| 1. |
- 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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| 2. |
- Alagic, Z., et al.
(författare)
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Ultra-low-dose CT for extremities in an acute setting : initial experience with 203 subjects
- 2020
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Ingår i: Skeletal Radiology. - : Springer Nature. - 0364-2348 .- 1432-2161. ; 49:4, s. 531-539
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe purpose of this study was to assess if ultra-low-dose CT is a useful clinical alternative to digital radiographs in the evaluation of acute wrist and ankle fractures.Materials and methodsAn ultra-low-dose protocol was designed on a 256-slice multi-detector CT. Patients from the emergency department were evaluated prospectively. After initial digital radiographs, an ultra-low-dose CT was performed. Two readers independently analyzed the images. Also, the radiation dose, examination time, and time to preliminary report was compared between digital radiographs and CT.ResultsIn 207 extremities, digital radiography and ultra-low-dose CT detected 73 and 109 fractures, respectively (p < 0.001). The odds ratio for fracture detection with ultra-low-dose CT vs. digital radiography was 2.0 (95% CI, 1.4–3.0). CT detected additional fracture-related findings in 33 cases (15.9%) and confirmed or ruled out suspected fractures in 19 cases (9.2%). The mean effective dose was comparable between ultra-low-dose CT and digital radiography (0.59 ± 0.33 μSv, 95% CI 0.47–0.59 vs. 0.53 ± 0.43 μSv, 95% CI 0.54–0.64). The mean combined examination time plus time to preliminary report was shorter for ultra-low-dose CT compared to digital radiography (7.6 ± 2.5 min, 95% CI 7.1–8.1 vs. 9.8 ± 4.7 min, 95% CI 8.8–10.7) (p = 0.002). The recommended treatment changed in 34 (16.4%) extremities.ConclusionsUltra-low-dose CT is a useful alternative to digital radiography for imaging the peripheral skeleton in the acute setting as it detects significantly more fractures and provides additional clinically important information, at a comparable radiation dose. It also provides faster combined examination and reporting times.
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| 3. |
- 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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| 4. |
- 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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| 5. |
- 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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| 6. |
- Edlund, R, et al.
(författare)
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Cone-Beam CT in diagnosis of scaphoid fractures
- 2016
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Ingår i: Skeletal radiology. - : Springer Science and Business Media LLC. - 1432-2161 .- 0364-2348. ; 45:2, s. 197-204
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Tidskriftsartikel (refereegranskat)
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| 7. |
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| 8. |
- 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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| 9. |
- 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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| 10. |
- Gärdin, Anna, et al.
(författare)
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The long-term clinical and MRI results following eccentric calf muscle training in chronic Achilles tendinosis
- 2010
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Ingår i: Skeletal Radiology. - : Springer Science and Business Media LLC. - 0364-2348 .- 1432-2161. ; 39:5, s. 435-442
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate the long-term results following eccentric calf-muscle training in patients with chronic Achilles tendinopathy.MATERIALS AND METHODS: A total of 24 patients with chronic Achilles tendinopathy were included in a study evaluating MRI findings and clinical symptoms before and after 3 months of daily eccentric calf-muscle strength training. Median duration of symptoms was 18 months (range 6-120). Four of the patients did not perform the prescribed treatment for different reasons and were followed for 14 months. The resulting 20 treated patients completed 4.2-year (range 29-58 months) follow up. Tendon volume was evaluated by using 3D seed growing technique and signal abnormalities were visually semi-quantitatively graded. Level of pain and performance was categorized using a questionnaire completed by the patient.RESULTS: In the symptomatic treated patients, median intensity level of pain decreased from moderate/severe at time of inclusion to mild at follow up (p < 0.05). Median level of performance increased from severe impairment at time of inclusion to normal at follow up (p < 0.05). 12 out of 20 patients had raised intratendinous signal at time of inclusion compared to 2 out of 20 patients at follow up (p < 0.001). Mean tendon-volume measured 6.7 cm(3) (SD 2.0) at time of inclusion and 6.4 cm(3) (SD 2.0) at follow up (p = 0.18). The four symptomatic non-treated tendons did not improve regarding pain, performance, intratendinous signal or tendon volume.CONCLUSION: We found decreased pain, improved performance and decreased intratendinous signal both compared to index examination and immediately after the 3 months training regimen in a 4.2-year clinical and MRI follow up, in a group of patients treated with heavy loaded eccentric calf-muscle training for chronic Achilles tendinopathy. The improvements were greater at 4.2-year follow up, despite no further active treatment, than immediately after the treatment. This may indicate a good long-term prognosis for Achilles tendinosis patients.
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