov (United States)

    Charles-Schoeman, Christina; van der Heijde, Désirée; Burmester, Gerd R; Nash, Peter; Zerbini, Cristiano A F; Connell, Carol A; Fan, Haiyun; Kwok, Kenneth; Bananis, Eustratios; Fleischmann, Roy

    2018-02-01

    Tofacitinib has been investigated for the treatment of rheumatoid arthritis (RA) in phase III studies in which concomitant glucocorticoids (GC) were allowed. We analyzed the effect of GC use on efficacy outcomes in patients with RA receiving tofacitinib and/or methotrexate (MTX) or conventional synthetic disease-modifying antirheumatic drugs (csDMARD) in these studies. Our posthoc analysis included data from 6 phase III studies (NCT01039688; NCT00814307; NCT00847613; NCT00853385; NCT00856544; NCT00960440). MTX-naive patients or patients with inadequate response to csDMARD or biological DMARD received tofacitinib 5 or 10 mg twice daily alone or with csDMARD, with or without concomitant GC. Patients receiving GC (≤ 10 mg/day prednisone or equivalent) before enrollment maintained a stable dose throughout. Endpoints included the American College of Rheumatology (ACR) 20/50/70 response rates, rates of Clinical Disease Activity Index (CDAI)-defined low disease activity (LDA; CDAI ≤ 10) and remission (CDAI ≤ 2.8), and changes from baseline in CDAI, 28-joint count Disease Activity Score (DAS28-4)-erythrocyte sedimentation rate (ESR), Health Assessment Questionnaire-Disability Index (HAQ-DI), pain visual analog scale (VAS), and modified total Sharp score. Of 3200 tofacitinib-treated patients, 1258 (39.3%) received tofacitinib monotherapy and 1942 (60.7%) received tofacitinib plus csDMARD; 1767 (55.2%) received concomitant GC. ACR20/50/70 response rates, rates of CDAI LDA and remission, and improvements in CDAI, DAS28-4-ESR, HAQ-DI, and pain VAS with tofacitinib were generally similar with or without GC in monotherapy and combination therapy studies. GC use did not appear to affect radiographic progression in tofacitinib-treated MTX-naive patients. MTX plus GC appeared to inhibit radiographic progression to a numerically greater degree than MTX alone. Concomitant use of GC with tofacitinib did not appear to affect clinical or radiographic efficacy. MTX plus GC showed a

  5. TRPV4 related skeletal dysplasias: a phenotypic spectrum highlighted byclinical, radiographic, and molecular studies in 21 new families

    Directory of Open Access Journals (Sweden)

    Sillence David

    2011-06-01

    Full Text Available Abstract Background The TRPV4 gene encodes a calcium-permeable ion-channel that is widely expressed, responds to many different stimuli and participates in an extraordinarily wide range of physiologic processes. Autosomal dominant brachyolmia, spondylometaphyseal dysplasia Kozlowski type (SMDK and metatropic dysplasia (MD are currently considered three distinct skeletal dysplasias with some shared clinical features, including short stature, platyspondyly, and progressive scoliosis. Recently, TRPV4 mutations have been found in patients diagnosed with these skeletal phenotypes. Methods and Results We critically analysed the clinical and radiographic data on 26 subjects from 21 families, all of whom had a clinical diagnosis of one of the conditions described above: 15 with MD; 9 with SMDK; and 2 with brachyolmia. We sequenced TRPV4 and identified 9 different mutations in 22 patients, 4 previously described, and 5 novel. There were 4 mutation-negative cases: one with MD and one with SMDK, both displaying atypical clinical and radiographic features for these diagnoses; and two with brachyolmia, who had isolated spine changes and no metaphyseal involvement. Conclusions Our data suggest the TRPV4 skeletal dysplasias represent a continuum of severity with areas of phenotypic overlap, even within the same family. We propose that AD brachyolmia lies at the mildest end of this spectrum and, since all cases described with this diagnosis and TRPV4 mutations display metaphyseal changes, we suggest that it is not a distinct entity but represents the mildest phenotypic expression of SMDK.

  6. Clinical, Radiographic and Microbiological Evaluation of High Level Laser Therapy, a New Photodynamic Therapy Protocol, in Peri-Implantitis Treatment; a Pilot Experience

    Directory of Open Access Journals (Sweden)

    Gianluigi Caccianiga

    2016-01-01

    Full Text Available Aim. Endosseous implants are widely used to replace missing teeth but mucositis and peri-implantitis are the most frequent long-term complications related with dental implants. Removing all bacterial deposits on contaminated implant surface is very difficult due to implant surface morphology. The aim of this study was to evaluate the bactericidal potential of photodynamic therapy by using a new high level laser irradiation protocol associated with hydrogen peroxide in peri-implantitis. Materials and Methods. 10 patients affected by peri-implantitis were selected for this study. Medical history, photographic documentation, periodontal examination, and periapical radiographs were collected at baseline and 6 months after surgery. Microbiological analysis was performed with PCR Real Time. Each patient underwent nonsurgical periodontal therapy and surgery combined with photodynamic therapy according to High Level Laser Therapy protocol. Results. All peri-implant pockets were treated successfully, without having any complication and not showing significant differences in results. All clinical parameters showed an improvement, with a decrease of Plaque Index (average decrease of 65%, range 23–86%, bleeding on probing (average decrease of 66%, range 26–80%, and probing depth (average decrease of 1,6 mm, range 0,46–2,6 mm. Periapical radiographs at 6 months after surgery showed a complete radiographic filling of peri-implant defect around implants treated. Results showed a decrease of total bacterial count and of all bacterial species, except for Eikenella corrodens, 6 months after surgery. Conclusion. Photodynamic therapy using HLLT appears to be a good adjunct to surgical treatment of peri-implantitis.

  7. Validation of a Japanese version of the Scoliosis Research Society-22 Patient Questionnaire among idiopathic scoliosis patients in Japan.

    Science.gov (United States)

    Hashimoto, Hideki; Sase, Takeshi; Arai, Yasuhisa; Maruyama, Toru; Isobe, Keijirou; Shouno, Yasuhiro

    2007-02-15

    A cross-sectional observational study to determine the response distribution, internal consistency, and construct, concurrent, and discriminative validities of The Scoliosis Research Society-22 (SRS-22) Patient Questionnaire translated into Japanese as compared with the other language versions. To validate the Japanese version of SRS22. The SRS-22 was translated into several languages but yet not into Japanese. The Japanese SRS-22 and Medical Outcomes Study Short Form 36 were simultaneously administered to 114 adolescent idiopathic scoliosis patients. Exploratory factor analysis revealed a 4-factor structure, though several items were not loaded as theoretically expected. The originally constructed Japanese SRS-22 subscales and the English version showed similar response distribution. Internal consistency was fair but lower than that of the English version. The concurrent validity of the translated version, except for the self-image subscale, was supported using Medical Outcomes Study Short Form 36 subscales as a reference. The function scale differed significantly by curve angle magnitude and treatment status. The self-image score was the highest in patients under observation when curve angle was or = 40 degrees, respectively. The Japanese SRS-22 is valid and may be useful for clinical evaluation of Japanese scoliosis patients, though the self-image subscale may need further assessment.

  8. Radiographic tales

    DEFF Research Database (Denmark)

    Mussmann, Bo Redder

    Purpose Until now a large number of scientific studies have focused on technological aspects of radiography. This study is a step in another direction which examines the relationship between man and technology within radiography instead of considering man and technology as separate entities. Meth...... of their narrative alertness. Errors and failure to keep the time schedule can, however, lead the radiographers to a change of perspective that makes them displace man from the scene of radiography by playing on the premises of technology.......Purpose Until now a large number of scientific studies have focused on technological aspects of radiography. This study is a step in another direction which examines the relationship between man and technology within radiography instead of considering man and technology as separate entities...... a practice in which the relationship between man and technology is marked by a struggle of domination of one over the other. The struggle expresses itself through two competing plots: A diagnostic plot with a prevailing, but not merely chronological structure mostly composed of events tied to pathology...

  9. Comparison of Srs-24 And Srs-22 Scores in Thirty Eight Adolescent Idiopathic Scoliosis Patients Who Had Undergone Surgical Correction

    Directory of Open Access Journals (Sweden)

    CYW Chan

    2009-05-01

    Full Text Available Adolescent idiopathic scoliosis is a spinal deformity that affects patients’ self image and confidence. Surgery is offered when the curvature is greater than 50 degrees based on the likelihood of curvature progression. Outcome measures for scoliosis correction can be described in terms of radiological improvement or improvement of health related quality of life scores. The Scoliosis Research Society 22 (SRS-22 and Scoliosis Research Society 24 (SRS-24 questionnaires are widely accepted and used to characterize clinical results. Therefore, this prospective study of 38 patients aims to investigate how the SRS-24 and SRS-22 questionnaires compare to each other in terms of scoring when the same group of patients is evaluated. The SRS-22 questionnaire tends to give an inflated value in the overall score, pain and self image domain compared to the SRS-24 questionnaire.

