P107 Can a computer sense the symptoms of osteoarthritis from a radiograph? Initial findings from a pilot, AI approach to osteoarthritis assessment

Abstract Background/Aims Osteoarthritis is the most common joint disease and is associated with substantial morbidity for the affected individual and a significant financial burden for the health system at large. There is a marked discrepancy between the extent of osteoarthritis observed via plain radiography and the magnitude of clinical symptoms. For this reason we aimed to investigate whether, using an artificial intelligence approach, we could train an algorithm to diagnose osteoarthritis and if we were able to find correlations between clinical symptoms and radiographic images. Methods Anterior-posterior and lateral radiographic images of the knees and hips were ascertained from members of the Hertfordshire Cohort Study (HCS, a group of community-dwelling older adults in the UK) and were merged with anterior-posterior knee X-rays obtained from Mendeley (a repository of open-access images). The HCS contributed 1,445 images, which were equally split into training and testing sets, and the Mendeley cohort provided 2,889 training and 828 testing radiographs. The radiographic images were passed through a detection network in order to identify the region of interest (the knee or hip joint), thereby streamlining the necessary information in the image. Next, a classification network was trained with the goal of differentiating the Kellgren and Lawrence (KL) grade for each joint. Finally, the clinical symptoms and radiographic grading was subject to pairwise correlation, using Spearman rank-order correlation. Results The HCS sample included 222 males and 221 females with a mean age of 76 years (SD 2.6). In terms of detection of the join, an average accuracy of 99% was achieved. The classification task utilised alternative evaluation metrics, with the best network achieving 58% accuracy, 63% average precision and 61% average recall in the KL grading task. Superior results were obtained with knee joints than hips. However, when using the dichotomous outcomes of ‘osteoarthritis’ (defined by a KL ≥ 2) or ‘no osteoarthritis’, the results significantly improved, obtaining an accuracy of 81.2%. Significant correlations were observed between the majority of pain symptoms and the radiograph images, with the strongest correlations seen at the knees with; pain going up or down stairs (rho 0.30), pain standing upright (rho 0.30), pain walking on hard surface (rho 0.28), pain walking on uneven surface (rho 0.31) and pain standing from chair (rho -0.30). Conclusion To conclude, in this pilot study, we have trained an algorithm, to diagnose osteoarthritis of the knees and hips with limited accuracy. We have also demonstrated moderate correlations with some specific pain symptoms. It will be interesting to see whether these initial findings are replicated as we expand this project into other cohorts. Disclosure N.R. Fuggle: None. D. Pinto Pereira: None. E.M. Dennison: None. C. Cooper: None. S. Mahmoodi: None.

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405 Radiological Analysis of Gentamicin Eluting Synthetic Bone Graft Substitute Used in The Management of Gustilo IIIB Open Fractures

British Journal of Surgery ◽

10.1093/bjs/znab134.273 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

A Aljawadi ◽

I Madhi ◽

T Naylor ◽

M Elmajee ◽

A Islam ◽

...

Keyword(s):

Bone Graft ◽

Cortical Thickness ◽

Bone Graft Substitute ◽

Fracture Site ◽

Open Fractures ◽

X Rays ◽

Radiographic Images ◽

Synthetic Bone ◽

Synthetic Bone Graft

Abstract Background Management of traumatic bone void associated with Gustilo IIIB open fractures is challenging. Gentamicin eluting synthetic bone graft substitute (Cerament-G) had been recently utilised for the management of patients with these injuries. This study aims to assess radiological signs of Cerament-G remodelling. Method Retrospective data analysis of all patients admitted to our unit with IIIB open fractures who had Cerament-G applied as avoid filler. Postoperative radiographic images of the fracture site at 6-weeks, 3-months, 6-months and at the last follow-up were reviewed. The radiological signs of Cerament-G integration, percent of void healing, and bone cortical thickness at the final follow-up were assessed. Results 34 patients met our inclusion criteria, mean age: 42 years. Mean follow-up time was 20 months. 59% of patients had excellent (>90%) void filling, 26.4% of patients had 50-90% void filling, and 14.6% had < 50% void filling. Normal bone cortical thickness was restored on AP and Lateral views in 55.8% of patients. No residual Cerement-G was seen on X-rays at the final follow-up in any of the patients. Conclusions Our results showed successful integration of Cerament-G with excellent void filling and normal cortical thickness achieved in more than half of the patients.

