Computed tomography improves intra-observer reliability, but not the inter-observer reliability of the Eaton–Glickel classification

2012 ◽  
Vol 38 (2) ◽  
pp. 187-191 ◽  
Author(s):  
T. B. Hansen ◽  
O. G. Sørensen ◽  
L. Kirkeby ◽  
M. Homilius ◽  
A. L. Amstrup
Keyword(s):  
Computed Tomography ◽  
Degenerative Changes ◽  
Bone Cysts ◽  
Trapeziometacarpal Joint ◽  
Plain Radiographs ◽  
Observer Reliability ◽  
Computed Tomography Scans ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
The Mean

This study aimed to evaluate whether computed tomography improves the intra- and inter-observer reliability of the Eaton–Glickel classification of trapeziometacarpal joint osteoarthritis. The osteoarthritis of the trapeziometacarpal joint was evaluated with conventional radiographs and computed tomography by two hand surgeons, two registrars and one radiologist in 50 hands of 43 patients (12 male and 31 female) who had a median age of 60 years (46–80). Using plain radiographs, we found a mean intra-observer reliability of 0.54 (0.51–0.74), and the intra-observer reliability was improved to 0.76 (0.64–0.86) using computed tomography. Using plain radiographs, the mean inter-observer reliability was poor at 0.17 (0.04–0.51) and did not improve using computed tomography with a mean inter-observer reliability of 0.22 (0.02–0.38). In particular, the agreement in the distinction between Eaton–Glickel stage III and IV and the evaluation of the degenerative changes in the scaphotrapezio joint was low using computed tomography-scans. The detection of bone cysts on computed tomography was more precise than on plain radiographs.

scholarly journals A Comparison of Intra-Observer and Inter-Observer Reliability of Plain Radiographs, Standard Computed Tomography Scans and Mobile Computed Tomography Scans in the Assessment of Distal Radius Fractures: A Cadaveric Study

2019 ◽  
pp. 53
Author(s):  
Sitthiphong Suwannaphisit ◽  
Saowapar Yoykaew ◽  
Chitchaya Suwanraksa ◽  
Varah Yuenyongviwat ◽  
Porames Suwanno ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Observer Agreement ◽  
Ct Scans ◽  
Radius Fractures ◽  
Plain Radiographs ◽  
Observer Reliability ◽  
Computed Tomography Scans ◽  
Mobile Ct

Objective: Diagnosis of a distal end radius fracture relies on various imaging studies. However, the relative usefulness of these studies is still a matter of some controversy. The aim of this study was to compare the intra-observer and inter-observer reliability of plain radiographs, standard computed tomography (CT) scans and mobile CT scans in the assessment of distal radius fractures as categorized by the Fernandez classification method. The secondary objective was to compare the dosages of radiation between the different imaging modalities. Material and Methods: Sixteen fresh cadaveric wrist bones were used in this experimental study. The desired fractures were created in the bones to mimic Fernandez types I-V fractures and plain radiographs were taken in 4 views. Standard CT and mobile CT scans were also taken with the fractured bones in the same four positions. Interobserver reliability was assessed using Kappa statistics to determine the diagnostic consistency among the nine observers. Inter-observer agreement was assessed based on the Fernandez classification system diagnoses. Results: Overall, the inter-observer agreement was substantial for the Fernandez classifications (Kappa range 0.636 0.727) in all types of imaging. For intra-observer agreement, the analysis found higher agreement for both standard CT scans and mobile CT scans. The standard CT images imparted a higher average dose of radiation than both the mobile CT scans and the plain radiographs.Conclusion: The mobile CT scan can provide an alternative imaging method for precise diagnosis of distal end radius fractures, with the additional benefits of mobility and lower radiation exposure. 

scholarly journals Repair of Orbital Floor Fractures: Our Experience and New Technical Findings

2010 ◽  
Vol 3 (4) ◽  
pp. 217-221 ◽  
Author(s):  
Pasquale Piombino ◽  
Giorgio Iaconetta ◽  
Roberto Ciccarelli ◽  
Antonio Romeo ◽  
Alessia Spinzia ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Maxillofacial Surgery ◽  
Orbital Floor ◽  
Economic Costs ◽  
Orbital Floor Fractures ◽  
Computed Tomography Scans ◽  
Resorbable Materials ◽  
Preoperative Examination