  10. Clinical, radiographic, and scintigraphic findings associated with enthesitis of the lateral collateral ligaments of the tarsocrural joint in Standardbred racehorses

    International Nuclear Information System (INIS)

    Boero, M.J.; Kneller, S.K.; Baker, G.J.; Metcalf, M.R.; Twardock, A.R.

    1988-01-01

    Injury of the lateral collateral ligaments of the tarsocrural joints was diagnosed in nine Standardbred pacers. The average age was 4.9 years. The severity of the lameness varied from severe to subtle and joint effusion was seen in eight of 10 tarsocrural joints. A positive hindlimb flexion test was seen in four of six cases in which results were recorded. The identification of the site of involvement was based on a focal intense 'hot spot' seen on scintigraphy, and new bone formation seen radiographically at the anatomical sites of insertion of the long lateral collateral ligament of the tarsocrural joint in nine limbs and the short lateral collateral ligament of one limb. The authors believe this injury to be enthesitis caused by the cyclic trauma of training and racing speed. The primary therapy was rest. Of six cases which returned to training, three raced as well or better than before injury

  11. Clinical and radiographic features, treatment and outcome in 15 horses with fracture of the medial aspect of the patella

    International Nuclear Information System (INIS)

    Dyson, S.; Wright, I.; Kold, S.; Vatistas, N.

    1992-01-01

    A sagittal fracture of the medial aspect of the patella was identified in 15 horses, 2 of which had been kicked and 12 of which had hit a fixed fence while jumping. Eight horses showed concurrent fragmentation of the base of the patella, and 2 had sustained a concurrent fracture of the distal end of the lateral trochlear ridge of the femur. A cranioproximal-craniodistal oblique radiographic view was essential to identify the site of the medial patellar fracture and to determine its configuration. Fourteen horses were treated by surgical removal of the medial patellar fracture fragment(s). Of 12 horses (83%) without evidence of pre-existing degenerative joint disease, 10 were treated successfully with return to full athletic function

  12. Responsiveness and Minimal Important Changes of the Scoliosis Research Society-22 Patient Questionnaire in Subjects With Mild Adolescent and Moderate Adult Idiopathic Scoliosis Undergoing Multidisciplinary Rehabilitation.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Foti, Calogero; Ferrante, Simona

    2017-06-01

    Single-center, prospective study. Evaluating the responsiveness and minimal important changes (MICs) for the Scoliosis Research Society-22 Patient Questionnaire (SRS-22) in adolescent idiopathic scoliosis (AIS) and adult idiopathic scoliosis (AS). Despite the SRS-22 properties have been investigated in various different languages, there is still a lack of information concerning responsiveness and MIC, limiting the use of SRS-22 for clinical and research purposes. At the beginning and end of multidisciplinary rehabilitation programs, 149 subjects with mild AIS (Cobb angle self-perceived image, 0.40 (0.609;79;42) for AIS and 0.60 (0.751;61;82) for AS. Correlations between change scores of the SRS-22 domains and GPE were low to moderate, ranging from -0.347 to -0.667. The SRS-22 was sensitive in detecting clinical changes in subjects with adolescent and adult scoliosis. We recommend taking the MICs provided into account when assessing patients' improvement or planning studies in these clinical contexts. 3.

  13. Radiation risk assessment in neonatal radiographic examinations of the chest and abdomen: a clinical and Monte Carlo dosimetry study

    International Nuclear Information System (INIS)

    Makri, T; Yakoumakis, E; Papadopoulou, D; Gialousis, G; Theodoropoulos, V; Sandilos, P; Georgiou, E

    2006-01-01

    Seeking to assess the radiation risk associated with radiological examinations in neonatal intensive care units, thermo-luminescence dosimetry was used for the measurement of entrance surface dose (ESD) in 44 AP chest and 28 AP combined chest-abdominal exposures of a sample of 60 neonates. The mean values of ESD were found to be equal to 44 ± 16 μGy and 43 ± 19 μGy, respectively. The MCNP-4C2 code with a mathematical phantom simulating a neonate and appropriate x-ray energy spectra were employed for the simulation of the AP chest and AP combined chest-abdominal exposures. Equivalent organ dose per unit ESD and energy imparted per unit ESD calculations are presented in tabular form. Combined with ESD measurements, these calculations yield an effective dose of 10.2 ± 3.7 μSv, regardless of sex, and an imparted energy of 18.5 ± 6.7 μJ for the chest radiograph. The corresponding results for the combined chest-abdominal examination are 14.7 ± 7.6 μSv (males)/17.2 ± 7.6 μSv (females) and 29.7 ± 13.2 μJ. The calculated total risk per radiograph was low, ranging between 1.7 and 2.9 per million neonates, per film, and being slightly higher for females. Results of this study are in good agreement with previous studies, especially in view of the diversity met in the calculation methods

  14. Radiation risk assessment in neonatal radiographic examinations of the chest and abdomen: a clinical and Monte Carlo dosimetry study

    Science.gov (United States)

    Makri, T.; Yakoumakis, E.; Papadopoulou, D.; Gialousis, G.; Theodoropoulos, V.; Sandilos, P.; Georgiou, E.

    2006-10-01

    Seeking to assess the radiation risk associated with radiological examinations in neonatal intensive care units, thermo-luminescence dosimetry was used for the measurement of entrance surface dose (ESD) in 44 AP chest and 28 AP combined chest-abdominal exposures of a sample of 60 neonates. The mean values of ESD were found to be equal to 44 ± 16 µGy and 43 ± 19 µGy, respectively. The MCNP-4C2 code with a mathematical phantom simulating a neonate and appropriate x-ray energy spectra were employed for the simulation of the AP chest and AP combined chest-abdominal exposures. Equivalent organ dose per unit ESD and energy imparted per unit ESD calculations are presented in tabular form. Combined with ESD measurements, these calculations yield an effective dose of 10.2 ± 3.7 µSv, regardless of sex, and an imparted energy of 18.5 ± 6.7 µJ for the chest radiograph. The corresponding results for the combined chest-abdominal examination are 14.7 ± 7.6 µSv (males)/17.2 ± 7.6 µSv (females) and 29.7 ± 13.2 µJ. The calculated total risk per radiograph was low, ranging between 1.7 and 2.9 per million neonates, per film, and being slightly higher for females. Results of this study are in good agreement with previous studies, especially in view of the diversity met in the calculation methods.

  15. SU-E-I-15: Comparison of Radiation Dose for Radiography and EOS in Adolescent Scoliosis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Schueler, B; Walz-Flannigan, A [Mayo Clinic, Rochester, MN (United States)

    2014-06-01

    Purpose: To estimate patient radiation dose for whole spine imaging using EOS, a new biplanar slot-scanning radiographic system and compare with standard scoliosis radiography. Methods: The EOS imaging system (EOS Imaging, Paris, France) consists of two orthogonal x-ray fan beams which simultaneously acquire frontal and lateral projection images of a standing patient. The patient entrance skin air kerma was measured for each projection image using manufacturer-recommended exposure parameters for spine imaging. Organ and effective doses were estimated using a commercially-available Monte Carlo simulation program (PCXMC, STUK, Radiation and Nuclear Safety Authority, Helsinki, Finland) for a 15 year old mathematical phantom model. These results were compared to organ and effective dose estimated for scoliosis radiography using computed radiography (CR) with standard exposure parameters obtained from a survey of pediatric radiographic projections. Results: The entrance skin air kerma for EOS was found to be 0.18 mGy and 0.33 mGy for posterior-anterior (PA) and lateral projections, respectively. This compares to 0.76 mGy and 1.4 mGy for CR, PA and lateral projections. Effective dose for EOS (PA and lateral projections combined) is 0.19 mSv compared to 0.51 mSv for CR. Conclusion: The EOS slot-scanning radiographic system allows for reduced patient radiation dose in scoliosis patients as compared to standard CR radiography.

  16. Associations between treatment, scoliosis, pulmonary function, and physical performance in long-term survivors of sarcoma.