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49. Clinical Characteristics of the 2019 Eastern Equine Encephalitis Virus Outbreak in Michigan

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.359 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S154-S154

Author(s):

Adam T Ladzinski ◽

Matthew T Rumschlag ◽

Aditya Mehta ◽

Eric Edewaard ◽

Pimpawan Boapimp ◽

...

Keyword(s):

Clinical Symptoms ◽

The United States ◽

Encephalitis Virus ◽

Eastern Equine Encephalitis Virus ◽

Radiographic Images ◽

Eastern Equine Encephalitis ◽

Male Predominance ◽

Equine Encephalitis Virus ◽

Neuroinvasive Disease ◽

Neurologic Sequelae

Abstract Background Eastern Equine Encephalitis Virus (EEEV) is a mosquito-borne alphavirus responsible for unpredictable outbreaks of severe neurologic disease in humans. While the vast majority of human EEEV infections are either asymptomatic or clinically nonspecific, a minority of patients develops neuroinvasive disease (EEE), which is a devastating illness with a mortality of at least 30%. No treatments are known to be effective. EEEV infection is relatively rare in the United States, with an annual average nationwide incidence of 7 cases between 2009 and 2018. However, 2019 was an exceptionally active year for human EEEV disease, yielding 38 nationwide confirmed cases, including 10 in Michigan, comprising the state’s largest outbreak to date. Methods EEE cases were identified by a regional network of physicians. Cases were defined by presentation with clinical symptoms of encephalitis, and by identification of EEEV IgM antibodies or RNA in cerebrospinal fluid (CSF), or EEEV-specific IgM in serum as confirmed by plaque reduction neutralization test. Radiographic images were evaluated and clinical data abstracted through chart review and clinical follow-up where possible. Results Records from 7 patients were identified and reviewed. The median age was 64, with a male predominance, and all presented in August. Notably, commercial arboviral CSF serology was uniformly negative on the initial CSF sample, and diagnosis was not made until a mean of 23 days (range: 12–38 days) after presentation. Testing in public health laboratories yielded the diagnosis in 5 out of 7 cases. Imaging findings were heterogeneous, but most patients exhibited abnormal findings in the thalamus and/or basal ganglia, and one patient displayed prominent pons and midbrain abnormalities. 4 patients died, while 2 patients survived with severe neurologic sequelae, and 1 patient recovered without sequelae. One patient underwent a limited postmortem examination, which revealed diffuse meningoencephalitis and focal vascular necrosis. Conclusion EEE is a frequently fatal condition whose diagnosis is often delayed, and for which no effective treatments are known. Improved diagnostics are needed to facilitate further clinical studies of EEE and encourage the development of potential therapies. Disclosures All Authors: No reported disclosures

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Visualizing Fluid Flows With X-Rays

Volume 1: Symposia, Parts A and B ◽

10.1115/fedsm2007-37023 ◽

2007 ◽

Cited By ~ 4

Author(s):

Theodore J. Heindel ◽

Terrence C. Jensen ◽

Joseph N. Gray

Keyword(s):

Computed Tomography ◽

Flow Visualization ◽

Three Dimensional ◽

Fluid Flows ◽

X Rays ◽

Radiographic Images ◽

Optical Access ◽

X Ray ◽

X Ray Computed ◽

Density Map

There are several methods available to visualize fluid flows when one has optical access. However, when optical access is limited to near the boundaries or not available at all, alternative visualization methods are required. This paper will describe flow visualization using an X-ray system that is capable of digital X-ray radiography, digital X-ray stereography, and digital X-ray computed tomography (CT). The unique X-ray flow visualization facility will be briefly described, and then flow visualization of various systems will be shown. Radiographs provide a two-dimensional density map of a three dimensional process or object. Radiographic images of various multiphase flows will be presented. When two X-ray sources and detectors simultaneously acquire images of the same process or object from different orientations, stereographic imaging can be completed; this type of imaging will be demonstrated by trickling water through packed columns and by absorbing water in a porous medium. Finally, local time-averaged phase distributions can be determined from X-ray computed tomography (CT) imaging, and this will be shown by comparing CT images from two different gas-liquid sparged columns.

