Comparison of extra-articular radiographic parameters of distal radius fractures on plain radiographs and CT scans

2021 ◽  
pp. 175319342110210
Author(s):  
Simon B. Kramer ◽  
Caroline A. Selles ◽  
Daniel Bakker ◽  
Niels W. L. Schep
Keyword(s):  
Ct Scan ◽  
Intraclass Correlation ◽  
Plain Radiograph ◽  
Ulnar Variance ◽  
Ct Scans ◽  
Distal Radial Fractures ◽  
Plain Radiographs ◽  
Radial Inclination ◽  
Radiographic Parameters ◽  
Radiograph Measurements

The aim of this study was to compare extra-articular radiographic parameters of distal radial fractures measured on plain radiographs and CT scans. Two researchers independently measured four extra-articular radiographic parameters (dorsal tilt, carpal alignment, radial inclination and ulnar variance) on both radiographs and CT scans in 85 patients. Inter-observer reliability for both techniques was assessed, along with the agreement between CT scans and radiographs using the intraclass correlation coefficient and Bland–Altman plots. The results showed that dorsal tilt, carpal alignment, radial inclination and ulnar variance can be measured reliably on both radiographs and CT scans. At a patient level, carpal alignment, radial inclination and ulnar variance CT scan measurements are an acceptable alternative to plain radiograph measurements in the vast majority of patients. In contrast, dorsal tilt CT scan measurements are not comparable with radiographs in 40% of the cases. Therefore, caution should be taken in measuring dorsal tilt on CT scans.

scholarly journals Radiologic Assessment for Evaluating the Post-operative Reduction of Syndesmosis: A Retrospective Study

2021 ◽  
Vol 8 (1) ◽  
pp. 29-36
Author(s):  
Ali Yeganeh ◽  
◽  
Mehdi Moghtadaei ◽  
Babak Otoukesh ◽  
Mohammad Soleymani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Cohort Study ◽  
Ct Scan ◽  
Retrospective Cohort ◽  
Ct Scans ◽  
Radiographic Measurement ◽  
Plain Radiographs ◽  
Clear Space ◽  
Radiographic Parameters

Background: Assessing the reduction of syndesmosis is highly recommended due to the complications occurring after the malreduction of the syndesmosis. This study evaluated the post-operative Computed Tomography (CT) scans and standard plain radiographs for assessing the reduction of syndesmosis post-operatively. Objectives: Evaluating the radiologic assessments of post-operative reduction of syndesmosis. Methods: In this retrospective cohort study, 45 patients presented with ankle fractures and syndesmosis failure to the emergency department of our hospital between 2015 and 2019 were evaluated by post-operative CT scans and plain radiographs. Results: Diastasis was demonstrated in 18 patients (40%) in plain radiographs, in 4 patients (8%) by tibial clear space, in 5 patients (11%) by medial clear space, in 10 patients (22%) by AP tibiofibular overlap, and in patients 8 (17%) by mortise tibiofibular overlap. Diastasis was demonstrated in 24 patients (53%) in CT scans, of whom 18 patients had abnormal radiographic parameters, while 6 patients had normal radiographic parameters. Conclusion: We found a post-operative CT scan more useful than standard plain radiographic measurement for assessing the reduction of the syndesmosis. We suggest the use of post-operative CT scan as a routine to evaluate the syndesmosis reduction.

How much is the effective dose from medical imaging in pediatric patients in the neurosurgery department?

2021 ◽  
Author(s):  
B. Zeinali-Rafsanjani ◽  
S. Haseli ◽  
R. Jalli ◽  
M. Saeedi-Moghadam
Keyword(s):  
Medical Imaging ◽  
Ionizing Radiation ◽  
Ct Scan ◽  
Effective Dose ◽  
Pediatric Patients ◽  
Ct Scans ◽  
Imaging Data ◽  
Plain Radiographs ◽  
Brain Ct ◽  
Abdomen Ct