    Science.gov (United States)

    Interiano, Rodrigo B; Kaste, Sue C; Li, Chenghong; Srivastava, Deo Kumar; Rao, Bhaskar N; Warner, William C; Green, Daniel M; Krasin, Matthew J; Robison, Leslie L; Davidoff, Andrew M; Hudson, Melissa M; Fernandez-Pineda, Israel; Ness, Kirsten K

    2017-10-01

    Longer survival for children with sarcoma has led to the recognition of chronic health conditions related to prior therapy. We sought to study the association of sarcoma therapy with the development of scoliosis. We reviewed patient demographics, treatment exposures, and functional outcomes for patients surviving >10 years after treatment for sarcoma between 1964 and 2002 at our institution. The diagnosis of scoliosis was determined by imaging. Functional performance and standardized questionnaires were completed in a long-term follow-up clinic. We identified 367 patients, with median age at follow-up of 33.1 years. Scoliosis was identified in 100 (27.2%) patients. Chest radiation (relative risk (RR), 1.88 (95% confidence interval (CI), 1.21-2.92), p sarcoma are at risk of developing scoliosis when treatment regimens include chest radiation or rib resection. Identification of these risk factors may allow for early intervention designed to prevent adverse long-term outcomes. Cancer survivors at risk of developing scoliosis may benefit from monitoring of pulmonary status and early physical therapy.

  17. Intraoperative implant rod three-dimensional geometry measured by dual camera system during scoliosis surgery.

    Science.gov (United States)

    Salmingo, Remel Alingalan; Tadano, Shigeru; Abe, Yuichiro; Ito, Manabu

    2016-05-12

    Treatment for severe scoliosis is usually attained when the scoliotic spine is deformed and fixed by implant rods. Investigation of the intraoperative changes of implant rod shape in three-dimensions is necessary to understand the biomechanics of scoliosis correction, establish consensus of the treatment, and achieve the optimal outcome. The objective of this study was to measure the intraoperative three-dimensional geometry and deformation of implant rod during scoliosis corrective surgery.A pair of images was obtained intraoperatively by the dual camera system before rotation and after rotation of rods during scoliosis surgery. The three-dimensional implant rod geometry before implantation was measured directly by the surgeon and after surgery using a CT scanner. The images of rods were reconstructed in three-dimensions using quintic polynomial functions. The implant rod deformation was evaluated using the angle between the two three-dimensional tangent vectors measured at the ends of the implant rod.The implant rods at the concave side were significantly deformed during surgery. The highest rod deformation was found after the rotation of rods. The implant curvature regained after the surgical treatment.Careful intraoperative rod maneuver is important to achieve a safe clinical outcome because the intraoperative forces could be higher than the postoperative forces. Continuous scoliosis correction was observed as indicated by the regain of the implant rod curvature after surgery.

  18. Reliability and validity of the persian version of the scoliosis research society-22r questionnaire.

    Science.gov (United States)

    Mousavi, Sayed Javad; Mobini, Bahram; Mehdian, Hossein; Akbarnia, Behrouz; Bouzari, Behshad; Askary-Ashtiani, Ahmadreza; Montazeri, Ali; Parnianpour, Mohamad

    2010-04-01

    Cross-sectional validation study to investigate psychometric properties of adapted Persian version of the Scoliosis Research Society-22r (SRS-22r) questionnaire. OBJECTIVES.: To translate the SRS-22r into Persian and to evaluate the internal consistency, reliability, and validity of the Persian SRS-22r. The SRS-22r has not been translated and validated for Persian-speaking patients with idiopathic scoliosis. This was to provide a validated instrument to measure health-related quality of life in patients with idiopathic scoliosis in Iran. The translation and cultural adaptation of the original questionnaire were carried out in accordance with the published guidelines. About 84 patients with adolescent idiopathic scoliosis were participated in the study. The Short Form Health Survey (SF-36) was used to test convergent validity of the Persian SRS-22r. Moderate to high correlations were found between the SRS-22r domains and SF-36 subscales. The correlations ranged from 0.54 to 0.67 (function/activity domain), 0.48 to 0.74 (pain domain), 0.45 to 0.55 (self image domain), 0.66 to 0.85 (mental health domain), and 0.35 to 0.55 (satisfaction domain) (P adolescent patients with scoliosis in Iran. It is simple and easy to use and now can be applied in clinical settings and future outcome studies in Iran.

  19. A Retrospective Radiographic Survey of Pathology Associated with Impacted Third Molars among Patients Seen in Oral & Maxillofacial Surgery Clinic of College of Dentistry, Riyadh.

    Science.gov (United States)

    Khawaja, Naveed Ahmad; Khalil, Hesham; Parveen, Kauser; Al-Mutiri, Abdulmajeed; Al-Mutiri, Saif; Al-Saawi, Abdullah

    2015-04-01

    The purpose of this study is to determine the type and frequency of pathological conditions around third molar teeth among randomly selected patient's records in Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh. Totally, 281 patient panoramic radiographs were selected with detectable pathology among 570 files of patients seen in oral and maxillofacial surgery clinics 2 years retrospectively. Almost 17-55 years age (mean age 25.43) was selected. The following radiographs were analyzed for all pathology associated impacted teeth; dental caries, bone resorption, periodontitis, and apical pathology. The study found caries, external bone resorption and periodontitis are highly frequent to mesioangular and horizontal in mandibular impacted third molar compared to maxillary impacted third molar. Overall result evaluated that tooth #28 related periodontitis is significant (P = 0.021), and tooth #38 related bone resorption, tooth #48 related root caries, bone resorption and apical pathology are highly significant (P = 0.000) comparing to others. This study also concluded the high frequency of root caries, bone resorption and apical pathology reported in relation to mandibular impacted third teeth. Significant results were also achieved with periodontitis in relation to mesiangular and vertical angulation of left impacted maxillary third molars. Prophylactic removal of impacted third molars is recommended in many studies to avoid future risk of associated pathology. Retained asymptomatic impacted third molars imply pathology that could be difficult in later ages as less morbidity in younger ages.

  20. Schroth physiotherapeutic scoliosis-specific exercises for adolescent idiopathic scoliosis: how many patients require treatment to prevent one deterioration? – results from a randomized controlled trial - “SOSORT 2017 Award Winner”

    Directory of Open Access Journals (Sweden)

    Sanja Schreiber

    2017-11-01

    Full Text Available Abstract Background Recent randomized controlled trials (RCTs support using physiotherapeutic scoliosis-specific exercises (PSSE for adolescents with idiopathic scoliosis (AIS. All RCTs reported statistically significant results favouring PSSE but none reported on clinical significance. The number needed to treat (NNT helps determine if RCT results are clinically meaningful. The NNT is the number of patients that need to be treated to prevent one bad outcome in a given period. A low NNT suggests that a therapy has positive outcomes in most patients offered the therapy. The objective was to determine how many patients require Schroth PSSE added to standard care (observation or brace treatment to prevent one progression (NNT of the Largest Curve (LC or Sum of Curves (SOC beyond 5° and 10°, respectively over a 6-month interval. Methods This was a secondary analysis of a RCT. Fifty consecutive participants from a scoliosis clinic were randomized to the Schroth PSSE + standard of care group (n = 25 or the standard of care group (n = 25. We included males and females with AIS, age 10–18 years, all curve types, with curves 10°- 45°, with or without brace, and all maturity levels. We excluded patients awaiting surgery, having had surgery, having completed brace treatment and with other scoliosis diagnoses. The local ethics review board approved the study (Pro00011552. The Schroth intervention consisted of weekly 1-h supervised Schroth PSSE sessions and a daily home program delivered over six months in addition to the standard of care. A prescription algorithm was used to determine which exercises patients were to perform. Controls received only standard of care. Cobb angles were measured using a semi-automatic system from posterior-anterior standing radiographs at baseline and 6 months. We calculated absolute risk reduction (ARR and relative risk reduction (RRR. The NTT was calculated as: NNT = 1/ARR. Patients with missing values (PSSE

  1. Radiographic findings in immunodeficiency

    International Nuclear Information System (INIS)

    Obregon, R.; Lynch, D.A.; Cink, T.M.; Newell, J.D.; Kirkpatrick, C.

    1991-01-01

    This paper reviews the chest radiographs and high-resolution CT (HRCT) scans in patients with immunodeficiency disorders and define the role of HRCT. Thirty-three cases were retrospectively graded according to the consensus of two radiologists. Patients with HIV seropositivity and asthma were excluded. HRCT was performed in 12 cases with standard techniques. Diagnoses included common variable hypogammaglobulinemia (n = 19), X-linked agammaglobulinemia (n = 4), chronic mucocutaneous candidiasis (n = 4), and selective immunoglobulin g deficiencies (n = 2). Chest radiographs showed bronchiectasis in 11 of 33 cases with a predominant lower lobe distribution (82%). Nodules were present in six cases and mucus plugs in four cases. HRCT showed bronchiectasis in nine of 12 cases; in five of these nine cases, bronchiectasis was not apparent on chest radiographs. Other HRCT findings included segmental air trapping (four of 12), mucus plugs (three of 12), hazy consolidation (four of 12), nodules (five of 12), and bronchiolectasis (two of 12). Therapy was altered in seven of 12 cases in which HRCT was performed. Most pertinent to clinical management were the presence of a thymoma (n = 1) and severe focal of diffuse bronchiectasis

  2. [Therapy of scoliosis from a historical perspective].