We report our experience with the repair of the orbital floor fractures and present new technical findings. We evaluated 30 subjects with pure blowout fractures treated at the Department of Maxillofacial Surgery of the Federico II University of Naples, Italy, between 2005 and 2007. A preoperative examination by computed tomography scans provided classification of the orbital floor fractures into small and large fractures by measurement of the bone defect to choose the appropriate reconstructive implant materials, resorbable or nonresorbable. The clinical follow-up has been performed at 1 week, 1 month, 3 months, and 6 months. We observed a resolution of preoperative symptoms. The scar was not evident, and there was an absence of postoperative complications. We concluded that the use of resorbable materials for small orbital floor fractures and nonresorbable materials for large orbital floor fractures offers satisfactory results in both functional and aesthetic considerations. Furthermore, the new technical findings allow standardization of the surgical technique to be more accurate, also reducing the economic costs.

Frontonasal and Craniofrontonasal Dysplasia: Preoperative Quantitative Description of the Cranio-Orbito-Zygomatic Region Based on Computed and Conventional Tomography

1994 ◽  
Vol 31 (2) ◽  
pp. 97-105 ◽  
Author(s):  
Stephanie M Moffat ◽  
Jeffrey C. Posnick ◽  
Gaylene E. Pron ◽  
Derek C. Armstrong
Keyword(s):  
Computed Tomography ◽  
Clinical Presentation ◽  
Matched Control ◽  
Quantitative Description ◽  
Frontonasal Dysplasia ◽  
Orbital Wall ◽  
Computed Tomography Scans ◽  
Conventional Tomography ◽  
The Mean ◽  
Medial Orbital Wall

The unoperated cranio-orbito-zygomatic complex of 18 children (mean 4.7 years) with frontonasal dysplasia (FND) and 12 children (mean 1.1 years) with craniofrontonasal dysplasia (CFND) was quantified by 15 standard measurements performed on either computed tomography scans or facial tomograms. The results were compared with age-matched control values. In the FND group, the mean anterior interorbital and mid-interorbital distances were significantly increased at 148% and 118% of normal, and in the CFND patients, at 177% and 140% of normal. Excessive medial orbital wall protrusion (mean, 145% of normal in FND and 177% in CFND), shortened zygomatic arch lengths (mean, 94% of normal In FND and 91% in CFND), and reduced cephalic lengths (mean, 96% of normal in FND and 83% in CFND) were all observed. An expanded interzygomatic buttress distance was documented only in the CFND group, at 111% of normal. The clinical presentation of craniofacial deformities such as FND and CFND can be objectively described by a numerical analysis of the bony pathology.

Assessment of scapholunate instability with dynamic computed tomography

2019 ◽  
Vol 45 (4) ◽  
pp. 375-382 ◽  
Author(s):  
Lionel Athlani ◽  
Kamel Rouizi ◽  
Jonathan Granero ◽  
Gabriela Hossu ◽  
Alain Blum ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Prospective Study ◽  
Gap Size ◽  
Dynamic Computed Tomography ◽  
Level Of Evidence ◽  
Plain Radiographs ◽  
Scapholunate Instability ◽  
The Mean ◽  
A Prospective Study

We performed a prospective study to evaluate the values of dynamic four-dimensional computed tomography in assessing suspected chronic scapholunate instability. Forty patients were evaluated with radiographs, arthrography, and four-dimensional computed tomography. On plain radiographs and computed tomography, we found 16 patients with definite scapholunate instability, five with questionable scapholunate instability, and 19 with absence of scapholunate instability. We used four-dimensional computed tomography to evaluate the size of the scapholunate gap during radioulnar deviation. The mean and maximal values of the gap size were lowest in the patients with absence of scapholunate instability and highest in those with definite scapholunate instability. When comparing the scapholunate gap sizes of the patients with absent and questionable scapholunate instability, the range of the gap sizes was significantly higher in the patients with questionable scapholunate instability. We conclude that four-dimensional computed tomography aids assessment of chronic scapholunate instability, which allows the differentiation between patients without and those with definite or questionable scapholunate instability. Level of evidence: II

scholarly journals Union Rate on Hinge Side after Open-Door Laminoplasty Using Maxillofacial Titanium Miniplate

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Koopong Siribumrungwong ◽  
Theerasan Kiriratnikom ◽  
Boonsin Tangtrakulwanich
Keyword(s):  
Computed Tomography ◽  
Cervical Canal ◽  
Open Door ◽  
Union Rate ◽  
Japanese Orthopedic Association ◽  
Computed Tomography Scans ◽  
Before And After ◽  
The Mean ◽  
Scan Data ◽  
Titanium Miniplate

