scholarly journals Comparison of ultrasonographic, radiographic and intra-operative findings in severe hip osteoarthritis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mika T. Nevalainen ◽  
Kyösti V. Kauppinen ◽  
Tuukka Niinimäki ◽  
Simo S. Saarakkala
Keyword(s):  
Femoral Head ◽  
Gold Standard ◽  
Diagnostic Performance ◽  
Hip Osteoarthritis ◽  
Conventional Radiography ◽  
Rater Reliability ◽  
The Us ◽  
Oxford Hip Score ◽  
Us Findings ◽  
Operative Findings

AbstractAim of this study was to assess the US findings of patients with late-stage hip OA undergoing total hip arthroplasty (THA), and to associate the US findings with conventional radiography (CR) and intraoperative findings. Moreover, the inter-rater reliability of hip US, and association between the US and Oxford Hip Score (OHS) were evaluated. Sixty-eight hips were included, and intraoperative findings were available on 48 hips. Mean patient age was 67.6 years and 38% were males. OA findings—osteophytes at femoral collum and anterosuperior acetabulum, femoral head deformity and effusion—were assessed on US, CR and THA. The diagnostic performance of US and CR was compared by applying the THA findings as the gold standard. Osteoarthritic US findings were very common, but no association between the US findings and OHS was observed. The pooled inter-rater reliability (n = 65) varied from moderate to excellent (k = 0.538–0.815). When THA findings were used as the gold standard, US detected femoral collum osteophytes with 95% sensitivity, 0% specificity, 81% accuracy, and 85% positive predictive value. Concerning acetabular osteophytes, the respective values were 96%, 0%, 88% and 91%. For the femoral head deformity, they were 92%, 36%, 38% and 83%, and for the effusion 49%, 85%, 58% and 90%, respectively. US provides similar detection of osteophytes as does CR. On femoral head deformity, performance of the US is superior to CR. The inter-rater reliability of the US evaluation varies from moderate to excellent, and no association between US and OHS was observed in this patient cohort.

Global inter-rater reliability, scale validity, and local perception: Panss ratings and reactions from 4 Countries

2011 ◽  
Vol 26 (S2) ◽  
pp. 453-453
Author(s):  
A. De Fries ◽  
S. Liechti ◽  
M. Opler ◽  
S. Lane ◽  
E. Ivanova ◽  
...  
Keyword(s):  
Gold Standard ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Rater Training ◽  
Data Set ◽  
Rater Reliability ◽  
Local Perception ◽  
The Us ◽  
Schizophrenic Patients ◽  
Rater Performance

Introduction/objectives/aimsWe compared cohorts of raters from different countries who received training on the PANSS. We attempted to determine if there was any consistent by-country impact on specific items, factors, or subscales. We also queried raters about their perceptions of the instrument they were asked to use vis-à-vis their local patient population.MethodsThe data set comes from standardized rater training events involving raters from four countries: India (n = 83), Russia (n = 59), the US (n = 63), and Romania (n = 76). Raters scored interviews of schizophrenic patients using the PANSS. Scores were compared and intra-class correlation coefficients (ICCs) and rater agreement with “gold standard” scores were evaluated. The results were viewed against raters’ responses to questions about how well the PANSS items correlated to the presentation of symptoms.ResultsRaters from the US and Russia demonstrated a higher level of inter-rater consistency with ICCs of 0.883 and 0.835, respectively. For eight PANSS items, all raters demonstrated at least 80% agreement with the gold standard scores. For ten PANSS items, there was at least one country whose raters scored below 60% agreement. The PANSS items with the lower inter-rater reliability were the same items raters indicated as problematic in local settings.ConclusionThe differences in rater performance indicate that standardized rater training is broadly effective but that there are some important differences in the way in which different groups conceptualize symptomatology and corresponding PANSS items. This suggests a need to tailor training to ensure reliability and validity in the use of this instrument.

