scholarly journals Acute knee trauma – Does a normal X-ray rule out significant injury? The sensitivity and specificity of X-rays in comparison to magnetic resonance imaging (MRI)

2018 ◽  
Vol 55 ◽  
pp. S84
Author(s):  
A.D.F. Ang ◽  
J. Fultang ◽  
S.G.F. Abram ◽  
L.E. Smythe ◽  
S.J. Spencer
2017 ◽  
Vol 63 (6) ◽  
pp. 500-503 ◽  
Author(s):  
Leonardo Souza Alves ◽  
Cesar Estanislau ◽  
Lucio Barreto ◽  
Francisco Batista ◽  
Nivaldo Toppa

Sumary The identification of a escrotal mass without pain or report of trauma should be investigated to rule out scrotal cancer. We report the case of a young Brazilian boy who underwent orchiectomy after magnetic resonance imaging (MRI) and duplex scan (DS) indicating a high possibility of cancer. Blood exams ruled out the possibility of cancer. Testicular biopsy was not indicated. After surgery the diagnostic was extensive orchiepididymitis by Schistosoma. In endemic areas orchiepididymis by Schistosoma should be investigate to avoid unnecessary surgeries. This patient was also infected with Zika virus.


2008 ◽  
Vol 36 (2) ◽  
pp. 315-319 ◽  
Author(s):  
Charles A. Nelson

Magnetic resonance imaging (MRI) is a noninvasive imaging tool that utilizes a strong magnetic field and radio frequency waves to visualize in great detail organs, soft tissue, and bone. Unlike conventional x-rays (including computed tomography [CT]), there is no exposure to ionizing radiation and at most field strengths (generally below 7 Tesla) the procedure is considered safe for nearly every age group. Because it is non-invasive (i.e., does not break the skin or harm the body) and possesses excellent spatial resolution (down to millimeters), the use of MRI as a research tool has increased exponentially over the past decade. Uses have ranged from add-ons to a clinical study (e.g., after scanning a child who has fallen from a bicycle, the radiologist might do an extra sequence to explore ways of obtaining higher resolution images) to studies of brain development in typically developing children. In addition, a major effort has been made in recent years to use MRI to study brain function (so-called “functional MRI” [fMRI]). Because the clinical utility of fMRI has not yet been realized, fMRI is still considered highly exploratory, and we cannot yet identify incidental findings of a functional (as opposed to structural) nature.


Medicina ◽  
2009 ◽  
Vol 45 (8) ◽  
pp. 624 ◽  
Author(s):  
Dalius Malcius ◽  
Martynas Jonkus ◽  
Gintaras Kuprionis ◽  
Almantas Maleckas ◽  
Eglė Monastyreckienė ◽  
...  

Objective. The aim of this study was to establish and compare diagnostic accuracy (sensitivity, specificity, and diagnostic odds ratio) of plain x-ray, ultrasonography, bone scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI) in pediatric acute hematogenous osteomyelitis. Material and methods. Analysis of patients’ data, hospitalized at the Department of Pediatric Surgery with suspected acute hematogenous osteomyelitis in the period of 2002–2008, was carried out prospectively. Inclusion criteria were age of 1–18 years, pain in bone area, fever, functional disorder, and (or) signs of infection. Plain x-ray, ultrasonography, bone scintigraphy, computed tomography, and magnetic resonance imaging were performed. The recommendations of Standards for Reporting of Diagnostic Accuracy were used in study design. Results. A total of 183 patients were included into the study. Acute hematogenous osteomyelitis was diagnosed in 156 (85%) patients, and 27 (15%) had other diseases. A total of 169 early plain x-rays (median on the first day of hospital stay), 142 late x-rays (15th day of hospital stay), 82 ultrasonographies (second day), 76 bone scintigraphy (third day), 38 MRI scans (seventh day), and 17 CT (15th day) were performed. The sensitivity of ultrasonography was 0.55 (95% CI, 0.43–0.67); specificity, 0.47 (95% CI, 0.24–0.7); and diagnostic odds ratio, 1.08 (95% CI, 0.3–3.84). The sensitivity of CT was 0.67 (95% CI, 0.38–0.88); specificity, 0.5 (95% CI, 0.01– 0.98); and diagnostic odds ratio, 2.0 (95% CI, 0.02–172.4). The sensitivity of early x-ray was 0.16 (95% CI 0.1–0.23); specificity, 0.96 (95% CI, 0.78–1.0); and diagnostic odds ratio, 4.34 (95% CI, 0.63–186.3). The sensitivity of MRI was 0.81 (95% CI, 0.64–0.93); specificity, 0.67 (95% CI, 0.22–0.96); and diagnostic odds ratio, 8.67 (95% CI, 0.91–108.5). The sensitivity of late x-ray was 0.82 (95% CI, 0.75–0.88); specificity, 0.92 (95% CI, 0.62–1.0); and diagnostic odds ratio, 51.17 (95% CI, 6.61–2222.0). The sensitivity of bone scintigraphy was 0.81 (95% CI, 0.68–0.90); specificity, 0.84 (95% CI, 0.60–0.97); and diagnostic odds ratio, 22.30 (95% CI, 4.9–132.7). Conclusions. Our analysis showed that late x-ray is the most valuable radiologic method in the diagnosis of acute hematogenous osteomyelitis, but bone scintigraphy and magnetic resonance imaging are the most valuable tests at the onset of the disease.