Background. One of the important complications of open-door laminoplasty is a premature laminoplasty closure. In order to prevent premature laminoplasty closure many techniques have been described and a titanium miniplate is one of the instruments to maintain cervical canal expansion. This study was performed to evaluate the effectiveness of titanium miniplates on the union rate for open-door laminoplasty.Materials and Methods. We performed open-door laminoplasty in 68 levels of fourteen patients using maxillofacial titanium miniplates. Axial computed tomography scans were obtained at 6 months postoperatively to evaluate the union rates of the hinge side. The Japanese Orthopedic Association (JOA) score was used to compare the clinical outcomes before and after surgery.Results. Computed tomography scan data was available on 68 levels in 14 patients. There were no premature closures of the hinge or miniplate dislodgements. The union rate on the hinge side was 70.5% (48/68). The mean JOA score increased significantly from 7.0 before surgery to 10.2, 12.2, and 13.0 after surgery at 1, 3, and 6 months, respectively.Conclusion. Open-door laminoplasty using maxillofacial titanium miniplates can provide union rates comparable to other techniques. It can maintain canal expansion without failures, dislodgements, and premature closures.

Stackable Carbon Fiber Cages for Thoracolumbar Interbody Fusion After Corpectomy: Long-term Outcome Analysis

Neurosurgery ◽  
2011 ◽  
Vol 68 (3) ◽  
pp. 810-819 ◽  
Author(s):  
Robert F Heary ◽  
Arvin Kheterpal ◽  
Antonios Mammis ◽  
Sanjeev Kumar
Keyword(s):  
Computed Tomography ◽  
Carbon Fiber ◽  
Vertebral Body ◽  
Additional Patient ◽  
Preoperative Imaging ◽  
Plain Films ◽  
Computed Tomography Scans ◽  
The Mean

Abstract BACKGROUND: Reconstruction of the thoracolumbar spine after corpectomy is a challenge for fractures, infections, and tumors. OBJECTIVE: To analyze fusion rates, clinical outcomes, and the percent of vertebral body coverage achieved by using stackable carbon fiber–reinforced polyetheretherketone cages in thoracolumbar corpectomies, and to measure the actual size of the cages and compare this measurement with the size of the vertebra(e) replaced by the cage. METHODS: A retrospective study of 40 patients who underwent thoracolumbar corpectomies was performed. Preoperative imaging included plain films, computed tomography scans, and magnetic resonance imaging. Postoperatively, plain films and computed tomography scans were obtained, and the width of decompression and cross-sectional area of the cage were measured. The ratio of the area of the cage to the calculated area of the replaced vertebral body was used to determine the percent of vertebral body coverage. RESULTS: The mean follow-up period was 43 months. Successful fusion was observed in 39 patients. One patient experienced cage subsidence with kyphosis. One additional patient incurred a neurological complication that was corrected without long-term consequence. The mean correction of sagittal alignment was 10°, and the mean width of bony decompression was 20 mm. The mean ratio of the area of the carbon fiber cage to the area of the resected vertebral body was 60%. CONCLUSION: Stackable carbon fiber cages are effective devices for achieving thoracolumbar fusions. No failures of the cages occurred over long-term follow-up. Excellent clinical and radiographic results were achieved by covering a mean of 60% of the vertebral body with the cage.

scholarly journals Comparison of Imaging Softwares for Upper Airway Evaluation: Preliminary Study

2018 ◽  
Vol 11 (4) ◽  
pp. 273-277
Author(s):  
Guilherme dos Santos Trento ◽  
Lucas Borin Moura ◽  
Rubens Spin-Neto ◽  
Philipp Christian Jürgens ◽  
Marisa Aparecida Cabrini Gabrielli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Digital Imaging ◽  
Upper Airway ◽  
Cone Beam ◽  
Maxillary Expansion ◽  
Accuracy And Precision ◽  
Significant Difference ◽  
Computed Tomography Scans ◽  
The Mean ◽  
Preliminary Study

