Radiographic Assessment of the Robert and Lateral Views in Trapeziometacarpal Osteoarthrosis

Hand Surgery ◽  
2015 ◽  
Vol 20 (02) ◽  
pp. 251-259 ◽  
Author(s):  
Jonathan Oheb ◽  
Yuri Lansinger ◽  
Joshua A. Jansen ◽  
Jimmy Q. Nguyen ◽  
Margaret A. Porembski ◽  
...  
Keyword(s):  
Disease Severity ◽  
Joint Pain ◽  
Interrater Reliability ◽  
Lateral View ◽  
X Rays ◽  
Radiographic Assessment ◽  
Patient Demographics ◽  
Radiographic Disease ◽  
Stage 1 ◽  
Subchondral Sclerosis

Background: To evaluate the effectiveness of the Robert view in assessing trapeziometacarpal arthrosis and to compare the accuracy of the Robert and lateral views in staging trapeziometacarpal (TM) joint arthrosis. Methods: Patient demographics were obtained. Four participating raters reviewed 62 randomly selected thumb x-rays of patients presenting with thumb TM joint pain. Lateral and Robert-hyperpronation views were assessed using an analysis of 13 criteria. Results: X-rays of 62 thumbs for 58 patients were evaluated. The average patients' age was 64 (47-87) and 51 (80%) were females. The majority of X-rays evaluated fell into stage 3. Stage 2 was the second most common level of arthritis encountered and the least was stage 1. More osteophytes were encountered in the trapezium than metacarpal on both the Robert and lateral views. The Robert view was superior in detecting osteophytes on the trapezium than the lateral view. Osteophyte size varied from 1.7 to 2 mm. The lateral view displayed 61 cases with dorsal metacarpal subluxation (98%). The Robert view displayed 48 cases (77%) with radial metacarpal subluxation and 9 cases (15%) with ulnar metacarpal subluxation. Thumb metacarpal adduction deformity was encountered on the lateral view in 20 cases (32%) whereas on the Robert view it was encountered in 14 cases (23%). Subchondral sclerosis was encountered on the Robert view in 56 thumbs (90%) while it was seen on the lateral view in 52 thumbs (84%). Pantrapezial arthritis involving the STT joint was encountered equally in 16 cases (26%) on the Robert view and the lateral views. The study found a moderate level of interrater reliability on both the lateral and Robert views. With the exception of osteophytes encountered on the trapezium versus the metacarpal, there were no other statistically significant findings. Conclusions: This study confirms that each of the Robert and lateral views offer unique information and combining both views enhances the ability to assess radiographic disease severity, and should be the recommended set of X-rays for assessing TM osteoarthrosis.

scholarly journals Towards computer-aided severity assessment via deep neural networks for geographic and opacity extent scoring of SARS-CoV-2 chest X-rays

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
A. Wong ◽  
Z. Q. Lin ◽  
L. Wang ◽  
A. G. Chung ◽  
B. Shen ◽  
...  
Keyword(s):  
Neural Networks ◽  
Monte Carlo ◽  
Lung Disease ◽  
Disease Severity ◽  
Deep Neural Networks ◽  
Cross Validation ◽  
X Rays ◽  
Computer Aided ◽  
Monte Carlo Cross Validation ◽  
Validation Experiments

AbstractA critical step in effective care and treatment planning for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause for the coronavirus disease 2019 (COVID-19) pandemic, is the assessment of the severity of disease progression. Chest x-rays (CXRs) are often used to assess SARS-CoV-2 severity, with two important assessment metrics being extent of lung involvement and degree of opacity. In this proof-of-concept study, we assess the feasibility of computer-aided scoring of CXRs of SARS-CoV-2 lung disease severity using a deep learning system. Data consisted of 396 CXRs from SARS-CoV-2 positive patient cases. Geographic extent and opacity extent were scored by two board-certified expert chest radiologists (with 20+ years of experience) and a 2nd-year radiology resident. The deep neural networks used in this study, which we name COVID-Net S, are based on a COVID-Net network architecture. 100 versions of the network were independently learned (50 to perform geographic extent scoring and 50 to perform opacity extent scoring) using random subsets of CXRs from the study, and we evaluated the networks using stratified Monte Carlo cross-validation experiments. The COVID-Net S deep neural networks yielded R$$^2$$ 2 of $$0.664 \pm 0.032$$ 0.664 ± 0.032 and $$0.635 \pm 0.044$$ 0.635 ± 0.044 between predicted scores and radiologist scores for geographic extent and opacity extent, respectively, in stratified Monte Carlo cross-validation experiments. The best performing COVID-Net S networks achieved R$$^2$$ 2 of 0.739 and 0.741 between predicted scores and radiologist scores for geographic extent and opacity extent, respectively. The results are promising and suggest that the use of deep neural networks on CXRs could be an effective tool for computer-aided assessment of SARS-CoV-2 lung disease severity, although additional studies are needed before adoption for routine clinical use.