    Science.gov (United States)

    Harms, J; Rauschmann, M; Rickert, M

    2015-12-01

    Scoliosis can be considered as one of the classical orthopedic diseases of the spine. The history of orthopedics is closely connected to the development of the therapy of scoliosis. In the eighteenth and the beginning of the nineteenth centuries the therapy of scoliosis was mainly a conservative corrective orthopedic treatment with a variety of corset forms and extension bed treatment. In the middle of the nineteenth century physiotherapy (movement therapy) became established as an supplementary active treatment. The first operations for treatment of scoliosis were carried out in 1839. The real success with surgical procedures for improvement in corrective options was connected to the introduction of metal spinal implants in the early 1960s.

  3. Implant Mandibular Overdentures Retained by Immediately Loaded Implants: A 1-Year Randomized Trial Comparing the Clinical and Radiographic Outcomes Between Mini Dental Implants and Standard-Sized Implants.

    Science.gov (United States)

    Zygogiannis, Kostas; Aartman, Irene Ha; Parsa, Azin; Tahmaseb, Ali; Wismeijer, Daniel

    The aim of this 1-year randomized trial was to evaluate and compare the clinical and radiographic performance of four immediately loaded mini dental implants (MDIs) and two immediately loaded standard-sized tissue-level (STL) implants, placed in the interforaminal region of the mandible and used to retain mandibular overdentures (IODs) in completely edentulous patients. A total of 50 completely edentulous patients wearing conventional maxillary dentures and complaining about insufficient retention of their mandibular dentures were divided into two groups; 25 patients received four MDIs and 25 patients received two STL implants. The marginal bone loss (MBL) at the mesial and distal sides of each implant was assessed by means of standardized intraoral radiographs after a period of 1 year. Implant success and survival rates were also calculated. Immediate loading was possible for all patients in the first group. In the second group, an immediate loading protocol could not be applied for 10 patients. These patients were treated with a delayed loading protocol. A mean MBL of 0.42 ± 0.56 mm for the MDIs and 0.54 ± 0.49 mm for the immediately loaded STL implants was recorded at the end of the evaluation period. There was no statistically significant difference between the MDIs and the immediately loaded STL implants. Two MDIs failed, resulting in a survival rate of 98%. The success rate was 91%. For the immediately loaded conventional implants, the survival rate was 100% and the success rate 96.7% after 1 year of function. However, in 10 patients, the immediate loading protocol could not be followed. Considering the limitations of this short-term clinical study, immediate loading of four unsplinted MDIs or two splinted STL implants to retain mandibular overdentures seems to be a feasible treatment option. The marginal bone level changes around the MDIs were well within the clinically acceptable range.

  4. Duchenne muscular dystrophy: the management of scoliosis

    Science.gov (United States)

    Gardner, Adrian C.; Roper, Helen P.; Chikermane, Ashish A.; Tatman, Andrew J.

    2016-01-01

    This study summaries the current management of scoliosis in patients with Duchenne Muscular Dystrophy. A literature review of Medline was performed and the collected articles critically appraised. This literature is discussed to give an overview of the current management of scoliosis within Duchenne Muscular Dystrophy. Importantly, improvements in respiratory care, the use of steroids and improving surgical techniques have allowed patients to maintain quality of life and improved life expectancy in this patient group. PMID:27757431

  5. Assessment of the level of agreement in the interpretation of plain radiographs of lumbar spondylosis among clinical physiotherapists in Ghana.

    Science.gov (United States)

    Bello, Ajediran I; Ofori, Eric K; Alabi, Oluwasegun J; Adjei, David N

    2014-03-29

    Objective physical assessment of patients with lumbar spondylosis involves plain film radiographs (PFR) viewing and interpretation by the radiologists. Physiotherapists also routinely assess PFR within the scope of their practice. However, studies appraising the level of agreement of physiotherapists' PFR interpretation with radiologists are not common in Ghana. Forty-one (41) physiotherapists took part in the cross-sectional survey. An assessment guide was developed from findings of the interpretation of three PFR of patients with lumbar spondylosis by a radiologist. The three PFR were selected from a pool of different radiographs based on clarity, common visible pathological features, coverage body segments and short post production period. Physiotherapists were required to view the same PFR after which they were assessed with the assessment guide according to the number of features identified correctly or incorrectly. The score range on the assessment form was 0-24, interpreted as follow: 0-8 points (low), 9-16 points (moderate) and 17-24 points (high) levels of agreement. Data were analyzed using one sample t-test and fisher's exact test at α = 0.05. The mean score of interpretation for the physiotherapists was 12.7 ± 2.6 points compared to the radiologist's interpretation of 24 points (assessment guide). The physiotherapists' levels were found to be significantly associated with their academic qualification (p = 0.006) and sex (p = 0.001). However, their levels of agreement were not significantly associated with their age group (p = 0.098), work settings (p = 0.171), experience (p = 0.666), preferred PFR view (p = 0.088) and continuing education (p = 0.069). The physiotherapists' skills fall short of expectation for interpreting PFR of patients with lumbar spondylosis. The levels of agreement with radiologist's interpretation have no link with year of clinial practice, age, work settings and continuing education. Thus

  6. Assessment of the level of agreement in the interpretation of plain radiographs of lumbar spondylosis among clinical physiotherapists in Ghana

    International Nuclear Information System (INIS)

    Bello, Ajediran I; Ofori, Eric K; Alabi, Oluwasegun J; Adjei, David N

    2014-01-01

    Objective physical assessment of patients with lumbar spondylosis involves plain film radiographs (PFR) viewing and interpretation by the radiologists. Physiotherapists also routinely assess PFR within the scope of their practice. However, studies appraising the level of agreement of physiotherapists’ PFR interpretation with radiologists are not common in Ghana. Forty-one (41) physiotherapists took part in the cross-sectional survey. An assessment guide was developed from findings of the interpretation of three PFR of patients with lumbar spondylosis by a radiologist. The three PFR were selected from a pool of different radiographs based on clarity, common visible pathological features, coverage body segments and short post production period. Physiotherapists were required to view the same PFR after which they were assessed with the assessment guide according to the number of features identified correctly or incorrectly. The score range on the assessment form was 0–24, interpreted as follow: 0–8 points (low), 9–16 points (moderate) and 17–24 points (high) levels of agreement. Data were analyzed using one sample t-test and fisher’s exact test at α = 0.05. The mean score of interpretation for the physiotherapists was 12.7 ± 2.6 points compared to the radiologist’s interpretation of 24 points (assessment guide). The physiotherapists’ levels were found to be significantly associated with their academic qualification (p = 0.006) and sex (p = 0.001). However, their levels of agreement were not significantly associated with their age group (p = 0.098), work settings (p = 0.171), experience (p = 0.666), preferred PFR view (p = 0.088) and continuing education (p = 0.069). The physiotherapists’ skills fall short of expectation for interpreting PFR of patients with lumbar spondylosis. The levels of agreement with radiologist’s interpretation have no link with year of clinial practice, age, work settings and continuing education. Thus, routine PFR viewing

  7. Measuring Acetabular Cup Orientation on Antero-Posterior Radiographs of the Hip after Total Hip Arthroplasty with a Vector Arithmetic Radiological Method. Is It Valid and Verified for Daily Clinical Practice?

