| 1. |
- Gataa, Khaldun Ghali, et al.
(författare)
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Factors affecting the success of CT-guided core biopsy of musculoskeletal lesions with a 13-G needle
- 2024
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Ingår i: Skeletal Radiology. - 0364-2348 .- 1432-2161. ; 53:4, s. 725-731
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine the value of CT-guided bone core biopsy and investigate factors that affect diagnostic yield and biopsy outcome. Materials and methods: The single-centre retrospective analysis included 447 patients who had CT-guided core biopsy with a 13-G needle (Bonopty®) from January 2016 to December 2021. Histological results or ≥ 6 months of clinical and radiological follow-up served as outcome references. A successful biopsy was classified as “diagnostic” when a definitive diagnosis was made and “adequate” when only the malignant or benign nature of the tumour could be determined. Biopsies were “nondiagnostic” when the nature of the lesion could not be determined. The occult lesions were defined as not seen on CT but visible on other modalities. Results: In 275 (62%) females and 172 (38%) males, the overall success rate was 85% (383 biopsies), with 314 (70%) diagnostic biopsies and 69 (15%) adequate biopsies. There was no relationship between biopsy success and the localisation of the lesion, length of biopsy material, or number of biopsy attempts. The lesions’ nature had a statistically significant effect on biopsy success with lytic and mixed lesions having the highest success rate. Occult lesions had the lowest success rate. Conclusion: CT-guided bone core biopsy is an effective method in the workup of musculoskeletal diseases with the highest success rate in lytic and mixed lesions. No apparent relationship was found between biopsy success and biopsy length, number of attempts, or localisation of the lesion.
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| 2. |
- Mahmood, Sarwar S, 1975-, et al.
(författare)
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Validity, reliability and reproducibility of plain radiographic measurements after total hip arthroplasty
- 2015
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Ingår i: Skeletal Radiology. - : Springer. - 0364-2348 .- 1432-2161. ; 44:3, s. 345-351
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Tidskriftsartikel (refereegranskat)abstract
- In total hip arthroplasty (THA), radiographic preoperative planning and postoperative evaluation of acetabular component, femoral offset (FO) and leg length discrepancy (LLD) require good validity, interobserver reliability and intraobserver reproducibility. In this study, we evaluated the validity of the Sundsvall method of FO measurement and the interobserver reliability and intraobserver reproducibility of measurement of FO, LLD, acetabular cup inclination and anteversion. Ninety patients with primary unilateral osteoarthritis (OA) were included in this prospective study. On postoperative radiographs FO by the Sundsvall method (femoral axis-pelvic midline), FO by a standard method (femoral axis-hip rotational centre-teardrop point), LLD (inter-teardrop line-lesser trochanter), acetabular cup inclination (on AP view the angle between the cup rim and transischial line) and anteversion (on lateral view the angle between the face of acetabulum and a line perpendicular to the horizontal plane) were measured. The interobserver reliability and intraobserver reproducibility were calculated for three independent observers. The concurrent validity and degree of prediction of the Sundsvall method are measured by comparing its results with the standard method. The interobserver reliability of all measurements was excellent (ICC > 0.80), except for LLD, which was substantial (ICC = 0.79). The intraobserver reproducibility of all measurements was excellent (ICC > 0.80). The concurrent validity of the Sundsvall method compared to the standard method was good with a positive correlation. The Sundsvall method is as reliable as the standard method. The evaluated radiographic measurement methods have the required validity and reliability to be used in clinical practice.
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| 3. |
- Geijer, Mats, 1957, et al.
(författare)
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Clinical utility of tomosynthesis in suspected scaphoid fracture. A pilot study.
- 2011
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Ingår i: Skeletal radiology. - : Springer Science and Business Media LLC. - 1432-2161 .- 0364-2348. ; 40:7, s. 863-7
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Tidskriftsartikel (refereegranskat)abstract
- Radiography alone will not detect all scaphoid fractures. There is a reported prevalence between 9 and 33% of occult scaphoid fractures. The evidence-based literature suggests that magnetic resonance imaging (MRI) is the most suitable secondary imaging modality due to the ability to evaluate the bone marrow directly and to also identify other injuries. However, there is no consensus on the choice of follow-up imaging strategy-computed tomography, MRI, or bone scan-across different institutions. Tomosynthesis is a new digital tomographic method creating multiple thin tomographic sections. The purpose of this study was to evaluate the clinical utility of tomosynthesis in suspected occult fracture.
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| 4. |
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| 5. |
- Söderman, Tomas, et al.