scholarly journals The knee adduction moment and knee osteoarthritis symptoms: relationships according to radiographic disease severity

2017 ◽  
Vol 25 (1) ◽  
pp. 34-41 ◽  
Author(s):  
M. Hall ◽  
K.L. Bennell ◽  
T.V. Wrigley ◽  
B.R. Metcalf ◽  
P.K. Campbell ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Disease Severity ◽  
Knee Adduction Moment ◽  
Radiographic Disease

Clinicoradiographic Assessment of Flexible Flatfoot in Children

2010 ◽  
Vol 100 (6) ◽  
pp. 463-471 ◽  
Author(s):  
Maria Grazia Benedetti ◽  
Lisa Berti ◽  
Sofia Straudi ◽  
Francesco Ceccarelli ◽  
Sandro Giannini
Keyword(s):  
Daily Living ◽  
Functional Limitation ◽  
Standing Position ◽  
Valgus Deformity ◽  
Lateral View ◽  
Heel Pain ◽  
Clinical Parameters ◽  
Radiographic Assessment ◽  
Radiographic Measurements ◽  
Flexible Flatfoot

Background: Radiographic assessment is still used to evaluate flexible flatfoot in children. Methods: To find a set of radiologic parameters for assessing this disease, we studied 53 children aged 10 to 14 years. The degree of plantar collapse was measured by Viladot’s classification (grades 0–4). The degree of valgus deformity measured in the heel in a standing position, the presence of painful points, and functional limitation during daily-living activities were also reported. The children underwent standard radiography of the foot under load. On the dorsoplantar view, the talocalcaneal, hallux metatarsophalangeal, and first intermetatarsal angles were measured. On the lateral view, the talocalcaneal, Costa Bertani, talometatarsal, talonavicular, and tibiotalar angles were measured. The radiographic measurements were compared with the data reported in the literature and were correlated with the clinical parameters studied (degree of flatfoot, valgus deviation of the heel, pain, and functional limitation). Results: The radiographic measures that resulted increased with respect to the reference values reported in the literature for the Costa Bertani (93.1% of feet), talometatarsal (93.5%), talonavicular (89.1%), and tibiotalar (69.7%) angles, all in the lateral view. Of the angles assessed in the dorsoplantar view, the hallux metatarsophalangeal (11.1%) and first intermetatarsal (24.2%) angles were increased. The degree of flatfoot was correlated with the Costa Bertani angle (P < .0005). In the group with pain, the lateral talocalcaneal (P = .016) and first intermetatarsal (P = .02) angles were increased compared within the group without pain. Conclusions: Despite technical limitations, we still consider standard radiography of the foot, combined with clinical examination, to be a valid tool for assessing flexible flatfoot in children, especially when surgical treatment is expected and when a basic measure of the structural setup of the foot is necessary. (J Am Podiatr Med Assoc 100(6): 463–471, 2010)

scholarly journals Association Between SARS-CoV-2 RNAemia and Post-Acute Sequelae of COVID-19.

2021 ◽  
Author(s):  
Nikhil Ram Mohan ◽  
David Kim ◽  
Angela J Rogers ◽  
Catherine A Blish ◽  
Kari C Nadeau ◽  
...  
Keyword(s):  
Disease Severity ◽  
Acute Phase ◽  
Viral Rna ◽  
Patient Demographics

Determinants of Post-Acute Sequelae of COVID-19 are not known. Here we show that 75% of patients with viral RNA in blood (RNAemia) at presentation were symptomatic in the post-acute phase. RNAemia at presentation successfully predicted PASC, independent of patient demographics, initial disease severity, and length of symptoms.

scholarly journals Functional outcome of calcaneal locking compression plate

2018 ◽  
Vol 4 (3) ◽  
pp. 493
Author(s):  
George Thomas ◽  
Jinny John
Keyword(s):  
Functional Outcome ◽  
Plantar Flexion ◽  
Lateral Approach ◽  
Lateral View ◽  
Locking Compression Plate ◽  
X Rays ◽  
Calcaneal Fractures ◽  
Compression Plate ◽  
American Orthopaedic ◽  
Böhler’S Angle

