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Lateral Radiographs (lateral + radiograph)
Selected AbstractsUnderdiagnosis of Vertebral Fractures Is a Worldwide Problem: The IMPACT StudyJOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2005Pierre D Delmas MD Abstract Accurate radiographic diagnosis of vertebral fractures is important. This multicenter, multinational study assessed radiographic diagnoses of vertebral fracture in 2451 postmenopausal women with osteoporosis. Comparison between local and central readings yielded a false-negative rate of 34%. Underdiagnosis of vertebral fracture is a worldwide problem. Introduction: Vertebral fractures are the most common complication of osteoporosis. Although they are associated with significant morbidity, they frequently do not come to clinical attention. Accurate radiographic diagnosis is important. Materials and Methods: In a multicenter, multinational prospective study (the IMPACT trial), the accuracy of radiographic diagnosis of vertebral fracture was evaluated in postmenopausal women 65,80 years of age newly diagnosed with osteoporosis (based on BMD measurement). Lateral radiographs of the thoracolumbar spine were evaluated for identification of vertebral fractures, first locally and subsequently at a central reading center, using a validated semiquantitative method. False-positive and false-negative rates were calculated based on adjudicated discrepancies between the initial interpretation at the local site and the subsequent central reading, considered the "reference standard." Results: Of 2451 women with an evaluable radiograph both centrally and locally, 789 (32%) had at least one vertebral fracture. Adjudicated discrepancies (n = 350 patients) between local and central readings because of undetected vertebral fracture (68%) or equivocal terminology in the local radiology report (32%) yielded a false-negative rate of 34%. Conclusions: Underdiagnosis of vertebral fractures was observed in all geographic regions (false-negative rates: North America, 45.2%; Latin America, 46.5%; Europe/South Africa/Australia, 29.5%). The false-positive rate was 5% globally. Underdiagnosis of vertebral fracture is a worldwide problem attributable in part to a lack of radiographic detection, use of ambiguous terminology in the radiology report, or both. Efforts to improve accuracy and reduce variability in terminology and interpretation may increase the effectiveness of spinal radiography for detecting vertebral fractures in patients with osteoporosis. [source] Is there a relationship between head posture and craniomandibular pain?JOURNAL OF ORAL REHABILITATION, Issue 11 2002C. M. Visscher SUMMARY, An often-suggested factor in the aetiology of craniomandibular disorders (CMD) is an anteroposition of the head. However, the results of clinical studies to the relationship between CMD and head posture are contradictory. Therefore, the first aim of this study was to determine differences in head posture between well-defined CMD pain patients with or without a painful cervical spine disorder and healthy controls. The second aim was to determine differences in head posture between myogenous and arthrogenous CMD pain patients and controls. Two hundred and fifty persons entered the study. From each person, a standardized oral history was taken and blind physical examinations of the masticatory system and of the neck were performed. The participants were only included into one of the subgroups when the presence or absence of their symptoms was confirmed by the results of the physical examination. Head posture was quantified using lateral photographs and a lateral radiograph of the head and the cervical spine. After correction for age and gender effects, no difference in head posture was found between any of the patient and non-patient groups (P > 0·27). Therefore, this study does not support the suggestion that painful craniomandibular disorders, with or without a painful cervical spine disorder, are related to head posture. [source] Sagittal spinal alignment in patients with Legg-Calve-Perthes diseasePEDIATRICS INTERNATIONAL, Issue 5 2007HIROSHI KITOH Abstract Background: Legg-Calve-Perthes disease (LCPD) is an avascular necrosis of the capital femoral epiphysis in children. Several studies found a pathophysiological relationship between LCPD and juvenile Scheuermann's kyphosis, suggesting an abnormal spinal condition related to osteochondrogenesis. In the present study sagittal spinal alignment of the patients with LCPD was analyzed to examine associated spinal involvement. Methods: A standing lateral radiograph of the spine was evaluated in 78 patients who had a history of LCPD. Various parameters of sagittal spinal alignment, including thoracic kyphosis (TK), lumbar lordosis (LL), sacral inclination (SI), apex of thoracic kyphosis (TK-apex) and lumbar lordosis (LL-apex), and sagittal balance (SB; positive SB values represent a sagittal balance in front of the sacrum) were measured and compared between the patients with and without vertebral abnormalities. Results: Compared to previously published normative data, relatively decreased LL was evident in LCPD. Most of the patients (65%) had negative SB, which was correlated with decreased SI, more proximal TK-apex, and more distal LL-apex. Vertebral abnormalities including end-plate irregularities and wedging vertebrae were observed in 20 patients. Decreased SI, more distal LL-apex, and more negative SB were remarkable in the patients with vertebral abnormalities. Conclusions: The patients tended to stand in greater negative sagittal balance associated with decreased LL. The characteristic sagittal alignment was prominent especially in the patients with vertebral abnormalities. Wedging vertebrae, probably due to growth disturbance of the vertebral bodies, could result in decreased LL, which leads to posterior pelvic tilt and posterior shift of sagittal balance. [source] Inter- and intra-observer reliability of radiographic scores commonly used for the evaluation of haemophilic arthropathyHAEMOPHILIA, Issue 3 2008M. SILVA Summary., Although the severity of haemophilic arthropathy is commonly assessed using established radiographic scoring systems, there is limited available information about their inter- and