Medical imaging with ionizing radiation in pediatric patients is rising, and their radiation sensitivity is 2–3 times more than adults. The objective of this study was to estimate the total effective dose (ED) of all medical imaging by CT scan and plain radiography in patients in pediatric neurosurgery department. Patients with at least one brain CT scan and recorded dose length product (DLP) were included. Patients’ imaging data were collected from the picture-archiving-and-communicating system (PACS) using their national code to find all their medical imaging. Total ED (mSv) from CT scans and plain radiographs were calculated. A total of 300 patients were included, of which 129 were females and 171 males with a mean age of 5.45 ± 4.34 years. Mean DLPs of brain, abdomen, and chest CT were 329.16, 393.06, 284.46 mGy.cm. The most frequent CT scans in these children were brain CT scans with ED range of 0.09 to 47.09 mSv. Total ED due to all CT scans and plain radiographs were in the range of 0.38 to 63.41 mSv. Although the mean DLP of each brain, chest, and abdomen CT of patients was in the range of DRLs reported by previous studies, the patients with numerous CT scans received more radiation doses than mean ED (6.21 mSv between all age groups). The most frequent CT scan was the brain, and the most frequent plain radiographs were chest and lower extremities. It can be concluded that reducing the number of CT scans or plain radiographs by appropriate physical exams or replacing them with modalities that do not use ionizing radiation can reduce ED.

Radiographic and CT Evaluation of Tibiofibular Syndesmotic Diastasis: A Cadaver Study

1997 ◽  
Vol 18 (11) ◽  
pp. 693-698 ◽  
Author(s):  
Nabil A. Ebraheim ◽  
Jike Lu ◽  
Hua Yang ◽  
Anis O. Mekhail ◽  
Richard A. Yeasting
Keyword(s):  
Ct Scan ◽  
Ct Scanning ◽  
Cadaver Study ◽  
Lower Limbs ◽  
Ankle Injuries ◽  
Ct Scans ◽  
Tibiofibular Syndesmosis ◽  
Postoperative Evaluation ◽  
Plain Radiographs ◽  
Ct Evaluation

Twelve cadaver lower limbs were used for radiographic and CT assessment of the tibiofibular syndesmosis. Plastic spacers were placed in the distal tibiofibular intervals of each specimen in successive 1-mm increments until diastasis could be appreciated on the plain radiographs. All 2- and 3-mm diastases could be noted and clearly identified on CT scans, while the 1-, 2-mm, and half of the 3-mm syndesmotic diastases could not be appreciated with routine radiographs. CT scanning is more sensitive than radiography for detecting the minor degrees of syndesmotic injuries. Therefore, a CT scan can be performed in cases of syndesmotic instability after ankle injuries and for preoperative or postoperative evaluation of the integrity of the distal tibiofibular syndesmosis in cases of doubtful condition of the syndesmosis.

scholarly journals Imaging diagnosis of radial head fractures—evaluation of plain radiography vs. CT scans

2021 ◽  
Author(s):  
Zhenhua Zhao ◽  
Yiming Lyu ◽  
Tim Leschinger ◽  
Kilian Wegmann ◽  
Lars Peter Müller ◽  
...  
Keyword(s):  
Ct Scan ◽  
Radial Head ◽  
Plain Radiography ◽  
Ct Scans ◽  
Fracture Classification ◽  
Permanent Disability ◽  
Radial Head Fractures ◽  
Articular Fracture ◽  
Plain Radiographs ◽  
Observer Reliability

Abstract Background Radial head fractures represent a common pathology that can cause permanent disability, especially if not treated correctly. Plain radiographs as well as computed tomography (CT) scans represent important diagnostic measures. The specific differences between these two imaging modalities with regard to diagnosis of radial head fractures have not been evaluated to date. Objective This study aimed to compare estimations of fracture classification, percentage of articular fracture involvement, and fragment sizes through plain radiography with CT scan evaluations. Methods A total of 52 consecutive cases of isolated radial head fractures with plain radiographs and CT scans were evaluated retrospectively. Two observers analyzed the fracture classification according to Mason, the percentage of articular fracture involvement, and the size of the largest fracture fragment by means of CT. Three trauma surgeons estimated these parameters through blinded plain radiographs. Intra- and inter-observer reliability were evaluated. Results The CT scan evaluations showed high intra- and inter-observer reliability without significant differences between the two observers. X‑ray estimations of fracture classifications showed only fair agreements. Moreover, the estimations of articular fracture involvement and fragment sizes differed significantly from the CT scan evaluations. While the fragment size tended to be underrated, the articular involvement tended to be overrated. Conclusion This study shows that plain radiographs often provide unreliable information regarding classification, articular involvement, and fragment sizes of radial head fractures. When in doubt, an additional CT scan should be carried out to assess the injury in greater detail.