<p class="abstract"><strong>Background:</strong> The calcaneus is the frequently injured tarsal bone.75% of calcaneal fractures are intraarticular. Treating calcaneal fractures is a challenge for orthopaedic surgeon due to complex fracture pathology. Our aim is to evaluate the functional outcome of calcaneum Locking compression plate in patients with intraarticular calcaneal fractures with Bohler’s angle &lt;20 degree who are admitted in the department of Orthopaedics, Government Medical College, Kottayam.</p><p><strong>Methods:</strong> In this study, 41 patients with 42 intraarticular calcaneal fractures were operated on with locking compression plate through lateral approach during the period of July 2015 to December 2016. Radiological evaluation done with X-rays. Bohler’s angle was measured from lateral view and those patients with angle &lt;20<sup>0</sup> were selected for study. Patients were followed up clinically and radiologically for 24 weeks. Radiological assessment was done by Bohlers angle. Functional outcome was assessed using American Orthopaedic Foot and Ankle Society (AOFAS) scale.<strong></strong></p><p class="abstract"><strong>Results:</strong> At 24 weeks follow up, 90.5% of the study population had excellent to good functional outcome and 9.5% had fair and none had poor result. All patients had stable hind foot with all having good dorsiflexion and plantar flexion. But some patients had limited inversion and eversion. The mean postoperative Bohler’s angle was 30.02±3.97.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and internal fixation with locking compression plate gives sound functional outcome, if the surgery is well timed. Anatomical articular reduction especially of the posterior facet to be achieved and restoration of Bohler’s angle to normal range to be attempted.</p>

scholarly journals Saliva viral load is a dynamic unifying correlate of COVID-19 severity and mortality

2021 ◽  
Author(s):  
Julio Silva ◽  
Carolina Lucas ◽  
Maria Sundaram ◽  
Benjamin Israelow ◽  
Patrick Wong ◽  
...  
Keyword(s):  
Viral Load ◽  
Disease Severity ◽  
T Cell Subsets ◽  
Temporal Association ◽  
Strongly Correlated ◽  
Immunological Parameters ◽  
Viral Loads ◽  
Patient Demographics ◽  
Over Time

While several clinical and immunological parameters correlate with disease severity and mortality in SARS-CoV-2 infection, work remains in identifying unifying correlates of coronavirus disease 2019 (COVID-19) that can be used to guide clinical practice. Here, we examine saliva and nasopharyngeal (NP) viral load over time and correlate them with patient demographics, and cellular and immune profiling. We found that saliva viral load was significantly higher in those with COVID-19 risk factors; that it correlated with increasing levels of disease severity and showed a superior ability over nasopharyngeal viral load as a predictor of mortality over time (AUC=0.90). A comprehensive analysis of immune factors and cell subsets revealed strong predictors of high and low saliva viral load, which were associated with increased disease severity or better overall outcomes, respectively. Saliva viral load was positively associated with many known COVID-19 inflammatory markers such as IL-6, IL-18, IL-10, and CXCL10, as well as type 1 immune response cytokines. Higher saliva viral loads strongly correlated with the progressive depletion of platelets, lymphocytes, and effector T cell subsets including circulating follicular CD4 T cells (cTfh). Anti-spike (S) and anti-receptor binding domain (RBD) IgG levels were negatively correlated with saliva viral load showing a strong temporal association that could help distinguish severity and mortality in COVID-19. Finally, patients with fatal COVID-19 exhibited higher viral loads, which correlated with the depletion of cTfh cells, and lower production of anti-RBD and anti-S IgG levels. Together these results demonstrated that viral load – as measured by saliva but not nasopharyngeal — is a dynamic unifying correlate of disease presentation, severity, and mortality over time.

scholarly journals Improving Fluoroscopic Visualization for Lower Cervical Medial Branch Blocks with a Modified Swimmer’s View: A Technical Report

2018 ◽  
Vol 1 (21;1) ◽  
pp. 303-308
Author(s):  
David Stolzenberg
Keyword(s):  
Facet Joint ◽  
Lateral View ◽  
Medial Branch ◽  
X Rays ◽  
Zygapophyseal Joint ◽  
Target Zones ◽  
Technical Report ◽  
Future Prospective Study ◽  
Medial Branch Block ◽  
Practice Methods

