Relationship between hip joint medial space ratio and collapse of femoral head in non-traumatic osteonecrosis: a retrospective study

ABSTRACT To retrospectively analyze the medial space ratio (MSR) of the hip joint to evaluate its efficacy in predicting osteonecrosis of femoral head (ONFH)-induced collapse and its impacts on the mechanical environment of necrotic femoral head. In this retrospective analysis of traditional Chinese medicine, non-traumatic ONFH (NONFH) patients from January 2008 to December 2013 were selected. The patients were divided into collapse group and non-collapse group based on whether the femoral head collapsed. The anatomical parameters including center–edge (CE) angle, sharp angle, acetabular depth ratio and MSR were evaluated. Receiver operating characteristic curves were estimated to evaluate the sensitivity and specificity of MSR and CE angle in collapse prediction. The results showed that 135 patients (151 hips) were included in this study. The differences in CE angle and MSR between collapse group and non-collapse group were statistically significant. The mean survival time of the hips of patients with MSR <20.35 was greater (P < 0.001) than that of patients with MSR >20.35. The ONFH patients with MSR >20.35 were prone to stress concentration. We could conclude that the hip joint MSR and CE angle strongly correlated with the collapse of NONFH. The specificity of MSR is higher than that of CE angle. When MSR is >20.35, the collapse rate of ONFH will increase significantly.

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Ultrasound grayscale ratio: a reliable parameter for differentiating papillary thyroid microcarcinoma from micronodular goiter

10.21203/rs.2.21897/v1 ◽

2020 ◽

Author(s):

Chenke Xu ◽

Lifang Yu ◽

Jianhua Fang ◽

Zhijiang Han ◽

Dingcun Luo ◽

...

Keyword(s):

Operating Characteristic ◽

Roc Curves ◽

Mean Value ◽

Papillary Thyroid ◽

Diagnostic Efficacy ◽

Receiver Operating Characteristic Curves ◽

Thyroid Microcarcinoma ◽

Reliable Parameter ◽

The Mean ◽

Reading System

Abstract Background: To evaluate the reliability and diagnostic efficacy of the ultrasound grayscale ratio (UGSR) for differentiating papillary thyroid microcarcinomas (PTMC) from micronodular goiters (diameter ≤ 1.0cm).Methods: The ultrasound data of 241 pathologically-confirmed cases of patients with 265 PTMC and 141 patients with 168 micronodular goiters were retrospectively reviewed. All patients underwent outpatient ultrasonic examination and preoperative ultrasonic positioning. The RADinfo radiograph reading system (Zhejiang RAD Information Technology Co., Ltd., China) was used to measure and calculated the UGSR of PTMC, micronodular goiters. Patients were divided into the outpatient examination, preoperative positioning, and mean value groups, and the receiver operating characteristic curves (ROC) were calculated to obtain the optimal UGSR threshold for distinguishing PTMC from micronodular goiters.Results: The UGSR values of the PTMC and micronodular goiters were 0.56±0.14 and 0.80±0.19 (t=5.84, P<0.01) in the outpatient examination group, 0.55±0.14 and 0.80±0.19 (t=18.74, P<0.01) in the preoperative positioning group, and 0.56±0.12 and 0.80±0.18 (t=16.49, P<0.01) in the mean value group. The areas under the ROC curves in the outpatient examination, preoperative positioning, and mean value groups were 0.860, 0.856, and 0.875, respectively. When the cut-off UGSR values for the outpatient examination, preoperative positioning, and mean value groups were 0.649, 0.646, and 0.657, the sensitivity and specificity for predicting PTMC were 78.9% and 86.9%, 79.2% and 83.9%, 82.6%, and 85.7%, respectively. A reliable UGSR value was obtained between the outpatient examination and preoperative positioning groups (ICC=0.79, P=0.68).Conclusion: The UGSR is an accurate and feasible tool for differentiating PTMC from micronodular goiters with better diagnostic efficacy.