Clinical Application of Computer-Aided Diagnosis According to S-Detect in Category 4 Breast Lesions: Prospective Single-Center Study (Preprint)

2020 ◽  
Author(s):  
Pengfei Sun ◽  
Chen Chen ◽  
Weiqi Wang ◽  
Lei Liang ◽  
Dan Luo ◽  
...  
Keyword(s):  
Clinical Management ◽  
Diagnostic Performance ◽  
Breast Biopsy ◽  
Computer Aided Diagnosis ◽  
Breast Lesions ◽  
Breast Masses ◽  
Computer Aided ◽  
Conventional Ultrasound ◽  
Us Findings ◽  
Aided Diagnosis

BACKGROUND Computer-aided diagnosis (CAD) is a useful tool that can provide a reference for the differential diagnosis of benign and malignant breast lesion. Previous studies have demonstrated that CAD can improve the diagnostic performance. However, conventional ultrasound (US) combined with CAD were used to adjust the classification of category 4 lesions has been few assessed. OBJECTIVE The objective of our study was to evaluate the diagnosis performance of conventional ultrasound combined with a CAD system S-Detect in the category of BI-RADS 4 breast lesions. METHODS Between December 2018 and May 2020, we enrolled patients in this study who received conventional ultrasound and S-Detect before US-guided biopsy or surgical excision. The diagnostic performance was compared between US findings only and the combined use of US findings with S-Detect, which were correlated with pathology results. RESULTS A total of 98 patients (mean age 51.06 ±16.25 years, range 22-81) with 110 breast masses (mean size1.97±1.38cm, range0.6-8.5) were included in this study. Of the 110 breast masses, 64/110 (58.18%) were benign, 46/110 (41.82%) were malignant. Compared with conventional ultrasound, a significant increase in specificity (0% to 53.12%, P<.001), accuracy (41.81% to70.19%, P<.001) were noted, with no statistically significant decrease on sensitivity(100% to 95.65% ,P=.48). According to S-Detect-guided US BI-RADS re-classification, 30 out of 110 (27.27%) breast lesions underwent a correct change in clinical management, 74of 110 (67.27%) breast lesions underwent no change and 6 of 110 (5.45%) breast lesions underwent an incorrect change in clinical management. The biopsy rate decreased from 100% to 67.27 % (P<.001).Benign masses among subcategory 4a had higher rates of possibly benign assessment on S-Detect for the US only (60% to 0%, P<.001). CONCLUSIONS S-Detect can be used as an additional diagnostic tool to improve the specificity and accuracy in clinical practice. S-Detect have the potential to be used in downgrading benign masses misclassified as BI-RADS category 4 on US by radiologist, and may reduce unnecessary breast biopsy. CLINICALTRIAL none

scholarly journals What is the association between MRI and conventional radiography in measuring femoral head migration?

2021 ◽  
pp. 1-5
Author(s):  
Hans-Christen Husum ◽  
Michel Bach Hellfritzsch ◽  
Mads Henriksen ◽  
Kirsten Skjaerbaek Duch ◽  
Martin Gottliebsen ◽  
...  
Keyword(s):  
Femoral Head ◽  
Conventional Radiography

The association between femoral neck shaft angle and degenerative disease of the hip in a cadaveric model

2021 ◽  
pp. 112070002110130
Author(s):  
Leigh-Anne Tu ◽  
Douglas S Weinberg ◽  
Raymond W Liu
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Hip Osteoarthritis ◽  
Volume Ratio ◽  
Femoral Head Coverage ◽  
Neck Shaft Angle ◽  
Hip Arthritis ◽  
Femoral Version ◽  
Shaft Angle ◽  
The Impact

Background: While the influences of acetabular dysplasia and overcoverage on hip arthritis have been studied, the impact of femoral neck-shaft angle on hip arthritis is much more poorly understood. The purpose of this study is to determine if a relationship exists between neck shaft angle and the development of osteoarthritis, a better understanding of which would be useful to surgeons planning osteotomies about the hip. Methods: 533 cadaveric femora and acetabulae (1066 total) from the Hamann-Todd Osteological Collection (Cleveland, OH) were acquired. We measured true neck shaft angle using an AP photograph with the femoral neck parallel to the table. Femoral head volume to acetabular volume ratio, representing femoral head coverage, as well as femoral version were utilised. Correlation between neck shaft angle, femoral version, femoral head coverage and osteoarthritis were evaluated with multiple regression analysis. Results: The mean age and standard deviation was 56 ± 10 years. There were 64 females (12%) and 469 males. There were 380 Caucasians (71%) and 153 African-Americans. Mean femoral version was 11° ± 12° and mean true neck shaft angle was 127.7° ± 5.9° There was a strong correlation between age and arthritis (standardised beta 0.488, p < 0.001). There was a significant correlation between increasing true neck shaft angle and decreasing hip arthritis (standardised beta -0.024, p = 0.038). In the femoral head overcoverage subset, increasing true neck shaft angle was still significantly associated with decreasing hip arthritis (standardised beta −0.088, p = 0.018), although this relationship was not significant with femoral head undercoverage subset. Conclusions: With sufficient acetabular coverage, a relative increase in femoral neck shaft angle within the physiologic range is associated with decreased hip osteoarthritis. Clinical relevance: An understanding of the relationship between femoral neck shaft angle and hip osteoarthritis could be useful for surgeons planning pelvic or proximal femur osteotomies in children.