The interest about upper airway evaluation has increased lately. Therefore, many softwares have been developed aiming to improve and facilitate the analysis of airway volume. The objective of this study was to compare two different softwares packages, Mimics and Dolphin, in their accuracy and precision in upper airway space measurements. Preoperative cone beam computed tomography scans of nine nonsyndromic patients submitted to surgically assisted rapid maxillary expansion were included in this study. The imaging exams were converted to DICOM (digital imaging and communications in medicine) files and imported to the softwares. The mean volume for the Dolphin group (G1) was 10.791 cm3 (SD = 4.269 cm3) and for the Mimics group (G2) was 10.553 cm3 (SD = 4.564 cm3). There was no statistically significant difference between the two groups ( p = 0.105).

scholarly journals Root Canal Transportation after Root Canal Preparation with ProTaper Next, WaveOne Gold, and Twisted Files

2020 ◽  
Vol 9 (11) ◽  
pp. 3661
Author(s):  
Wojciech Eliasz ◽  
Kinga Kubiak ◽  
Wojciech Poncyljusz ◽  
Anna Surdacka
Keyword(s):  
Computed Tomography ◽  
Root Canal ◽  
Mean Value ◽  
Root Canal Preparation ◽  
Movement Kinematics ◽  
Root Canals ◽  
Adaptive Motion ◽  
Computed Tomography Scans ◽  
Canal Transportation ◽  
The Mean

Background: Root canal preparation during endodontic treatment may be associated with various complications, including a change in the original pathway of the root canal lumen. The aim of our study was to determine whether files of similar sizes that use various movement kinematics (rotary, reciprocal, adaptive motion) cause root canal transportation, and whether the differences between such systems are statistically significant. Methods: The degree of root canal transportation (DT) was calculated with the use of computed tomography scans for 3 groups of teeth (for each group: n = 20) in which the root canals were prepared using either rotary (ProTaper Next—PTN), reciprocal (WaveOne Gold—WOG), or adaptive movement (Twisted Files—TF) instruments. Results: For rotary ProTaper Next instruments, the mean value of the DT index was 0.0795 (SD = 0.0179) for 3 mm from the apex, 0.09 (SD = 0.0262) for 6 mm from the apex, and 0.106 (SD = 0.0221) for 9 mm from the apex. For reciprocal WaveOne Gold Primary instruments, the mean value of the DT index was 0.0355 (SD = 0.015) for 3 mm from the apex, 0.061 (SD = 0.02) for 6 mm from the apex, and 0.08 (SD = 0.25) for 9 mm from the apex. For Twisted Files, the mean value of the DT index was 0.05 (SD = 0.03) for 3 mm from the apex, 0.092 (SD = 0.17) for 6 mm from the apex, and 0.08 (SD = 0.02) for 9 mm from the apex. Conclusions: The use of PTN, WOG, and TF files resulted in root canal transportation to a different degree. The use of rotary PTN files produced the most transported preparation, whereas the use of WOG files produced the conservative root canal preparation that allowed the retention of the original shape of the root canal.

Clinical and radiological outcomes of the Ivory arthroplasty for trapeziometacarpal joint osteoarthritis with a minimum of 5 years of follow-up: a prospective single-centre cohort study

2013 ◽  
Vol 38 (8) ◽  
pp. 866-874 ◽  
Author(s):  
J. F. Goubau ◽  
C. K. Goorens ◽  
P. Van Hoonacker ◽  
B. Berghs ◽  
D. Kerckhove ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Survival Rates ◽  
Trapeziometacarpal Joint ◽  
Term Survival ◽  
Numerical Rating ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
The Mean

We present the results of a 5 year prospective follow-up study on the functional outcome after total replacement of the trapeziometacarpal joint with the Ivory prosthesis (Memometal, Stryker Corporate, Kalamazoo, Michigan, USA) in 22 patients. The female to male ratio was 21:1 and the mean age was 66 (range 54–78) years. The mean follow-up period was 67 (range 60–77) months after operation. Patient satisfaction was high. The mobility of the operated thumb was restored to a range of motion comparable to the contralateral thumb. Key pinch and grip strength improved by 13% and 31%, respectively. Overall function, according to Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, improved by 59%. Pain decreased by 85% according to the numerical rating scale. Radiological evaluation revealed no loosening of the implant after 5 years except in one patient who required revision due to polythene wear with secondary joint instability. Another patient had asymptomatic polythene wear that required no revision but remains in follow-up. The 5 year overall survival of the prosthesis was 95%. These medium-term results suggest that the Ivory arthroplasty is a reliable option for treating advanced trapeziometacarpal arthritis, because it appears to give a very good functional outcome and has the potential for long-term survival rates.

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