Background: Neural blockade of the cervical medial branches is a validated procedure in the diagnosis and treatment of cervical zygapophyseal joint pain. Fluoroscopic visualization of the lower cervical medial branch target zones (CMBTZs) in lateral view is sometimes challenging or not possible due to the patient’s shoulders obscuring the target. Large shoulders and short necks often exacerbate the problem. Clear visualization is critical to accuracy and safety. Objective: We aim to describe a method for optimal fluoroscopic visualization of the lower CMBTZs using a modified swimmer’s view. Study Design: A technical report. Setting: A private practice. Methods: Discussion with accompanying fluoroscopic images of the cervical spine, focusing on the lateral aspects of the lower cervical articular pillars in both the traditional lateral view and modified swimmer’s view. Four authors served as volunteers for undergoing fluoroscopic x-rays in both views. Visualization of each lower CMBTZ was attempted and stored. The most caudal, clearly visualized levels were compared in both views for each participant. Results: Visualization of the lower CMBTZs can be successfully obtained with the modified swimmer’s view and in select patients is superior to a lateral view. Limitations: A limitation to this study is the design as a technical report. A future prospective study is warranted. Conclusions: Modified swimmer’s view can serve as a primary method of visualizing the lower CMBTZs or an alternate view when a lateral view is unable to clearly demonstrate target landmarks. This can improve the ease, accuracy, and safety of performing diagnostic cervical medial branch blocks (CMBBs). Key words: Swimmer’s view, cervical medial branch block, facet joint, fluoroscopy

Radiographic Assessment of the Relative Lengths of the Bones of the Fingers of the Human Hand

2002 ◽  
Vol 27 (6) ◽  
pp. 546-548 ◽  
Author(s):  
R. HAMILTON ◽  
R. A. DUNSMUIR
Keyword(s):  
Fibonacci Sequence ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Human Hand ◽  
X Rays ◽  
Radiographic Assessment ◽  
Finger Tip ◽  
Distal Joint ◽  
Little Finger

The study assessed whether a relationship existed between the lengths of the phalanges of the fingers of the hand. The centres of rotation of the joints in each finger were determined by dissection of cadaveric hands. Using these data, the distances between the joint centres was determined on anteroposterior hand X-rays taken for clinical purposes. The study has shown that, for all the fingers, there is a ratio of1 for the distance between the metacarpophalangeal and proximal interphalangeal joint and the distance between the proximal interphalangeal joint and the finger tip. The ratio for the distances between the interphalangeal joints and the distal joint and the tip approximates to 1.3 for the index, middle and ring fingers and to 1.0 for the little finger. No evidence was found to support Littler’s hypothesis that the interarticular distances of the finger follow the Fibonacci sequence.

scholarly journals The knee adduction moment and osteoarthritis symptoms: relationships according to radiographic disease severity

2016 ◽  
Vol 24 ◽  
pp. S448-S449 ◽  
Author(s):  
M. Hall ◽  
K.L. Bennell ◽  
T.V. Wrigley ◽  
B.R. Metcalf ◽  
J. Kasza ◽  
...  
Keyword(s):  
Disease Severity ◽  
Knee Adduction Moment ◽  
Radiographic Disease

A Comparison of Radiographic Foot Measurements Taken in Two Different Positions

2001 ◽  
Vol 91 (5) ◽  
pp. 234-239 ◽  
Author(s):  
Jennifer A. Bryant
Keyword(s):  
Strong Correlation ◽  
Repeated Measures ◽  
Healthy Subjects ◽  
X Rays ◽  
Radiographic Assessment ◽  
Radiographic Measurements ◽  
Straight Ahead

The purpose of this study was to ascertain if positioning of the feet for radiographic assessment produces significant variations in measured angles, and if measurements taken from radiographs taken on two separate occasions are reproducible. Weightbearing x-rays were taken of both feet of ten male healthy subjects in two standardized positions: 1) the angle and base of gait and 2) the feet together and straight-ahead positions. The radiographs were repeated 2 weeks later. The results failed to demonstrate significant differences of radiographic measurements between the two specific foot-positioning methods. No significant differences were found between radiographic measurements of normal feet taken on different occasions. A strong correlation of the repeated measures suggests that weightbearing foot radiographs can be reliably reproduced. (J Am Podiatr Med Assoc 91(5): 234-239, 2001)

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