    Science.gov (United States)

    Craiovan, B; Weber, M; Worlicek, M; Schneider, M; Springorum, H R; Zeman, F; Grifka, J; Renkawitz, T

    2016-06-01

    The aim of this prospective study is to validate a vector arithmetic method for measuring acetabular cup orientation after total hip arthroplasty (THA) and to verify the clinical practice. We measured cup anteversion and inclination of 123 patients after cementless primary THA twice by two examiners on AP pelvic radiographs with a vector arithmetic method and compared with a 3D-CT based reconstruction model within the same radiographic coronal plane. The mean difference between the radiographic and the 3D-CT measurements was - 1.4° ± 3.9° for inclination and 0.8°± 7.9° for anteversion with excellent correlation for inclination (r = 0.81, p cup position after THA on pelvic radiographs by this vector arithmetic method, there is a need for a correct postoperative ap view, with special regards to the pelvic tilt for the future. • Measuring acetabular cup orientation on anteroposterior radiographs of the hip after THA is a helpful procedure in everyday clinical practice as a first-line imaging modality• CT remains the golden standard to accurately determine acetabular cup position.• Future measuring on radiographs for cup orientation after THA should account for integration of the pelvic tilt in order to maximize the measurement accuracy. Citation Format: • Craiovan B, Weber M, Worlicek M et al. Measuring Acetabular Cup Orientation on Antero-Posterior Radiographs of the Hip after Total Hip Arthroplasty with a Vector Arithmetic Radiological Method. Is It Valid and Verified for Daily Clinical Practice?. Fortschr Röntgenstr 2016; 188: 574 - 581. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Clinical study of pulmonary infection caused by mycobacterium avium complex. Evaluation of radiographic features on the primary pulmonary infection

    International Nuclear Information System (INIS)

    Harada, Yasuko; Harada, Susumu; Kitahara, Yoshinari; Kajiki, Akira; Maruyama, Masao; Takamoto, Masahiro; Ishibashi, Tsuneo

    1996-01-01

    During the 13 year period of 1982 to 1994 we had 103 patients with pulmonary Mycobacterium avium complex (MAC) infections. All met the criteria of atypical mycobacteriosis (Japanese Mycobacteriosis Research Group of the National Chest Hospitals). Of 103 patients 70 had no underlying pulmonary diseases and classified as primary type. Radiographic features of chest X-rays or computed tomography (CT) of primary infection were evaluated. Results obtained were as follows: Primary infection of MAC was classified into two types. One was localized type. This type was further classified into three patterns; tuberculosis-like pattern, pneumonia pattern in the lingual and/or middle lobe and pneumonia pattern in other lobes. Another one was diffuse type. Tuberculosis-like pattern was most common in males. On the other hand, the pneumonia pattern and the diffuse type were most common in females. Four characteristic features were seen as follows (Type 1-4) in the chest CT examination of diffuse pattern. Type 1: Nodules near the pleura. Type 2: Nodules with subpleural thickening. Type 3: Bronchial wall thickening and ectatic change of the draining bronchi. Type 4: Cystic bronchiectatic change associated with atelectasis of the segment or the lobe. Bronchiectatic changes became severe and widespreaded in all lung fields as the disease progressed slowly. These findings were more prevalent in the lingual and/or middle lobe than the other lobes. (author)

  9. Total elbow arthroplasty: a radiographic outcome study

    Energy Technology Data Exchange (ETDEWEB)

    Bai, Xue Susan [University of Washington, Department of Radiology, Box 357115, Seattle, WA (United States); Petscavage-Thomas, Jonelle M. [Penn State Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Ha, Alice S. [University of Washington, Department of Radiology, Box 354755, Seattle, WA (United States)

    2016-06-15

    Total elbow arthroplasty (TEA) is becoming a popular alternative to arthrodesis for patients with end-stage elbow arthrosis and comminuted distal humeral fractures. Prior outcome studies have primarily focused on surgical findings. Our purpose is to determine the radiographic outcome of TEA and to correlate with clinical symptoms such as pain. This is an IRB-approved retrospective review from 2005 to 2015 of all patients with semiconstrained TEA. All available elbow radiographs and clinical data were reviewed. Data analysis included descriptive statistics and Kaplan-Meier survival curves for radiographic and clinical survival. A total of 104 total elbow arthroplasties in 102 patients were reviewed; 75 % were in women and the mean patient age was 63.1 years. Mean radiographic follow-up was 826 days with average of four radiographs per patient. Seventy TEAs (67 %) developed radiographic complications, including heterotopic ossification (48 %), perihardware lucency (27 %), periprosthetic fracture (23 %), hardware subluxation/dislocation (7 %), polyethylene wear (3 %), and hardware fracture/dislodgement (3 %); 56 patients (55 %) developed symptoms of elbow pain or instability and 30 patients (30 %) underwent at least one reoperation. In patients with radiographic complications, 66 % developed elbow pain, compared to 19 % of patients with no radiologic complications (p = 0.001). Of the patients with radiographic complications, 39 % had at least one additional surgery compared to 0 % of patients without radiographic complications (p = 0.056). Radiographic complications are common in patients after total elbow arthroplasty. There is a strong positive association between post-operative radiographic findings and clinical outcome. Knowledge of common postoperative radiographic findings is important for the practicing radiologist. (orig.)

  10. Surgical treatment of anterior instability in rugby union players: clinical and radiographic results of the Latarjet-Patte procedure with minimum 5-year follow-up.

    Science.gov (United States)

    Neyton, Lionel; Young, Allan; Dawidziak, Bérangère; Visona, Enrico; Hager, Jean-Philippe; Fournier, Yann; Walch, Gilles

    2012-12-01

    Anterior instability in rugby players is characterized by the common finding of a bony lesion, which has been identified as a potential cause of recurrence after soft-tissue reconstruction. The Latarjet-Patte procedure is effective in the treatment of recurrent anterior instability in collision sports such as rugby union. We retrospectively assessed 34 rugby players (37 shoulders) stabilized with the Latarjet-Patte procedure. The mean follow-up was 12 years. All patients underwent clinical and radiographic assessment preoperatively and at final follow-up. Functional evaluation was performed with the Walch-Duplay and Rowe scores. A visual analog scale score for the evaluation of pain and the subjective shoulder value were recorded. In addition, all patients completed a questionnaire regarding the return to playing rugby. No recurrence of either dislocation or subluxation occurred. Persistent apprehension on clinical examination was present in 5 patients (14%). A bony lesion of the glenoid was present in 73% and a Hill-Sachs lesion in 68%. Sixty-five percent of the patients returned to playing rugby; only 1 patient did not return to playing rugby because of his shoulder. The mean Walch-Duplay and Rowe scores were 86 and 93 points, respectively. The mean subjective shoulder value was 90%. Radiographic healing of the bone block was observed in 89% of cases. At final follow-up, 11 patients (30%) had minor arthritic changes, with no cases of moderate or severe arthritis. The Latarjet-Patte procedure provides a reliable method for stabilizing the shoulder, resulting in a return to playing rugby in a high number of cases without increasing the risk of long-term arthritic degradation. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  11. Clinical and radiographic outcomes of medial open-wedge high tibial osteotomy with Anthony-K plate: prospective minimum five year follow-up data.

    Science.gov (United States)

    Altay, Mehmet Akif; Ertürk, Cemil; Altay, Nuray; Mercan, Ahmet Şükrü; Sipahioğlu, Serkan; Kalender, Ali Murat; Işıkan, Uğur Erdem

    2016-07-01

    The purpose of this study was to prospectively evaluate the clinical and radiographic outcomes, and complication rates, after a minimum of five years of follow-up after medial open wedge high tibial osteotomy (MOWHTO) using an Anthony-K plate. MOWHTO was performed on 35 knees of 34 consecutive patients. A visual analogue scale (VAS), and Western Ontario and McMaster University Osteoarthritis (WOMAC) and Lysholm scores, were used in clinical evaluation. Upon radiographic assessment, alignment was expressed as the femorotibial angle (FTA). The posterior tibial slope (PTS) and the Insall-Salvati Index (ISI) were also measured. VAS, WOMAC, and Lysholm scores improved significantly upon follow-up (p FTA was 4.68 ± 4.39° varus pre-operatively; at the last post-operative follow-up, the value was 8.43 ± 2.02° valgus. The mean correction angle was 13.1 ± 2.7°. A significant increase in PTS was evident (p < 0.01), as was a significant decrease in the ISI (p < 0.01). The overall complication rate was 8.6 %. The Anthony-K plate affords accurate correction, initially stabilises the osteotomy after surgery, and maintains such stability until the osteotomy gap is completely healed, without correction loss. The plate survival rate was 97.2 % after a minimum of five years of follow-up. The plate increased the PTS, as do other medial osteotomy fixation plates.

  12. Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment – SOSORT consensus paper 2005

    Directory of Open Access Journals (Sweden)

    Grivas Theodoros B

    2006-05-01

    Full Text Available Abstract Background Based on a recognized need for research to examine the premise that nonsurgical approaches can be used effectively to treat signs and symptoms of scoliosis, a scientific society on scoliosis orthopaedic and rehabilitation treatment (SOSORT was established in Barcelona in 2004. SOSORT has a primary goal of implementing multidisciplinary research to develop quantitative, objective data to address the role of conservative therapies in the treatment of scoliosis. This international working group of clinicians and scientists specializing in treatment of scoliosis met in Milan, Italy in January 2005. Methods As a baseline for developing a consensus for language and goals for proposed multicenter clinical studies, we developed questionnaires to examine current beliefs, before and after the meeting, regarding (1 the aims of physical exercises; (2 standards of treatment; and (3 the impact of such treatment performed by specialists in the field. Results The responses to the questionnaires show that, in principle, specialists in scoliosis physiotherapy do not disagree and that several features can be regarded, currently, as standard features in the rehabilitation of scoliosis patients. These features include autocorrection in 3D, training in ADL, stabilizing the corrected posture, and patient education.