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Verification of the Efficacy of New Diagnostic Criteria for Retropharyngeal Nodes in a Cohort of Nasopharyngeal Carcinoma Patients

10.21203/rs.3.rs-96689/v1 ◽

2020 ◽

Author(s):

Dom-Gene Tu ◽

Hsuan-Yu Chen ◽

Wei-Jen Yao ◽

Yu-Sheng Hung ◽

Yu-Kang Chang ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Traditional Method ◽

Operating Characteristic ◽

Standard Uptake Value ◽

Axial Diameter ◽

Receiver Operating Characteristic Curves ◽

Specificity And Sensitivity ◽

Chi Squared ◽

The Mean

Abstract Background: A multistage approach to diagnose lateral retropharyngeal nodes (LRPNs) of nasopharyngeal carcinoma (NPC) had been proposed and warranted for validation. Methods: From 2012 to 2017, we collected NPC cases with LRPNs before radiotherapy-based treatments. The responsive nodes or those that progressed during follow-up were positive. The proposed criteria for the multistage approach delimited LRPNs with a minimal axial diameter (MIAD) ≥ 6.1 mm were positive and if the mean standard uptake value ≥ 2.6, or if the maximal coronal diameter ≥ 25 mm and maximal axial diameter ≥ 8 mm with nodes MIAD < 6.1 mm were also positive. The outcomes were compared with the MIAD cutoff value ≥ 6 mm (traditional method). Chi-squared test was used to compare two areas under the curve (AUC) of receiver operating characteristic curves. Results: A total of 67 eligible NPC cases and 155 LRPNs (72 positive and 83 negative) were analyzed. The accuracy, specificity, and sensitivity of the traditional method were 0.91, 0.93, and 0.89, respectively. The values for the multistage approach all reached 0.94. The AUC was significantly greater for the multistage approach compared with that for the traditional method (p = 0.023). Conclusion: The results of LRPN data in this cohort of patients support the advantage of the multistage approach.

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Sex differences in anatomical parameters of acetabulum among asymptomatic Serbian population

Vojnosanitetski pregled ◽

10.2298/vsp1111935j ◽

2011 ◽

Vol 68 (11) ◽

pp. 935-939 ◽

Cited By ~ 2

Author(s):

Dejan Jeremic ◽

Ivana Zivanovic-Macuzic ◽

Maja Vulovic

Keyword(s):

Sex Differences ◽

Hip Joint ◽

Center Edge ◽

Acetabular Morphology ◽

Asymptomatic Patients ◽

Primary Osteoarthrosis ◽

Asymptomatic Subjects ◽

Center Edge Angle ◽

Roof Angle ◽

Anatomical Parameters

Background/Aim. Anatomical parameters of the bony components of the hip joint are essential for better understanding of etiopathogenesis of diseases like primary osteoarthrosis of the hip joint. The aim of this reserch was to examine the normal acetabular morphometry in Serbian population and to determine whether there are sex differences in anatomical parameters of the acetabulum among asymptomatic subjects. Methods. Pelvic radiographics of 320 adult asymptomatic patients (640 hips) were analyzed in 170 men and 150 women to determine the morphology of the acetabulum in Serbian population. For each hip the center edge angle of Wiberg (CEA), the acetabular angle of Sharp (AA), acetabular depth (AD), acetabular roof obliquity (ARO) and roof angle (RA) were measured. Results. The following average measurements for acetabulum geometry were obtained (X ? SD): CEA - 33.5 ? 6.5? (33.6 ? 5.8? in male, 33.3 ? 6.9? in female), AA - 38.0 ? 3.8? (37.5 ? 3.6? in male, 38.5 ? 3.9? in female), AD - 11.9 ? 2.8 mm (12.5 ? 2.7 mm in male, 11.2 ? 2.7 mm in female), ARO - 7.6 ? 5.7? (6.2 ? 4.9? in male, 9.0 ? 6.0? in female) and RA - 18.4 ? 10.0? (19.6 ? 8.5? in male, 17.1 ? 9.5? in female). There were significant differences in the CEA, AA, AD, ARO and RA related to gender (p < 0.01, t-test). Conclusion. There are significant gender differences in Serbian population for all the examined anatomical parameters of acetabulum. We found sex-related differences in acetabular morphology, female acetabulum being marginally more dysplastic than male acetabulum. There is also a clear tendency of female hips to be more dysplastic than male ones.