(författare)
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Static and dynamic CT imaging of the cervical spine in patients with rheumatoid arthritis
- 2015
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Ingår i: Skeletal Radiology. - : Springer Science and Business Media LLC. - 0364-2348 .- 1432-2161. ; 44:2, s. 241-248
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To compare CR with CT (static and dynamic) to evaluate upper spine instability and to determine if CT in flexion adds value compared to MR imaging in neutral position to assess compression of the subarachnoid space and of the spinal cord.MATERIALS AND METHODS:Twenty-one consecutive patients with atlantoaxial subluxation due to rheumatoid arthritis planned for atlantoaxial fusion were included. CT and MRI were performed with the neck in the neutral position and CT also in flexion. CR in neutral position and flexion were obtained in all patients except for one subject who underwent examination in flexion and extension.RESULTS:CR and CT measurements of atlantoaxial subluxation correlated but were larger by CR than CT in flexion, however, the degree of vertical dislocation was similar with both techniques irrespective of the position of the neck. Cervical motion was larger at CR than at CT. The spinal cord compression was significantly worse at CT obtained in the flexed position as compared to MR imaging in the neutral position.CONCLUSIONS:Functional CR remains the primary imaging method but CT in the flexed position might be useful in the preoperative imaging work-up, as subarachnoid space involvement may be an indicator for the development of neurologic dysfunction.
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| 6. |
- Weidenhielm, Lars, et al.
(författare)
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Prosthetic liner wear in total hip replacement : a longitudinal 13-year study with computed tomography.
- 2018
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Ingår i: Skeletal Radiology. - : Springer. - 0364-2348 .- 1432-2161. ; 47:6, s. 883-887
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Tidskriftsartikel (refereegranskat)abstract
- This case report follows a woman who had a total hip replacement in 1992 when she was 45 years old. Six serial computed tomography (CT) examinations over a period of 13 years provided information that allowed her revision surgery to be limited to liner replacement as opposed to replacement of the entire prosthesis. Additionally, they provided data that ruled out the presence of osteolysis and indeed none was found at surgery. In 2004, when the first CT was performed, the 3D distance the femoral head had penetrated into the cup was determined to be 2.6 mm. By 2017, femoral head penetration had progressed to 5.0 mm. The extracted liner showed wear at the thinnest part to be 5.5 mm, as measured with a micrometer. The use of modern CT techniques can identify problems, while still correctable without major surgery. Furthermore, the ability of CT to assess the direction of wear revealed that the liner wear changed from the cranial to dorsal direction.
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| 7. |
- Abat, Ferran, et al.
(författare)
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Ultrasound-guided versus blind interventions in patellar tendon lesions : a cadaveric study
- 2021
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Ingår i: Skeletal Radiology. - : Springer. - 0364-2348 .- 1432-2161. ; 50:5, s. 967-972
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The present study aims to analyze the accuracy of injections aimed to hit the proximal and depth part of the patellar tendon "target point" in patellar tendinopathy, comparing ultrasound-guided or non-ultrasound-guided (blind) injections.Methods: A cadaver randomized study was carried out. Injections were performed under ultrasound control, as well as blinded. There were 26 knees from fresh cadavers and injections were placed by 26 practitioners with experience in the use of musculoskeletal ultrasound and injection treatment. Each participant performed 6 ultrasound-guided and 6 blind punctures in different cadaveric specimens. This provided 312 injections that were analyzed in 2 different anatomical cuts, thus providing a database of 624 measurements for statistical analysis.Results: Statistically significant differences were observed (p < 0.0001) in the distance from the target point between the ultrasound-guided and the non-guided infiltrations. The "unguided" injections were considered to have been performed on average 10 mm away from the target point compared to the "ultrasound-guided" injections. The ultrasound-guided injections obtained an accuracy of 74.36% while the "non-ultrasound-guided" injections obtained an accuracy of 11.54% (p < 0.0001).Conclusion: The use of ultrasound to guide the positioning of injections on the dorsal side of the proximal patellar tendon had a significantly higher accuracy compared to blind injections. The finding provides knowledge of importance for injection treatment.
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| 8. |
- Christersson, Albert, et al.