  13. The effect of scoliosis implant design parameters on whole spine mechanical behavior

    NARCIS (Netherlands)

    Arts, J.J.; Marangalou, J. Hazrati; Meijer, G.; Ito, K.; van Rietbergen, B.; Homminga, J.J.

    2017-01-01

    Background Finite element (FE) models have become a standard pre-clinical tool to study biomechanics of spine and are used to simulate and evaluate different strategies in scoliosis treatment: examine their efficacy as well as the effect of different implant design parameters. The goal of this study

  14. Clinical and Radiographic Assessment of Peri-Implant Tissue in Posterior Areas with and Without the Need for Guided Bone Regeneration

    Directory of Open Access Journals (Sweden)

    Seyed Reza Arabi

    2016-07-01

    Full Text Available Background Dental implants are increasingly used in resorbed alveolar ridges, and the success of implants inserted concomitantly with guided bone regeneration (GBR needs to be evaluated. Objectives This study aimed to clinically and radiographically assess the peri-implant tissues in the posterior maxilla and mandible in cases in which dehiscence or fenestration occurred at the time of implant surgery and treated with GBR (simultaneously with implant placement in one session. A comparison was also made between the above-mentioned patients and controls in which implants were placed in intact bone (entire length of implant in bone. Patients and Methods This study was conducted on 12 patients as cases who received 17 standard implants (dehiscence or fenestration occurred after placement of 4 mm diameter standard implants and GBR was performed and 10 patients as the control group (those who received 17 standard implants, 4 mm in diameter and 10 mm in length, in adequate bone. Periapical (PA radiographs were obtained in the first 24 hours post-surgery. Radiographs were repeated at one month, at the time of loading (two months post-surgery, and at three and six months after loading to assess marginal bone loss. To assess the peri-implant soft tissue, thickness and width of the keratinized gingiva were evaluated. Data were analyzed using t-test and repeated measures analysis of variance. The level of significance was set to P = 0.05. Results The difference in distance from the bone crest to the implant shoulder between the two groups of cases and controls was significant at the following time points: baseline and 2 months post-surgery (P = 0.000, baseline and 6 months after loading (P = 0.01, 2 months post-surgery and 3 months after loading (P = 0.00, and 2 months post-surgery and 6 months after loading (P = 0.00. Changes in the width of the keratinized gingiva were not significant in the two groups of cases and controls at 2 months post-surgery (P = 0

  15. Radiographic neuroanatomy

    International Nuclear Information System (INIS)

    Fischer, H.W.; Ketonen, L.

    1990-01-01

    The authors map out the central nervous system as it is seen through X-ray imaging, computerized tomography, magnetic resonance, and nuclear medicine. Comparing the visual aspect of the central nervous system as it appears in both dissections and atlases of the human body with what a resident can expect to see in a clinical environment, the work is a reference to the neuroanatomy, and the technology used to observe it

  16. Radiographic neuroanatomy

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, H.W.; Ketonen, L.

    1990-01-01

    The authors map out the central nervous system as it is seen through X-ray imaging, computerized tomography, magnetic resonance, and nuclear medicine. Comparing the visual aspect of the central nervous system as it appears in both dissections and atlases of the human body with what a resident can expect to see in a clinical environment, the work is a reference to the neuroanatomy, and the technology used to observe it.

  17. Compound Heterozygosity for Null Mutations and a Common Hypomorphic Risk Haplotype in TBX6 Causes Congenital Scoliosis.

    Science.gov (United States)

    Takeda, Kazuki; Kou, Ikuyo; Kawakami, Noriaki; Iida, Aritoshi; Nakajima, Masahiro; Ogura, Yoji; Imagawa, Eri; Miyake, Noriko; Matsumoto, Naomichi; Yasuhiko, Yukuto; Sudo, Hideki; Kotani, Toshiaki; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Kota; Ikegawa, Shiro

    2017-03-01

    Congenital scoliosis (CS) occurs as a result of vertebral malformations and has an incidence of 0.5-1/1,000 births. Recently, TBX6 on chromosome 16p11.2 was reported as a disease gene for CS; about 10% of Chinese CS patients were compound heterozygotes for rare null mutations and a common haplotype defined by three SNPs in TBX6. All patients had hemivertebrae. We recruited 94 Japanese CS patients, investigated the TBX6 locus for both mutations and the risk haplotype, examined transcriptional activities of mutant TBX6 in vitro, and evaluated clinical and radiographic features. We identified TBX6 null mutations in nine patients, including a missense mutation that had a loss of function in vitro. All had the risk haplotype in the opposite allele. One of the mutations showed dominant negative effect. Although all Chinese patients had one or more hemivertebrae, two Japanese patients did not have hemivertebra. The compound heterozygosity of null mutations and the common risk haplotype in TBX6 also causes CS in Japanese patients with similar incidence. Hemivertebra was not a specific type of spinal malformation in TBX6-associated CS (TACS). A heterozygous TBX6 loss-of-function mutation has been reported in a family with autosomal-dominant spondylocostal dysostosis, but it may represent a spectrum of the same disease with TACS. © 2017 WILEY PERIODICALS, INC.

  18. Health related quality of life and perception of deformity in patients with adolescent idiopathic scoliosis.

    Science.gov (United States)

    Çolak, Tuğba Kuru; Akgül, Turgut; Çolak, Ilker; Dereli, Elif Elçin; Chodza, Mehmet; Dikici, Fatih

    2017-01-01

    Quality of life and cosmethic appearance have gained importance as outcomes in AIS treatment. Improving aesthetic appearance and quality of life are defined as the primary aims of scoliosis treatment by health professionals. Studies that assess and compare the different treatment results in the field of quality of life and cosmethics are some what limited. A cross-sectional study was designed to compare quality of life and deformity perception in patients with adolescent idiopathic scoliosis (AIS) received conservative (exercise or exercise + brace) or surgical treatment. A total of 68 (58 females) patients aged 10-18 years with AIS received conservative (exercise or exercise+brace) or surgical treatment were invited to participate in the study. Quality of life (Scoliosis Research Society-23 (SRS-23)) and perception of deformity (Walter Reed Visual Assessment (WRVAS)) were assessed. Conservatively treated patients had significantly superior scores in function domain of SRS-23 than surgically treated patients (exercise/surgery, exercise+brace/surgery; p= 0.009, 0.004). Otherwise, surgically treated patients had significantly superior scores in self-image (p= 0.000, 0.000), and satisfaction with management (p= 0.001, 0.006) domains of SRS-23, and WRVAS (p= 0.000, 0.000) than conservative groups. In addition to radiographic assessments, quality of life, aesthetic perception, functionality, satisfaction with management, psycho-social status should carefully be taken into consideration by health professionals in the teratment of AIS.

  19. CORRECTION OF SEVERE STIFF SCOLIOSIS THROUGH EXTRAPLEURAL INTERBODY RELEASE AND OSTEOTOMY (LIEPO

    Directory of Open Access Journals (Sweden)

    Cleiton Dias Naves

    Full Text Available ABSTRACT Objective: To report a new technique for extrapleural interbody release with transcorporal osteotomy of the inferior vertebral plateau (LIEPO and to evaluate the correction potential of this technique and its complications. Method: We included patients with scoliosis with Cobb angle greater than 90° and flexibility less than 25% submitted to surgical treatment between 2012 and 2016 by the technique LIEPO at the National Institute of Traumatology and Orthopedics (INTO. Sagittal and coronal alignment, and the translation of the apical vertebra were measured and the degree of correction of the deformity was calculated through the pre and postoperative radiographs, and the complications were described. Results: Patients had an average bleed of 1,525 ml, 8.8 hours of surgical time, 123° of scoliosis in the preoperative period, and a mean correction of 66%. There was no case of permanent neurological damage and no surgical revision. Conclusion: The LIEPO technique proved to be effective and safe in the treatment of severe stiff scoliosis, reaching a correction potential close to the PEISR (Posterior extrapleural intervertebral space release technique and superior to that of the pVCR (posterior Vertebral Column Resection with no presence of infection and permanent neurological deficit. New studies are needed to validate this promising technique.