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Ratio of the Medial Hip Joint Space as a Predictor for Collapse of the Femoral Head in Non-traumatic Osteonecrosis: A Retrospective Study and Finite Element Analysis

10.21203/rs.3.rs-27533/v1 ◽

2020 ◽

Author(s):

Tianye Lin ◽

Peng Yang ◽

Hongzhu Li ◽

Jingli Xu ◽

Binglang Xiong ◽

...

Keyword(s):

Finite Element Analysis ◽

Finite Element ◽

Femoral Head ◽

Cortical Bone ◽

Hip Joint ◽

Maximum Stress ◽

Survival Rates ◽

Element Analysis ◽

Space Ratio

Abstract Background: There has been no indicators that can effectively predict femoral head collapse in ONFH so far. The aim of this study is to retrospectively analyze the first-visit medial space ratio of the hip joint to evaluate its efficacy in predicting ONFH-induced collapse and impacts on the mechanical environment of necrotic femoral head.Methods: In this retrospective analysis for traditional Chinese medicine (TCM), non-traumatic osteonecrosis of femoral head (NONFH) patients from January 2010 to December 2016 were selected. The medial space ratio at their first visit and and collapse of the femoral head during the follow-up were recorded. Patients were divided into group A, B, C, D, and E according to the grading of the medial space ratio at the first visit. A total of 14 hip joint models with distinct medial space ratios were established. The maximum stress intensities of the cartilage, cortical bone and the necrotic area (N-unit area) of the femoral head in the models were quantitated using a finite element analysis.Results: One hundred twenty-eight patients (142 hips) were included in this study. The average follow-up time was 5.4±1.5 years.The Kaplan-Meier survival analysis showed that survival rates of the first-visit medial space ratios in group C and D were significantly higher (exceeding 45.76%) than that in group E (22.73%). There was no significant difference in the survival rates between group C and D (P > 0.05). The finite element analysis showed that in either the necrosis or non-necrosis group, the maximum stress in cartilage, cortical bone and the N-unit area of the femoral head increased with the medial space ratio decreasing. Conclusion: The medial space ratio shows clinical implications of predicting the collapse of NONFH except for assessing the relationship between the femoral head and the acetabulum. The stress concentrations of cartilage, cortical bone, and the necrotic area of the femoral head are enhanced with the medial space radio decreasing. Once the medial space ratio falls below 4 and continues to decline, the risk of necrotic collapse will become higher.

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Shelf Acetabuloplasty in the Treatment of Severe Legg-Calvé-Perthes Disease: Good Outcomes at Midterm Follow-Up

BioMed Research International ◽

10.1155/2013/859483 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Andrzej Grzegorzewski ◽

Marek Synder ◽

Krysztof Kmieć ◽

Karol Krajewski ◽

Michał Polguj ◽

...

Keyword(s):