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Osteoarthritis of the Ankle and Foot Complex in Former Greek Soccer Players

Foot & Ankle Specialist ◽

10.1177/1938640011422595 ◽

2011 ◽

Vol 4 (6) ◽

pp. 338-343 ◽

Cited By ~ 14

Author(s):

Elias Armenis ◽

Nikolaos Pefanis ◽

Georgios Tsiganos ◽

Panagiotis Karagounis ◽

Panagiotis Baltopoulos

Keyword(s):

Clinical Manifestations ◽

Cartilage Degeneration ◽

Joint Disease ◽

Soccer Players ◽

Control Group ◽

Radiographic Images ◽

Former Athletes ◽

Level Ii ◽

Analysis Of The Images ◽

Ankle And Foot

Sports activities cause increased loads in elite athletes’ joints. Current scientific knowledge highlights the importance of applied mechanical loads on the physiology and pathophysiology of the articular cartilage. Thus, it is possible that sporting activity has a role in the development of osteoarthritis (OA), a painful and damaging joint disease. The aim of the present study was to investigate and record osteoarthritic alterations in the ankle and foot complex in former Greek soccer players and also compare them with those in the general population. The study sample consisted of 170 male, former elite soccer players, aged between 42 and 55 years (mean = 49.8 years, standard deviation [SD] = 7.4). A control group of 132 men, aged between 42 and 55 years (mean, 50.7 years, SD = 9.9), with no regular athletic activity were examined. The development of osteoarthritic alterations was recorded through a questionnaire and clinical and radiological examination. Radiographic analysis of the images in former athletes group showed not only more signs of cartilage degeneration in comparison with the control group (P < .05) but also similar clinical manifestations (pain and impaired mobility; P > .05). Osteophyte formation is a frequent disease among former soccer players—with variations on radiographic images—but it does not appear in their clinical picture. However, it is likely that both spurs and subchondral sclerosis (main findings) are preclinical manifestations of OA. Levels of Evidence: Prognostic, Level II

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Complex treatment of diseases of the nasal cavity and paranasal sinuses at the present time

Medical Council ◽

10.21518/2079-701x-2021-18-134-139 ◽

2021 ◽

pp. 134-139

Author(s):

V. M. Svistushkin ◽

K. V. Eremeeva

Keyword(s):

Nasal Cavity ◽

Paranasal Sinuses ◽

Clinical Symptoms ◽

Local Treatment ◽

Silver Ions ◽

Upper Respiratory Tract ◽

Drug Induced ◽

High Incidence ◽

Upper Respiratory ◽

Pain Symptoms

The search for rational treatment of diseases of the nasal cavity and paranasal sinuses is due to the high incidence among the world's population. Despite the absolutely clear recommendations that would seem to greatly facilitate the choice and scope of therapy, it is extremely important to have a differentiated approach to each patient, depending on age, concomitant pathology, the nature of the course of the disease, the severity of clinical, primarily pain symptoms, and the presence of rhinogenic complications. Differential diagnosis of viral and bacterial acute rhinosinusitis (ARS) allows to avoid unreasonable prescription of antibiotics in the former case and choose therapy in such a way as to help relieve clinical symptoms, timely cure the disease and prevent complications. A systematic review of the literature was conducted with the analysis of scientific research data on the evaluation of the effectiveness of protargol or silver proteinate in the local treatment of upper respiratory tract diseases. A review of studies shows that silver proteinate has astringent, antiseptic and anti-inflammatory effects. The spectrum of antimicrobial action of silver is much wider than many antibiotics and sulfonamides. At the same time, pathogenic microflora is more sensitive to silver ions than non-pathogenic microflora. The analysis of the works also demonstrates the absence of adverse reactions when using this drug. The obtained data allow us to recommend preparations based on silver proteinate as a complex therapy for acute and chronic diseases of the nasal cavity and nasopharynx. The vasoconstrictive effect of protargol allows it to be used as an alternative to decongestants in order to avoid the development of drug-induced rhinitis and tachyphylaxis. Sialor® is a new, convenient, affordable, longer-shelf-life form of silver proteinate.

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Complement Component C1q as a Potential Diagnostic Tool for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Subtyping

Journal of Clinical Medicine ◽

10.3390/jcm10184171 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4171

Author(s):

Jesús Castro-Marrero ◽

Mario Zacares ◽

Eloy Almenar-Pérez ◽

José Alegre-Martín ◽

Elisa Oltra

Keyword(s):