(författare)
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Comparison of 2D radiography and a semi-automatic CT-based 3D method for measuring change in dorsal angulation over time in distal radius fractures
- 2016
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Ingår i: Skeletal Radiology. - : Springer Science and Business Media LLC. - 0364-2348 .- 1432-2161. ; 45:6, s. 763-769
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of the present study was to compare the reliability and agreement between a computer tomography-based method (CT) and digitalised 2D radiographs (XR) when measuring change in dorsal angulation over time in distal radius fractures. Materials and methods Radiographs from 33 distal radius fractures treated with external fixation were retrospectively analysed. All fractures had been examined using both XR and CT at six times over 6 months postoperatively. The changes in dorsal angulation between the first reference images and the following examinations in every patient were calculated from 133 follow-up measurements by two assessors and repeated at two different time points. The measurements were analysed using Bland-Altman plots, comparing intra- and inter-observer agreement within and between XR and CT. Results The mean differences in intra- and inter-observer measurements for XR, CT, and between XR and CT were close to zero, implying equal validity. The average intra- and inter-observer limits of agreement for XR, CT, and between XR and CT were +/- 4.4 degrees, +/- 1.9 degrees and +/- 6.8 degrees respectively. Conclusions For scientific purpose, the reliability of XR seems unacceptably low when measuring changes in dorsal angulation in distal radius fractures, whereas the reliability for the semi-automatic CT-based method was higher and is therefore preferable when a more precise method is requested.
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| 9. |
- Cristiani, Riccardo, et al.
(författare)
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High prevalence of associated injuries in anterior cruciate ligament tears: A detailed magnetic resonance imaging analysis of 254 patients
- 2024
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Ingår i: Skeletal Radiology. - : SPRINGER. - 0364-2348 .- 1432-2161.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To evaluate the type and prevalence of associated injuries by using magnetic resonance imaging (MRI) in patients with anterior cruciate ligament (ACL) tears.Methods Data from the Natural Corollaries and Recovery after ACL injury multicenter longitudinal cohort study were analyzed. Between May 2016 and October 2018, patients aged between 15 and 40 years, who had experienced an ACL tear within the last 6 weeks and sought medical attention at one of seven healthcare clinics in Sweden, were invited to participate. The mean time from injury to MRI was 19.6 +/- 15.2 days. An orthopedic knee surgeon and a musculoskeletal radiologist reviewed all the MRI scans. The following structures were assessed: posterior cruciate ligament (PCL), medial collateral ligament (MCL) complex, lateral collateral ligament (LCL), popliteus tendon, medial meniscus (MM), lateral meniscus (LM), and cartilage. In addition, the presence of bone bruising, impaction fractures in the lateral femoral condyle (LFC) or posterolateral tibia (PLT), and Segond fractures were also assessed. Results A total of 254 patients (48.4% males) with a mean age of 25.4 +/- 7.1 years were included. The prevalence of associated injuries was as follows: PCL (0.4%), MCL {41.3% [superficial MCL and deep MCL (dMCL) 16.5%; isolated dMCL 24.8%]}, LCL (2.4%), MM (57.4%), LM (25.2%), cartilage (15.0%), bone bruising (92.9%), impaction fracture in the LFC (45.7%) and PLT (4.7%), and Segond fracture (7.5%).Conclusions The prevalence of associated injuries in patients with ACL tears was high. The findings reported in this study may serve as a reference tool for orthopedic surgeons and radiologists in the diagnosis of associated injuries using MRI in patients with ACL tears.
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| 10. |
- Dhainaut, Alvilde, et al.
(författare)
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Long-term in-vitro precision of direct digital X-ray radiogrammetry
- 2011
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Ingår i: Skeletal Radiology. - : Springer Science and Business Media LLC. - 1432-2161 .- 0364-2348. ; 40:12, s. 1575-1579
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Tidskriftsartikel (refereegranskat)abstract
- Digital X-ray radiogrammetry (DXR) calculates peripheral bone mineral density (BMD) from hand radiographs. The short-term precision for direct DXR has been reported to be highly satisfactory. However, long-term precision for this method has not been examined. Thus, the aim of this study was to examine the long-term in-vitro precision for the new direct digital version of DXR. The in-vitro precision for direct DXR was tested with cadaver phantoms on four different X-ray systems at baseline, 3 months, 6 months, and in one machine also at 12 months. At each time point, 31 measurements were performed. The in-vitro longitudinal precision for the four radiographic systems ranged from 0.22 to 0.43% expressed as coefficient of variation (CV%). The smallest detectable difference (SDD) ranged from 0.0034 to 0.0054 g/cm(2). The in vitro long-term precision for direct DXR was comparable to the previous reported short-term in-vitro precision for all tested X-ray systems. These data show that DXR is a stable method for detecting small changes in bone density during 6-12 months of follow-up.
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