Femoral Head ◽

Type I ◽

Leg Length ◽

Midterm Results ◽

Type Iv ◽

Center Edge ◽

The Mean ◽

Shelf Acetabuloplasty ◽

Center Edge Angle

The aim of the study was to retrospectively review results of operative treatment for coverage deficit of femoral head in children with severe epiphysis displacement in Legg-Calvé-Perthes (LCP) disease. The material included 23 shelf acetabuloplasty procedures for LCP disease. The average age at diagnosis was 8.1 years (range 4–12). Mean follow-up was 5.8 years (range from 2.2 to 11.2 years). Mean Reimer's index decreased statistically significantly from a mean of 32% before surgery to 10.0% at the last follow-up (P<0.00001). The mean Wiberg center-edge angle increased also statistically significantly from a mean of 17.3° before procedure to 32.3° at the last follow-up (P<0.00001). According to the Stulberg classification, type I was observed in 2, type II in 13, type III in 6, and type IV in 2 hips. There were no differences in the range of motion or leg length discrepancy in preoperative and postoperative standing. Partial, not significant, bone graft resorption was noted in 6 cases in the first 6–9 months after surgery. To conclude, shelf acetabuloplasty allows achieving good midterm results in the treatment of severe stages of LCP disease. The procedure improves coverage of femoral head and allows its remodelling.

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Glasgow Coma Scale and Its Components on Admission: Are They Valuable Prognostic Tools in Acute Mixed Drug Poisoning?

Critical Care Research and Practice ◽

10.1155/2011/952956 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

N. Eizadi Mood ◽

A. M. Sabzghabaee ◽

Gh. Yadegarfar ◽

A. Yaraghi ◽

M. Ramazani Chaleshtori

Keyword(s):

Glasgow Coma Scale ◽

Operating Characteristic ◽

Attempted Suicide ◽

Mean Value ◽

Study Data ◽

Drug Poisoning ◽

Coma Scale ◽

Receiver Operating Characteristic Curves ◽

Significant Difference ◽

The Mean

Introduction. The verbal, eye, and motor components of Glasgow coma scale (GCS) may be influenced by poisoned patients' behavior in an attempted suicide. So, the values of admission GCS and its components for outcomes prediction in mixed drugs poisoning were investigated.Materials and Methods. A followup study data was performed on patients with mixed drugs poisoning. Outcomes were recorded as without complications and with complications. Discrimination was evaluated by calculating the area under the receiver operating characteristic curves (AUC).Results. There was a significant difference between the mean value of each component of GCS as well as the total GCS between patients with and without complication. Discrimination was best for GCS (AUC:0.933±0.020) and verbal (0.932±0.021), followed by motor (0.911±0.025), then eye (0.89±0.028).Conclusions. Admission GCS and its components seem to be valuable in outcome prediction of patients with mixed drug poisoning.

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Evaluation of hip joint laxity in crab-eating foxes (Cerdocyon thous)

Pesquisa Veterinária Brasileira ◽

10.1590/1678-5150-pvb-6757 ◽

2021 ◽

Vol 41 ◽

Author(s):

Maíra S. Castilho ◽

Sheila C. Rahal ◽

Maria J. Mamprim ◽

Letícia R. Inamassu ◽

Ramiro N. Dias Neto ◽

...

Keyword(s):

Hip Joint ◽

Hip Dysplasia ◽

Joint Laxity ◽

Mean Values ◽

Computed Tomographic ◽

Center Edge ◽

The Mean ◽

Intact Crab ◽

Orthopedic Diseases ◽

The Right

ABSTRACT: Like canids, crab-eating foxes may probably be predisposed to similar orthopedic diseases of domestic dogs, such as hip dysplasia. However, for the adequate hip dysplasia diagnosis in wild animals, the normality characteristics of each species must be determined. This study aimed to estimate radiographic and computed tomographic (CT) values of hip joint laxity in healthy crab-eating foxes. Fifteen intact crab-eating foxes, eight males and seven females, ages 1 to 5 and mean body mass of 6.66kg were used. Norberg angle (NA) was calculated from ventrodorsal hip-extended radiographs. To calculate the dorsolateral subluxation (DLS) score, the center distance (CD) index, the lateral center edge angle (LCEA), and the dorsal acetabular rim angle (DARA), measurements obtained from transverse CT images were used. No statistically significant differences were observed between the right and left sides in the radiographic and tomographic parameters. The mean NA was 107.57°. The mean DLS score, the CD index, the LCEA, and the DARA were 60.79%, 0.16, 98.25° and 13.47°, respectively. The data obtained are helpful in characterizing mean values of the hip joint in healthy crab-eating foxes, and can contribute to the knowledge of the species.