Chronic Fatigue Syndrome ◽

Clinical Symptoms ◽

Hierarchical Cluster ◽

Chronic Fatigue ◽

Blood Parameters ◽

Myalgic Encephalomyelitis ◽

Complement Factor ◽

Fatigue Syndrome ◽

Pain Symptoms ◽

Rule Out

Background: Routine blood analytics are systematically used in the clinic to diagnose disease or confirm individuals’ healthy status. For myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a disease relying exclusively on clinical symptoms for its diagnosis, blood analytics only serve to rule out underlying conditions leading to exerting fatigue. However, studies evaluating complete and large blood datasets by combinatorial approaches to evidence ME/CFS condition or detect/identify case subgroups are still scarce. Methods: This study used unbiased hierarchical cluster analysis of a large cohort of 250 carefully phenotyped female ME/CFS cases toward exploring this possibility. Results: The results show three symptom-based clusters, classified as severe, moderate, and mild, presenting significant differences (p < 0.05) in five blood parameters. Unexpectedly the study also revealed high levels of circulating complement factor C1q in 107/250 (43%) of the participants, placing C1q as a key molecule to identify an ME/CFS subtype/subgroup with more apparent pain symptoms. Conclusions: The results obtained have important implications for the research of ME/CFS etiology and, most likely, for the implementation of future diagnosis methods and treatments of ME/CFS in the clinic.

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History Page: Leaders in MSK Radiology

Seminars in Musculoskeletal Radiology ◽

10.1055/s-0041-1727094 ◽

2021 ◽

Vol 25 (02) ◽

pp. 274-276

Author(s):

Franz Kainberger ◽

Daniela Hahn

Keyword(s):

Radiation Oncology ◽

Scientific Work ◽

X Rays ◽

Radiographic Images ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Kienbock’S Disease

AbstractRobert Kienböck (1871–1953) may be regarded as one of the first musculoskeletal radiologists who began his clinical and scientific work 2 years after the discovery of X-rays. He lent his name to Kienböck's disease, a traumatic malacia and osteonecrosis of the lunate, and to several other eponyms of diseases, devices, and parameters in radiology and radiation oncology. With his meticulous analysis of radiographic images of the highest quality, he anticipated many theories that were proposed in later decades.

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Osteoarthritis and risk of mortality in the USA: a population-based cohort study

International Journal of Epidemiology ◽

10.1093/ije/dyy187 ◽

2018 ◽

Vol 47 (6) ◽

pp. 1821-1829 ◽

Cited By ~ 15

Author(s):

Angelico Mendy ◽

JuYoung Park ◽

Edgar Ramos Vieira

Keyword(s):

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Self Report ◽

Joint Disease ◽

Renal Diseases ◽

X Rays ◽

Risk Of Mortality ◽

Increased Risk ◽

Risk Of Cancer

Abstract Background Osteoarthritis (OA) is the most common joint disease, but its association with mortality is unclear. Methods We analysed data on adult participants in the 1988–94 and 1999–2010 National Health and Nutrition Examination Surveys, followed for mortality through 2011. OA was defined by self-report, and in a subset of participants 60 years or older with knee X-rays, radiographic knee OA (RKOA) was defined as Kellgren–Lawrence score ≥2. Cox proportional hazards were used to determine the mortality hazard ratio (HR) associated with self-reported OA and RKOA, adjusting for covariates. Results The sample included 51 938 participants followed for a median 8.9 years; 2589 of them had knee X-rays and were followed for a median of 13.6 years. Self-reported OA and RKOA prevalences were 6.6% and 40.6%, respectively. Self-reported OA was not associated with mortality. RKOA was associated with an increased risk of mortality from cardiovascular diseases (CVD) {HR 1.43 [95% confidence interval (CI): 1.32, 1.64]}, diabetes [HR 2.04 (1.87, 2.23)] and renal diseases [HR 1.14 (1.04, 1.25)], but with a reduced risk of cancer mortality [HR 0.88 (0.80, 0.96)]. Participants with early RKOA onset (diagnosed before age 40) had a higher risk of mortality from all causes [HR 1.53 (1.43, 1.65)] and from diabetes [HR 7.18 (5.45, 9.45)]. Obese participants with RKOA were at increased risk of mortality from CVD [HR 1.89 (1.56, 2.29)] and from diabetes [HR: 3.42 (3.01, 3.88)]. Conclusions Self-reported OA was not associated with mortality. RKOA was associated with higher CVD, diabetes and renal mortality, especially in people with early onset of the disease or with obesity.