scholarly journals AB0115 COMPARISON OF ULTRASOUND FINDINGS BETWEEN TNF INHIBITORS AND NON-TNF INHIBITORS AT FIRST BIOLOGICS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1086.2-1087
Author(s):  
T. Okano ◽  
T. Koike ◽  
K. Inui ◽  
K. Mamoto ◽  
Y. Yamada ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Power Doppler ◽  
Tnf Inhibitors ◽  
Tnf Inhibitor ◽  
Significant Difference ◽  
The Us ◽  
Us Findings ◽  
Improvement Ratio

Background:In rheumatoid arthritis (RA), biologics treatment is one of the effective treatment options. Usually, there is no difference in therapeutic effect regardless of which biologics is used, but the effect for joint synovitis is unknown. Recently, ultrasound (US) has played a role of sensitive imaging modality in the diagnosis and follow-up of patients with RA.Objectives:The aim of this study was to compare the improvement of US findings between TNF inhibitors and non-TNF inhibitors at first biologics in patients with RA.Methods:Fifty-four RA patients who started the first biologics from September 2016 to December 2018 were included in this longitudinal study (SPEEDY study, UMIN000028260). All the patients were performed clinical examination, blood test and US examination at baseline, 4, 12, 24, 36 and 52 weeks. A US examination was performed at the bilateral first to fifth metacarpophalangeal (MCP) joints, first interphalangeal (IP) and second to fifth proximal interphalangeal (PIP) joints, wrist joints (three part of radial, medial and ulnar) and first to fifth metatarsophalangeal (MTP) joints, by using HI VISION Ascendus (Hitachi Medical Corporation, Japan) with a multifrequency linear transducer (18-6 MHz). The gray scale (GS) and power Doppler (PD) findings were assessed by the semi-quantitative method (0-3). GS score and PD score (both 0-108 points) were defined as the sum of each score. The change of disease activity and US findings were compared between TNF group and non-TNF group.Results:Among 54 cases, 32 patients were used TNF inhibitor and 22 were non-TNF inhibitor. Age and duration of RA were significantly higher in the non-TNF group, and MTX dose was significantly lower in the non-TNF group. The baseline inflammatory markers tended to be higher in the non-TNF group and the disease activity was also higher in the non-TNF group. However, the US findings showed no significant difference in both GS and PD between two groups at baseline. US improvement ratio was no difference between TNF group and non-TNF group at 4, 12, 24, 36 and 52 weeks in both GS and PD score. Regardless of the type of biologics, patients with long-term disease duration tended to have poor improvement in US synovial fingings.Table 1.Baseline patient and disease characteristicsTNF (n=32)non-TNF (n=22)P valueFemale patients, n (%)21 (65.6)16 (72.7)0.767Age (years)63.5±15.471.0±9.00.030Disease duration (years)6.5±8.213.0±11.70.032CRP (mg/dl)1.8±2.53.0±3.20.170DAS28-ESR5.0±1.45.8±1.20.022GS score26.1±18.831.8±21.10.313PD score17.6±11.423.1±14.60.150Figure 1.GS and PD improvement ratio at 4, 12, 24, 36 and 52 weeksConclusion:There was no difference in the US findings improvement between patients with TNF inhibitor and non-TNF inhibitor at first biologics in patients with RA.References:[1]Grassi W, Okano T, Di Geso L, Filippucci E. Imaging in rheumatoid arthritis: options, uses and optimization. Expert Rev Clin Immunol. 2015;11:1131-46.[2]Nishino A, Kawashiri SY, Koga T, et al. Ultrasonographic Efficacy of Biologic andTargeted Synthetic Disease-ModifyingAntirheumatic Drug Therapy in RheumatoidArthritis From a Multicenter RheumatoidArthritis Ultrasound Prospective Cohort in Japan. Arthritis Care Res (Hoboken). 2018;70:1719-26.Acknowledgements:We wish to thank Atsuko Kamiyama, Tomoko Nakatsuka for clinical assistant, Setsuko Takeda, Emi Yamashita, Yuko Yoshida, Rika Morinaka, Hatsue Ueda and Tomomi Iwahashi for their special efforts as a sonographer and collecting data.Disclosure of Interests:None declared

scholarly journals Optimal clamping time in meatotomy procedure for children with meatal stenosis: Experience with 120 cases