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A Newly Modified Salter Osteotomy Technique for Treatment of Developmental Dysplasia of Hip That Is Associated with Decrease in Pressure on Femoral Head and Triradiate Cartilage

BioMed Research International ◽

10.1155/2019/6021271 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9

Author(s):

Seyed Mokhtar Esmaeilnejad-Ganji ◽

Seyed Mohammad Reza Esmaeilnejad-Ganji ◽

Mohammad Zamani ◽

Hesam Alitaleshi

Keyword(s):

Femoral Head ◽

Developmental Dysplasia ◽

Developmental Dysplasia Of Hip ◽

Center Edge ◽

Salter Osteotomy ◽

Innominate Osteotomy ◽

Femoral Shortening ◽

Osteotomy Technique ◽

The Mean

Background and Purpose. The Salter innominate osteotomy has been an effective method to treat the developmental dysplasia of hip (DDH) over the past decades; however, several postoperative complications and deficiencies were reported. In this study, we evaluated outcome of a newly modified Salter osteotomy in patients presenting with DDH. Methods. We reviewed retrospectively 76 patients (90 hips) with DDH aged ≥ 18 months, who underwent open reduction and a modified osteotomy by a single surgeon. The distal osteotomy segment of pelvis was shifted anterolaterally in the amount of osteotomy cross-section, but not downwards. The mean age at surgery was 2 years and 11 months (1.5 to 16 years). Femoral shortening was conducted when necessary. The duration of operation varied between 60 and 90 minutes. The mean follow-up was 4 years and one month (range 15 months to 7 years and 9 months). All patients were followed up both clinically (based on the modified MacKay criteria) and radiologically (based on the modified Severin criteria). Results. Clinically, 94.5% of hips had excellent and good results at final follow-up, and only 5.5% had a fair condition. Radiographically, at the final follow-up 77.8% of hips were grade IA (excellent), 12.2% were grade IB, 6.7% were grade II, and 3.3% were grade III (fair). The preoperative mean acetabular index was 47.85° (41° to 59), which decreased to 17.16° (13° to 22°) immediately after the surgery (p<0.0001) and progressed to 11.24° (7° to 19°) at the final follow-up (p<0.0001). The mean initial postoperative center-edge angle was 30.3° (25° to 42°) significantly improved to 39.1 (31° to 56°) at the final follow-up (p<0.0001). Avascular necrosis of femoral head occurred in 4.4% of hips (4 patients). Conclusion. The results show that our modified Salter osteotomy is safe and associated with significant benefit for the management of patients suffering from DDH.

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The Iliofemoral Line: A Radiographic Sign of Acetabular Dysplasia in the Adult Hip

The American Journal of Sports Medicine ◽

10.1177/0363546517708983 ◽

2017 ◽

Vol 45 (11) ◽

pp. 2493-2500 ◽

Cited By ~ 8

Author(s):

Matthew J. Kraeutler ◽

Zachary R. Ashwell ◽

Tigran Garabekyan ◽

Jesse A. Goodrich ◽

K. Linnea Welton ◽

...

Keyword(s):