intra-observer reliability. The purpose of the present study was to establish the inter-observer reliability (IEOR) and intra-observer reliability (IAOR) of three different methods available for the classification of haemophilic arthropathy, including the Arnold and Hilgartner classification, a modification to the Arnold and Hilgartner system described by Luck et al., and the classification described by Pettersson et al. Antero-posterior and lateral radiographs of 54 haemophilic joints were included for the analysis. To determine the IEOR for each one of the three radiographic systems, the radiographs were randomly evaluated by four observers, including two orthopaedic surgeons, one orthopaedic resident and one haematologist. For the determination of IAOR, all four reviewers repeated the assessment in a similar fashion, after a period of at least 2 weeks. IEOR and IAOR for the three classification systems was established using kappa (,) statistics. A Spearman rank correlation was used to determine the similarities between each reviewer's own interpretative scales. The IEOR was low for the Arnold and Hilgartner system (, = 0.35, P , 0.001) and the Luck system (, = 0.38, P , 0.001), but even lower for the Pettersson system (, = 0.06, P = 0.1). For the Pettersson system, particularly low , values were observed for the presence or absence of osteoporosis (, = 0.11, P = 0.0027), enlarged epiphysis (, = 0.10, P = 0.0039), erosion of joint margins (, = 0.11, P = 0.0018), and joint deformity (, = 0.16, P = 0.00001). However, a relatively high Spearman rank correlation for all three scales [rs = 0.75 (P < 0.001) for Arnold and Hilgartner system, rs = 0.74 (P < 0.001) for the Luck system and rs = 0.81 (P < 0.001) for Pettersson system] indicated an overall, general agreement among the reviewers with regard to the severity of the haemophilic arthropathy. There was a moderate IAOR value for both, the Arnold and Hilgartner system (, = 0.57, P = 0.00001) and the Luck system (, = 0.62, P = 0.00001) with a low IAOR value for the Pettersson system [, = 0.22, P = 0.00001). Currently available radiographic scoring systems for haemophilic arthropathy have low inter- and intra-observer reliability rates. Improvements, either through education or modification of the scoring systems, are critical in an era where correlations between clinical and radiographic scores have received significant attention. [source] Reliability of cranial base measurements on lateral skull radiographsORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 4 2008H Arponen Structured Abstract Authors,,, Arponen H, Elf H, Evälahti M, Waltimo-Sirén J Objective,,, To explore the reliability of identification of anatomic landmarks on lateral skull radiographs of young unaffected individuals that has conventionally been used to diagnose pathologic relationships in the craniovertebral junction. Material and Methods,,, From the Helsinki longitudinal growth study, 20 randomly selected lateral radiographs were analyzed and re-analyzed by two examiners. Both located seven cephalometric landmarks based on which five measurements were calculated. The differences of results were compared. With similar method three radiographs were analysed by 11 examiners and results were compared. Results,,, Some anatomic landmarks were easier to locate than others on lateral skull radiographs leading to differences in measurements based on them. We found the magnitude of the difference to be dependent on the landmark serving as reference. Inter- and intra-examiner errors were of similar magnitude, although intra-examiner error declined in the repeated landmark identification. Variation in a single landmark location had in general little effect on the measurement value. Conclusion,,, Variations in landmark location lead to differences in numeric evaluation of the anatomic relationships in the skull base area. These differences were, however, shown to have little clinical significance. Hence, the documented methods are applicable for screening of basilar pathology. [source] Periarticular lesions detected on magnetic resonance imaging: Prevalence in knees with and without symptomsARTHRITIS & RHEUMATISM, Issue 10 2003Catherine L. Hill Objective To evaluate, using magnetic resonance imaging (MRI), the prevalence of periarticular lesions in older persons with or without knee pain, and to assess the association of these lesions with knee pain. Methods Subjects ages 45 years and older, with or without knee pain, were recruited from Veterans Affairs medical centers and from the community. Weight-bearing posteroanterior, skyline, and lateral radiographs were obtained in all subjects. Subjects were divided into 3 groups: those with radiographic OA (ROA) and knee pain (n = 376), those with ROA and no knee pain (n = 51), and those with neither ROA nor knee pain (n = 24). A single knee (the more symptomatic one in subjects with knee pain) was imaged with a 1.5T scanner using T1- and T2-weighted and proton-density spin-echo imaging sequences. MRIs were read for the presence of periarticular lesions, which were categorized (according to their general location) as being either peripatellar (prepatellar, superficial infrapatellar, deep infrapatellar) or "other periarticular lesions" (semimembranosus,tibial collateral ligament bursitis, anserine bursitis, iliotibial band syndrome, tibiofibular cyst). Results Patients with knee pain had more severe radiographic disease than did subjects who were asymptomatic. Peripatellar lesions (prepatellar or superficial infrapatellar) were present in 12.1% of the patients with knee pain and ROA, in 20.5% of the patients with ROA and no knee pain, and in 0% of subjects with neither ROA nor knee pain (P = 0.116). However, other periarticular lesions were present in 14.9% of patients with both ROA and knee pain, in only 3.9% of patients with ROA but no knee pain, and in 0% of the group with no knee pain and no ROA (P = 0.004). Conclusion Although peripatellar lesions are equally common among subjects with knee pain and those without knee pain, other periarticular lesions (including bursitis and iliotibial band syndrome) are significantly more common among subjects with knee pain and may contribute to pain in these individuals. [source] | ||||||||||