  20. Idiopathic scoliosis: evaluation of loss of correction in postoperative follow-up

    Directory of Open Access Journals (Sweden)

    Liliane Faria Garcia

    2014-03-01

    Full Text Available OBJECTIVE: To evaluate the postoperative loss of scoliosis correction using third-generation instrumental, comparing the immediately postoperative period, and the last visit of the patients operated on from 2002 to 2010. METHOD: This was a cross-sectional study, conducted by analysis of medical records, in which 45 patients undergoing scoliosis correction were included. Variables were evaluated preoperatively, immediately postoperatively and in the last follow-up visit after surgery. Statistical analysis of data was performed in PASW program, with a significance level of 95%. RESULTS: Among the 45 patients studied, 88.9% were female and 82.8% were in the skeletally immature group. The mean pre-operative Cobb was 57°, the postoperative was 6.5° and at the last visit, it was 7.04°. There was no statistic difference between postoperative Cobb angle and that at the last examination (p = 0.176. CONCLUSION: There was no significant loss of scoliosis correction loss between the immediate postoperative and the final radiographic evaluation.

  1. Case Study: Manual Therapy in Patient of 18 Years with Youthful Scoliosis Idiopathic Summary

    Directory of Open Access Journals (Sweden)

    Claudia Yaneth Franco Monsalve

    2007-12-01

    Full Text Available Scoliosis is a lateral deviation of the spine from the mean line, characterized by a lateral curvature and a vertebral rotation. It is generallyof idiopathic character and appears mainly in adolescent females. Multiple techniques of conservative treatment for the scoliosis exist such as the manual therapy that complements the treatment for this pathology. This technique uses manipulation of soft tissue and bone, obtainingtherefore a more effective recovery, improving the quality of life of the patient. The objective of this study of case was to compareand to describe the changes in the conditionsof an eighteen years old patient, with left thoracolumbar scoliosis by the application of manual therapy; integral valuation was carried out by manual therapy, orthopedic, computerizedposition analysis, analyses the place of job, treatments with physical instruments, mobilizationsof the thoracic and lumbar joints (segmentsT5-T6, T6-T7, T7-T8, T8-T9, muscular energy techniques, exercises of global postural re-education, cervical and lumbar stabilization, exercises of fortification for weak musculature and stretching exercises to elongate retracted musculature. At the beginning of the treatment, the angle of Cobb was 24º ,verified through ax-ray, and after the sessions of manual therapy it was 18º, demonstrating significantly improved angle (6º. The effectiveness of the treatment was verified: diminution of the pain, increase of the muscular force, postural realignment, the satisfactionof the patient and significant recovery confirmed by the radiographic studies.

  2. Utility of an allograft tendon for scoliosis correction via the costo-transverse foreman.

    Science.gov (United States)

    Sun, Dong; McCarthy, Michael; Dooley, Adam C; Ramakrishnaiah, Raghu H; Shelton, R Shane; McLaren, Sandra G; Skinner, Robert A; Suva, Larry J; McCarthy, Richard E

    2017-01-01

    Current convex tethering techniques for treatment of scoliosis have centered on anterior convex staples or polypropylene tethers. We hypothesized that an allograft tendon tether inserted via the costo-transverse foramen would correct an established spinal deformity. In the pilot study, six 8-week-old pigs underwent allograft tendon tethering via the costo-transverse foreman or sham to test the strength of the transplanted tendon to retard spine growth. After 4 months, spinal deformity in three planes was induced in all animals with allograft tendons. In the treatment study, the allograft tendon tether was used to treat established scoliosis in 11 8-week-old pigs (spinal deformity > 50°). Once the deformity was observed (4 months) animals were assigned to either no treatment group or allograft tendon tether group and progression assessed by monthly radiographs. At final follow-up, coronal Cobb angle and maximum vertebral axial rotation of the treatment group was significantly smaller than the non-treatment group, whereas sagittal kyphosis of the treatment group was significantly larger than the non-treatment group. In sum, a significant correction was achieved using a unilateral allograft tendon spinal tether, suggesting that an allograft tendon tethering approach may represent a novel fusion-less procedure to correct idiopathic scoliosis. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:183-192, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  3. Radiographic examination for successful dental implant

    International Nuclear Information System (INIS)

    Lee, Sam Sun; Choi, Soon Chul

    2005-01-01

    Recently implant has become an important field in dental clinic. Radiographic examination of pre- and post-operation is essential for successful treatment. Clinicians should have knowledge about the purpose of the radiographic examination, suitable imaging modality for the cases, anatomic landmarks of tooth and jaw bone, advantage and limitation of panoramic radiographic examination for implant, principle and interpretation of cross-sectional imaging, bone mineral density, post-operative radiographic examination. This paper will be helpful to get above information for dentists who want to do dental implant successfully.

  4. Minimally Invasive Sacroiliac Joint Fusion Using a Novel Hydroxyapatite-Coated Screw: Preliminary 1-Year Clinical and Radiographic Results of a 2-Year Prospective Study.

    Science.gov (United States)

    Rappoport, Louis H; Luna, Ingrid Y; Joshua, Gita

    2017-05-01

    Proper diagnosis and treatment of sacroiliac joint (SIJ) pain remains a clinical challenge. Dysfunction of the SIJ can produce pain in the lower back, buttocks, and extremities. Triangular titanium implants for minimally invasive surgical arthrodesis have been available for several years, with reputed high levels of success and patient satisfaction. This study reports on a novel hydroxyapatite-coated screw for surgical treatment of SIJ pain. Data were prospectively collected on 32 consecutive patients who underwent minimally invasive SIJ fusion with a novel hydroxyapatite-coated screw. Clinical assessments and radiographs were collected and evaluated at 3, 6, and 12 months postoperatively. Mean (standard deviation) patient age was 55.2 ± 10.7 years, and 62.5% were female. More patients (53.1%) underwent left versus right SIJ treatment, mean operative time was 42.6 ± 20.4 minutes, and estimated blood loss did not exceed 50 mL. Overnight hospital stay was required for 84% of patients, and the remaining patients needed a 2-day stay (16%). Mean preoperative visual analog scale back and leg pain scores decreased significantly by 12 months postoperatively (P sacroiliac joint pain. Future clinical studies with larger samples are warranted to assess long-term patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. A comparative evaluation of extraction socket preservation with demineralized freeze-dried bone allograft alone and along with platelet-rich fibrin: A clinical and radiographic study

    Directory of Open Access Journals (Sweden)

    Dhaval J Thakkar

    2016-01-01

    Full Text Available Aims: To investigate clinically and radiographically, the bone fill in extraction sockets using demineralized freeze-dried bone allograft alone and along with platelet-rich fibrin (PRF. Materials and Methods: A randomized controlled clinical trial was carried out on 36 nonrestorable single-rooted teeth sites. Sites were randomized into demineralized freeze-dried bone allograft (DFDBA combined with PRF - test and DFDBA - control groups using a coin toss method. After the placement of graft material, collagen membrane was used to cover it. The clinical parameters recorded were ridge width and ridge height. All the parameters were recorded at baseline and at 90 and 180 days. Statistical Analysis Used: Independent t-test and paired t-test. Results: In both groups, there is significant reduction in loss of ridge width and ridge height from baseline to 90 days (P < 0.001, baseline to 180 days (P < 0.001, and 90-180 days (P < 0.001. However, when both the groups were compared the test group favored in the reduction of ridge width while there was no statistical difference in reduction of ridge height among at different intervals. Conclusions: Although DFDBA is considered as an ideal graft material, PRF can be used as an adjunctive with DFDBA for socket preservation.

  6. Gender difference in symptomatic radiographic knee osteoarthritis in the Knee Clinical Assessment – CAS(K: A prospective study in the general population

    Directory of Open Access Journals (Sweden)

    Duncan Rachel C

    2008-06-01

    Full Text Available Abstract Background A recent study of adults aged ≥50 years reporting knee pain found an excess of radiographic knee osteoarthritis (knee ROA in symptomatic males compared to females. This was independent of age, BMI and other clinical signs and symptoms. Since this finding contradicts many previous studies, our objective was to explore four possible explanations for this gender difference: X-ray views, selection, occupation and non-articular conditions. Methods A community-based prospective study. 819 adults aged ≥50 years reporting knee pain in the previous 12 months were recruited by postal questionnaires to a research clinic involving plain radiography (weight-bearing posteroanterior semiflexed, supine skyline and lateral views, clinical interview and physical examination. Any knee ROA, ROA severity, tibiofemoral joint osteoarthritis (TJOA and patellofemoral joint osteoarthritis (PJOA were defined using all three radiographic views. Occupational class was derived from current or last job title. Proportions of each gender with symptomatic knee ROA were expressed as percentages, stratified by age; differences between genders were expressed as percentage differences with 95% confidence intervals. Results 745 symptomatic participants were eligible and had complete X-ray data. Males had a higher occurrence (77% of any knee ROA than females (61%. In 50–64 year olds, the excess in men was mild knee OA (particularly PJOA; in ≥65 year olds, the excess was both mild and moderate/severe knee OA (particularly combined TJOA/PJOA. This male excess persisted when using the posteroanterior view only (64% vs. 52%. The lowest level of participation in the clinic was symptomatic females aged 65+. Within each occupational class there were more males with symptomatic knee ROA than females. In those aged 50–64 years, non-articular conditions were equally common in both genders although, in those aged 65+, they occurred more frequently in symptomatic

  7. Consultant radiographers: Profile of the first generation

    International Nuclear Information System (INIS)

    Forsyth, Lesley J.; Maehle, Valerie

    2010-01-01

    Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.