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2041

Journal of Clinical and Translational Science ◽

10.1017/cts.2017.91 ◽

2017 ◽

Vol 1 (S1) ◽

pp. 22-22

Author(s):

Halima Amjad ◽

David Roth ◽

Jennifer Wolff ◽

Esther Oh ◽

Quincy Samus

Keyword(s):

Lower Extremity ◽

Clinical Symptoms ◽

Psychiatric Symptoms ◽

Symptom Burden ◽

Community Dwelling ◽

Common People ◽

People With Dementia ◽

Lower Extremity Strength ◽

Religious Services ◽

Participation Restrictions

OBJECTIVES/SPECIFIC AIMS: Traditional hospice focuses on symptoms and quality of life (QOL) at the very end of life. Clinical symptoms and QOL in the last 1–2 years of life are also important and may be affected by dementia. Our objective was to characterize how symptoms differ between people with and without dementia in the last years before death and whether symptoms impact social dimensions of QOL. METHODS/STUDY POPULATION: We studied 1270 community-dwelling participants who died between 2011 and 2015 in the National Health and Aging Trends Study, a nationally representative cohort of older adults. From the last interview before death, we examined sensory (vision; hearing), physical (pain; problems with breathing, chewing/swallowing, speaking, upper or lower extremity strength/movement, and balance/coordination), and psychiatric (depression; anxiety; insomnia) symptoms by dementia status. We examined associations between symptoms and participation restrictions (visiting family/friends, attending religious services, participating in clubs/activities, going out for enjoyment, and engaging in favorite activity). RESULTS/ANTICIPATED RESULTS: Low energy (69%), pain (59%), and lower extremity strength/movement problems (56%) were most common. People with dementia (37.3% of decedents) had higher prevalence of all symptoms (p≤0.01), except pain, breathing problems, and insomnia. Dementia and greater symptom burden were independently associated with greater odds of participation restrictions (p<0.05). Problems speaking were significantly associated with limitations in all activities except for attending religious services. Balance/coordination, energy, and strength/movement problems were associated with limitations in 3 activities. DISCUSSION/SIGNIFICANCE OF IMPACT: Sensory, physical, and psychiatric symptoms are common in the year before death, with greater symptom prevalence in people with dementia. Both dementia and symptoms are associated with restrictions in participation. Older patients may benefit not only from earlier emphasis on palliative care but also programs and assistive devices that accommodate physical impairments.

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Direct Posterior Reduction and Fixation for the Treatment of Basilar Invagination With Atlantoaxial Dislocation

Neurosurgery ◽

10.1227/01.neu.0000367632.45384.5a ◽

2010 ◽

Vol 66 (4) ◽

pp. 678-687 ◽

Cited By ~ 103

Author(s):

Feng-Zeng Jian ◽

Zan Chen ◽

Karsten H. Wrede ◽

Madjid Samii ◽

Feng Ling

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Clinical Symptoms ◽

Pedicle Screws ◽

Clinical Results ◽

Basilar Invagination ◽

Atlantoaxial Dislocation ◽

X Rays ◽

Resonance Imaging ◽

Basilar Artery Thrombosis

Abstract OBJECTIVE To report the surgical technique and clinical results for the treatment of basilar invagination (BI) with atlantoaxial dislocation (AAD) by direct posterior reduction and fixation using intraoperative distraction between the occiput and C2 pedicle screws. METHODS From May 2004 to June 2008, 29 patients who had BI with AAD were surgically treated in our department. Pre- and postoperative dynamic cervical x-rays, computed tomographic scans, and 3-dimensional reconstruction views were performed to assess the degree of dislocation. Ventral compression of the cervicomedullary junction was evaluated by magnetic resonance imaging. For all patients, reduction of the AAD was conducted by intraoperative distraction between the occiput and C2 pedicle screws using a direct posterior approach. RESULTS Follow-up ranged from 6 to 50 months in 28 patients. Clinical symptoms improved in 26 patients (92.9%) and were stable in 2 patients (7.1%) without postoperative deterioration. Radiologically, complete or more than 50% reduction was achieved in 27 of 28 patients (96.4%). In 1 patient, the reduction was less than 50% because the direction of the facets on 1 side of the C1–C2 joint was vertically oriented, instead of horizontal. Overall, good decompression and bone fusion were shown on postoperative magnetic resonance imaging, computed tomography, or x-ray scans for all patients. There was 1 death in the series because of basilar artery thrombosis 1 week after the operation. CONCLUSION The direct posterior distraction technique between occiput and C2 pedicle screws is an effective, simple, fast, and safe method for the treatment of BI with AAD. Transoral odontoidectomy and cervical traction for the treatment of BI with AAD should be reconsidered.

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