2021 ◽  
Vol 59 (4) ◽  
pp. 418-425
Author(s):  
D. M. Kudinskii ◽  
A. V. Smirnov ◽  
L. I. Alekseeva ◽  
E. A. Taskina ◽  
A. M. Lila ◽  
...  

Standard radiography in direct projection is the “gold standard” in the diagnosis of hand osteoarthritis (HOA). However, the currently clinically most severe “erosive” or “inflammatory” phenotype of HOA is characterized by the presence of inflammatory symptoms such as bone marrow lession (BML), synovitis and tenosinovitis, which are not visible on the radiograph by the nature of the study due to the low optical density. In addition, X-ray examination is planar and has no possibility of multiplanar visualization. This dictated the need to search for a more informative visualization technique in HOA.Aim – to compare the sensitivity and specificity of standard radiography and magnetic resonance imaging (MRI) techniques in determining the symptoms of osteoarthritis (OA) of the distal interphalangeal (DIP), proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints of the right hand; to determine the indications for the appointment of MRI in patients with HOA.Materials and methods. The study included 64 women with clinically verified diagnosis of HOA according to ask criteria. For the first time, X-rays of the joints of the right hand in the anterior-posterior projection and MRI were performed for each of them. Each patient completed the AUSCAN questionnaire. X-rays were described according to the Kellgren and Lawrence systems, magnetic resonance imaging was analyzed according to the modified OHOA system. The sensitivity and specificity of the methods were compared based on the detection of 4 symptoms detected by radiography and MRI: joint space narrowing (JSN), osteophytes (OP), erosions and subluxations. The average age of the patients was 65.28±6.82 years, the age of onset was 48.81±7.73 years, the duration of the disease was 15.0 (10.0–19.5) years.Results. Both methods showed approximately equal identification JSN symptom in DIP and PIP, 95% definition JSN in MCP. OP were detected in 88% of patients in DIP according to radiography and in 95% – using MRI (p>0.05). In PIP OP were observed in 70% of patients on radiographs and in 86% on magnetic resonance imaging, in MCP – in 45% and 66% of cases, respectively. Erosion in DIP were found in 41% of patients according to MRI and 34% as a result of X-ray examination, in PIP – in 27% and 13% of cases, in MCP – in 60% and 8% of cases, respectively. Subluxations were determined in DIP 23% on radiographs in 31% of cases by MRI, in PIP – in 8% and 6% (p>0.05), in MCP subluxations almost never met – in 3% of cases by conventional radiography.Conclusions. MRI in HOA can be used in the detection of erosive process, differential diagnosis with other diseases of the joints, determination of inflammatory changes in the hands and assessment of their severity, but has no significant advantages over standard radiography in determining the symptoms of degenerative-dystrophic nature (JSN and OP). Subluxations of the MCP joints are not typical for the HOA.


2021 ◽  
Vol 25 (04) ◽  
pp. 538-545
Author(s):  
Shila Pazahr ◽  
Reto Sutter ◽  
Veronika Zubler

AbstractThe diagnostic cascade for elbow complaints starts with the physical examination and radiographs that already can clarify or rule out many causes. Depending on the suspected pathology, additional imaging is necessary. Magnetic resonance imaging (MRI) has the advantage of accurately demonstrating a broad spectrum of diseases. The main indication for noncontrast MRI of the elbow is chronic epicondylitis. For magnetic resonance (MR) arthrography, it is suspected chondral and osteochondral abnormalities. Indirect MR arthrography is an option when direct arthrography is not practicable. MR arthrography of the elbow with traction is feasible, with promising results for the assessment of the radiocapitellar cartilage.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jamie Sutherland Brown. ◽  
Richard B. Frobell ◽  
Anders Isacsson ◽  
Martin Englund ◽  
Ola Olsson

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Atsushi Terakado ◽  
Sumihisa Orita ◽  
Kazuhide Inage ◽  
Go Kubota ◽  
Tomohiro Kanzaki ◽  
...  

Background.Elderly female patients complaints of acute low back pain (LBP) may involve vertebral fracture (VF), among which occult VF (OVF: early-stage VF without any morphological change) is often missed to be detected by primary X-ray examination. The current study aimed to investigate the prevalence of VF and OVF and the diagnostic accuracy of the initial X-ray in detecting OVF.Method.Subjects were elderly women (>70 years old) complaining of acute LBP with an accurate onset date. Subjects underwent lumbar X-ray, magnetic resonance imaging (MRI), and bone mineral density (BMD) measurement at their first visit. The distribution of radiological findings from X-ray and magnetic resonance imaging (MRI) as well as the calculation of the prevalence of VF and OVF are investigated.Results. The prevalence of VF among elderly women with LBP was 76.5% and L1 was the most commonly injured level. Among VF cases, the prevalence of OVF was 33.3%. Furthermore, osteoporotic patients tend to show increased prevalence of VF (87.5%). The predictive values in detecting VF on the initial plain X-ray were as follows: sensitivity, 51.3%; specificity, 75.0%; and accuracy rate, 56.7%.Conclusions.Acute LBP patients may suffer vertebral injury with almost no morphologic change in X-ray, which can be detected using MRI.


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