  8. Consultant radiographers: Profile of the first generation

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, Lesley J., E-mail: l.forsyth@rgu.ac.u [School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom); Maehle, Valerie [Faculty of Health and Social Care, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom)

    2010-11-15

    Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.

  9. Intra-observer reproducibility and interobserver reliability of the radiographic parameters in the Spinal Deformity Study Group's AIS Radiographic Measurement Manual.

    Science.gov (United States)

    Dang, Natasha Radhika; Moreau, Marc J; Hill, Douglas L; Mahood, James K; Raso, James

    2005-05-01

    Retrospective cross-sectional assessment of the reproducibility and reliability of radiographic parameters. To measure the intra-examiner and interexaminer reproducibility and reliability of salient radiographic features. The management and treatment of adolescent idiopathic scoliosis (AIS) depends on accurate and reproducible radiographic measurements of the deformity. Ten sets of radiographs were randomly selected from a sample of patients with AIS, with initial curves between 20 degrees and 45 degrees. Fourteen measures of the deformity were measured from posteroanterior and lateral radiographs by 2 examiners, and were repeated 5 times at intervals of 3-5 days. Intra-examiner and interexaminer differences were examined. The parameters include measures of curve size, spinal imbalance, sagittal kyphosis and alignment, maximum apical vertebral rotation, T1 tilt, spondylolysis/spondylolisthesis, and skeletal age. Intra-examiner reproducibility was generally excellent for parameters measured from the posteroanterior radiographs but only fair to good for parameters from the lateral radiographs, in which some landmarks were not clearly visible. Of the 13 parameters observed, 7 had excellent interobserver reliability. The measurements from the lateral radiograph were less reproducible and reliable and, thus, may not add value to the assessment of AIS. Taking additional measures encourages a systematic and comprehensive assessment of spinal radiographs.

  10. Radiographers and trainee radiologists reporting accident radiographs: A comparative plain film-reading performance study

    International Nuclear Information System (INIS)

    Buskov, L.; Abild, A.; Christensen, A.; Holm, O.; Hansen, C.; Christensen, H.

    2013-01-01

    Aim: To compare the diagnostic accuracy and clinical validity of reporting radiographers with that of trainee radiologists whom they have recently joined in reporting emergency room radiographs at Bispebjerg University Hospital. Materials and methods: Plain radiographs of the appendicular skeleton from 1000 consecutive emergency room patients were included in the study: 500 primarily reported by radiographers and 500 by trainee radiologists. The final reporting was subsequently undertaken by a consultant radiologist in consensus with an orthopaedic surgeon. Two observers classified reports as either true positive/negative or false positive/negative based on the final report, which was considered the reference standard. To evaluate the severity of incorrect primary reports, errors were graded into three categories concerning clinical impact and erroneous reports graded as the most severe category were subsequently analysed. Mann–Whitney and Chi-squared tests were used to compare differences and associations between radiographers versus trainee radiologists regarding film reporting. Results: The sensitivity for correct diagnosis was 99% for reporting radiographers and 94% for trainee radiologists. The specificity was found to be 97% for reporting radiographers and 99% for trainee radiologists. Radiographers missed significantly fewer fractures (n = 2) than trainee radiologists (n = 14; p = 0.006) but had a higher, but not significant, degree of overcalling. No significant difference was found between groups regarding clinical impact of incorrect reporting. Conclusion: Trained radiographers report accident radiographs of the extremities with high accuracy and constitute a qualified resource to help meet increasing workload and demands in quality standards.

  11. Scoliosis

    Science.gov (United States)

    ... bigger braces. Braces are usually named after the cities where they were invented and have names like ... During the operation, the orthopedic surgeon fuses the bones in the spine together so that they can ...

  12. Scoliosis

    Science.gov (United States)

    ... or low-back pain that goes down the legs Weakness or tired feeling in the spine after sitting or standing for a long time Uneven hips or shoulders (one shoulder may be higher than the other) Spine curves more to one side Exams and Tests The health care provider will perform a physical ...

  13. Three-dimensional vertebral wedging in mild and moderate adolescent idiopathic scoliosis.

    Directory of Open Access Journals (Sweden)

    Sophie-Anne Scherrer

    Full Text Available Vertebral wedging is associated with spinal deformity progression in adolescent idiopathic scoliosis. Reporting frontal and sagittal wedging separately could be misleading since these are projected values of a single three-dimensional deformation of the vertebral body. The objectives of this study were to determine if three-dimensional vertebral body wedging is present in mild scoliosis and if there are a preferential vertebral level, position and plane of deformation with increasing scoliotic severity.Twenty-seven adolescent idiopathic scoliotic girls with mild to moderate Cobb angles (10° to 50° participated in this study. All subjects had at least one set of bi-planar radiographs taken with the EOS® X-ray imaging system prior to any treatment. Subjects were divided into two groups, separating the mild (under 20° from the moderate (20° and over spinal scoliotic deformities. Wedging was calculated in three different geometric planes with respect to the smallest edge of the vertebral body.Factorial analyses of variance revealed a main effect for the scoliosis severity but no main effect of vertebral Levels (apex and each of the three vertebrae above and below it (F = 1.78, p = 0.101. Main effects of vertebral Positions (apex and above or below it (F = 4.20, p = 0.015 and wedging Planes (F = 34.36, p<0.001 were also noted. Post-hoc analysis demonstrated a greater wedging in the inferior group of vertebrae (3.6° than the superior group (2.9°, p = 0.019 and a significantly greater wedging (p≤0.03 along the sagittal plane (4.3°.Vertebral wedging was present in mild scoliosis and increased as the scoliosis progressed. The greater wedging of the inferior group of vertebrae could be important in estimating the most distal vertebral segment to be restrained by bracing or to be fused in surgery. Largest vertebral body wedging values obtained in the sagittal plane support the claim that scoliosis could be initiated

  14. A comparison of the pathological, clinical and radiographical, features of cryptogenic organising pneumonia, acute fibrinous and organising pneumonia and granulomatous organising pneumonia.

    Science.gov (United States)

    Feinstein, Marc B; DeSouza, Shilpa A; Moreira, Andre L; Stover, Diane E; Heelan, Robert T; Iyriboz, Tunç A; Taur, Ying; Travis, William D

    2015-06-01

    Cryptogenic organising pneumonia (COP) and acute fibrinous and organising pneumonia (AFOP) are recognised patterns of organising pneumonia (OP), a condition that resembles pneumonia but is not caused by infection. We have recognised granulomatous organising pneumonia (GOP) to be a similar histopathological entity where non-necrotising granulomata are intimately associated with the organising connective tissue. To what degree COP, AFOP and GOP represent distinct clinical and pathological disorders is unknown. This cross-sectional study sought to compare the pathological, clinical, and radiographical features of these OP patterns. Surgical lung biopsy specimens were reviewed for consecutive patients referred with OP to a metropolitan cancer centre. Clinical information and CT images were acquired from the hospital electronic medical record to determine the clinical and CT characteristics of each OP pattern. Sixty-one patients (35 men, 26 women), mean age 61.5 years (range 8-85 years), were available for analysis. Of these, 43 patients (70%) had at least one prior cancer; 27 (44%) had received chemotherapy and 18 (30%) had received radiation. Approximately, half (32 patients) had respiratory symptoms, most commonly cough, dyspnoea and/or wheezing. While symptoms and mortality rates were not different among OP groups, AFOP patients more commonly had fever (p=0.04). GOP patients less commonly had received chemotherapy (p=0.03) and were more likely to present as masses/nodules (p=0.04). AFOP and GOP, a newly described OP form, possess clinical and pathological findings that set it apart from a COP, suggesting an emerging spectrum of OP. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.