Femoral Head ◽

Hip Dysplasia ◽

Acetabular Dysplasia ◽

Head Width ◽

Horizontal Distance ◽

Strongly Correlated ◽

Radiographic Parameter ◽

Level Of Evidence ◽

Additional Tool ◽

Center Edge

Background: Several radiographic parameters utilized for the diagnosis of acetabular dysplasia in adults suffer from poor reproducibility and reliability. Purpose: To define and validate a novel radiographic parameter (the iliofemoral line [IFL]) for the detection of frank and borderline hip dysplasia and to compare the sensitivity and specificity of this radiographic marker to those of previously validated qualitative parameters. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A consecutive cohort of 222 adult patients (436 hips) undergoing hip preservation surgery was included. The IFL, which extends from the lateral femoral neck through the inner cortical lip of the iliac crest, intersects the femoral head in cases of dysplasia. Percent medialization of the IFL was defined as the horizontal distance of the exposed femoral head lateral to the IFL, relative to the horizontal femoral head width at the center of the femoral head. Results: Percent medialization of the IFL was strongly correlated to the lateral center edge angle ( P < .0001). Values of percent medialization ranging from 15% to 22% predicted the presence of borderline hip dysplasia with a sensitivity of 62% and specificity of 89%, while values exceeding 22% predicted the presence of frank acetabular dysplasia with a sensitivity of 77% and specificity of 94%. By comparison, abnormality of the Shenton line demonstrated a sensitivity of 3.7% and specificity of 97% for the detection of borderline dysplasia and a sensitivity of 16% and specificity of 99% for the detection of frank acetabular dysplasia. Compared with the Shenton line, percent medialization of the IFL was significantly more sensitive for the detection of both borderline and frank acetabular dysplasia (both P < .0001). The intraobserver and interobserver reproducibility of the horizontal difference outside the IFL were 0.99 and 0.96, respectively. Conclusion: Percent medialization of the IFL is a reliable and accurate radiographic marker of frank acetabular dysplasia and, to a lesser extent, borderline dysplasia. The use of this radiographic parameter as an additional tool may enable the earlier detection of borderline and frank hip dysplasia in young adults presenting with hip pain.

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TO EVALUATE THE CHANGES IN HIP JOINT RELATED TO LOWER LIMB DOMINANCE AND ITS ASSOCIATION WITH HIP DISLOCATION

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2015.5.1.635-638 ◽

1969 ◽

Vol 5 (1) ◽

pp. 635-638

Author(s):

NIAZ MOHAMMAD ◽

MAQBOOL ILAHI ◽

QAISAR ZAMAN

Keyword(s):

Femoral Head ◽

Hip Joint ◽

Lower Limb ◽

Weight Bearing ◽

Hip Dislocation ◽

Congenital Dislocation ◽

Left Femur ◽

Horizontal Diameter ◽

The Mean ◽

The Right

BACKGROUND: The stability of a joint depends on the arrangement of the articular surfaces. Thefailure of acetabulum to deepen along with associated relaxed capsule can be a causative factor leadingto congenital dislocation of hip in babies. The right traumatic hip dislocation is less uncommon ascompared to left side in adults.OBJECTIVE: To correlate the majority of right-footed population with the bony parameters of hipjoint bilaterally and to find out its association with left congenital and right acquired traumaticdislocation of hip.MATERIAL AND METHODS: As the right footed people are considerably more (90%) than the leftfooted and this study work was correlated with the bones collected from cadavers in Anatomydepartment of KGMC Peshawar from January 2014 to December 2014. We included 14 pairs of femurs,14 pairs of hip bones in this study to see the structural differences when dominant hip joint is comparedwith non-dominant hip joints. The measurements were performed with the help of vernier caliper.RESULTS: The mean horizontal diameter of right (dominant) and left acetabulum was 50.14±0.69 mmand 52.35±0.65mm. The mean horizontal depth of right and left acetabulum was 22.21±0.82mm and25.25±0.52mm. The horizontal diameter of right and left femur was 46.42±0.62mm and 43.85±01mm.The thickness of femoral head was 26.71±01mm on right (dominant) side but this thickness was29.17±01mm on left side.CONCLUSION: The left acetabulum was having a significant larger diameter in adult, allowing thesmaller left femoral head to fit snugly which can be correlated with the more common left congenitaldislocation hip. On the other hand, in adults, the left acetabulum is deeper, allowing the thicker left headof femur as an adjustment for weight bearing functionwhile the larger rightfemoral head fit into acomparatively shallow socket. This may be a factor to improve mobility at the cost of stability; as righttraumatic dislocationhip is less uncommon as compared to left side.KEY WORDS: Hip joint, Ball and socket joint. Dominant lower limb, Right footedness,Left footedness, Congenital dislocation hip, Traumatic dislocation hip.

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