2021 ◽  
Vol 93 (2) ◽  
pp. 244-247
Author(s):  
Mehdi Shirazi ◽  
Umayir Chowdhury ◽  
Faisal Ahmed ◽  
Mohammad-Bagher Rajabalian ◽  
Hossein-Ali Nikbakht ◽  
...  
Keyword(s):  
Bladder Wall ◽  
Postoperative Bleeding ◽  
Urine Flow ◽  
Penile Curvature ◽  
Optimum Time ◽  
Meatal Stenosis ◽  
The Us ◽  
Urinary Stream ◽  
Us Findings

Objective: During meatotomy procedure for children with meatal stenosis (MS), a straight clamp used as a hemostat on the ventrum of the meatus before incised with scissors for clamping and holding bleeding from the site of operation. The aim of this study was to evaluate the optimum clamping time for meatotomy in children with MS. Materials and methods: All the patients with MS between 2014 to 2019 were enrolled in this retrospective study. Patients with uncircumcised penis, traumatic catheterization, any kind of penile abnormality such as hypospadias or penile curvature, and active urinary tract infection (UTI) were excluded. The indication of meatotomy was a pinpoint meatus that develops with dorsal or lateral deflection of the urinary stream and high-velocity urine flow. During meatotomy procedure, clamping time was examined in different groups such as 2, 3, and 4 minutes. The main symptoms of presentation and ultrasonography (US) findings were recorded and compared between groups. To assess the optimum time clamping, postoperative bleeding was noted carefully in all groups. The success rate was recorded at onemonth postoperative follow-up in the clinic. Results: Of the 120 patients with MS who underwent a meatotomy procedure, there were 40 (33.3%) participants in each group. The main symptoms were painful urination and urine stream deviation that represented in 54 (46%) patients. Bladder wall thickness was the main pre-operation finding in the US which was observed in 67 (55.8%) patients. In comparison between the groups related to clamping time, bleeding was observed and required suturing when clamping was applied for 2 minutes in 4 (3.3%) patients (p = 0.016). With a minimum follow-up of 12 months, no recurrent meatal stenosis was reported. Conclusions: Clamping time for more than 2 minutes may prevent bleeding during and after meatotomy.

scholarly journals Development of a Valid Simplified Chinese Version of the Oxford Hip Score in Patients With Hip Osteoarthritis

2013 ◽  
Vol 472 (5) ◽  
pp. 1545-1551 ◽  
Author(s):  
Wei Zheng ◽  
Jia Li ◽  
Jinzhu Zhao ◽  
Denghui Liu ◽  
Weidong Xu
Keyword(s):  
Hip Osteoarthritis ◽  
Chinese Version ◽  
Simplified Chinese ◽  
Oxford Hip Score

scholarly journals Still tied by golden fetters: the global response to the US recession of 1937–1938

2012 ◽  
Vol 19 (1) ◽  
pp. 21-48 ◽  
Author(s):  
Scott Urban ◽  
Tobias Straumann
Keyword(s):  
Exchange Rate ◽  
Gold Standard ◽  
Exchange Rate Regime ◽  
Central Banking ◽  
Eastern European ◽  
Standard View ◽  
Global Response ◽  
Policy Regime ◽  
The Us ◽  
Eastern European Countries

The US recession of 1937–8 is one of the deepest on record. Yet it did not produce a global depression – quite unlike 1930. According to the standard view, this reflected an unfettering of central banking after the collapse of the international gold standard circa 1931. We challenge this view. While Germany and a couple of Central and Eastern European countries were sheltered by binding exchange controls, most countries were still constrained by their golden fetters, as our new exchange rate regime classification suggests. The underlying policy regime was surprisingly similar to that of the 1929–30 downturn. What mattered was a quick reversal in US policy in 1938 and, for many countries, a more plentiful stock of international reserves.

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