Assessment of Bony Subfibular Impingement in Flatfoot Patients Using Weight-Bearing CT Scans

2018 ◽  
Vol 40 (2) ◽  
pp. 152-158 ◽  
Author(s):  
Clifford L. Jeng ◽  
Tyler Rutherford ◽  
Michael G. Hull ◽  
Rebecca A. Cerrato ◽  
John T. Campbell
Keyword(s):  
Ct Scan ◽  
Weight Bearing ◽  
Ct Scans ◽  
Level Of Evidence ◽  
Plain Radiographs ◽  
Posterior Tibial ◽  
Bony Impingement ◽  
Sinus Tarsi ◽  
Retrospective Comparative Study ◽  
Coronal View

Background: Lateral hindfoot pain in patients with flatfoot deformity is frequently attributed to subfibular impingement. It remains unclear whether this is primarily due to bony or soft-tissue impingement. No studies have used weight-bearing CT scans to evaluate subfibular impingement. Methods: Patients with posterior tibial tendonitis were retrospectively searched and reviewed. Subjects had documented flatfoot deformity, posterior tibial tenderness, weight-bearing plain radiographs, and a weight-bearing CT scan. CT scans were evaluated for calcaneofibular impingement on the coronal view and talocalcaneal impingement on the sagittal view. The distance between these structures was measured, along with the sinus tarsi volume. In the second part of this study, 6 normal volunteers underwent weight-bearing CT scans on a platform that held both feet in 20 degrees of varus, followed by 20 degrees of valgus. The same measurements were performed. Results: Thirty-five percent of flatfoot patients with posterior tibial tendonitis had bony impingement between the fibula and calcaneus on the coronal view. Thirty-eight percent had bony impingement between the talus and calcaneus on the sagittal view. Subjects with bony impingement based on CT scan had significantly higher talonavicular abduction angles on plain radiographs than those without impingement. Sinus tarsi volume decreased by more than half when the subtalar joint moved from varus to valgus in normal controls. Conclusion: Bony subfibular impingement in patients with flatfeet was less common than previously reported. Accurate diagnosis of bony impingement may be useful for surgical decision-making. Level of Evidence: Level III, retrospective comparative study.

Association between Functional Outcomes and Radiographic Reduction Following Surgery for Distal Radius Fractures

2019 ◽  
Vol 24 (03) ◽  
pp. 258-263
Author(s):  
Ronit Wollstein ◽  
Raviv Allon ◽  
Yoav Zvi ◽  
Alan Katz ◽  
Sharon Werech ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Outcome Measures ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Radius Fractures ◽  
Radial Inclination ◽  
Radiographic Parameters ◽  
Radiographic Measurements

Background: Quality of reduction in distal radius fractures (DRF) is assessed using radiographic parameters, however few studies examine the association between radiographic measurements and functional outcomes. Our purpose was to evaluate the relationship between radiographic measurements and clinical outcome measures following surgery for DRF using detailed testing to demonstrate further associations between post-surgical radiographic measurements and function. Methods: Measurements were performed on postoperative radiographs of 38 patients following ORIF of DRF. Measurements included: radial inclination, radial height, ulnar variance, volar tilt, radiocarpal interval (d2/w2), and the intra-articular step-off. Clinical outcome measures included motion, grip strength, functional dexterity testing, Moberg pick-up test, specific activities of daily living, DASH score, pain scale, manual-assessment questionnaire. Results: Different radiographic parameters correlated with different specific tasks. The parameter correlated with most functional tasks was ulnar-variance. Radial inclination, radial-styloid scaphoid distance, and fracture classification correlated with some functions. Intraarticular step-off, and radial height were not associated with functional testing. Conclusions: Surgical radiographic results may affect post-operative function. Detailed task specific testing may enable a better evaluation of surgical outcomes. Further study and refinement of functional assessment may change our surgical goals in DRF.

Outcome after Corrective Osteotomy for Malunited Fractures of the Distal End of the Radius

2002 ◽  
Vol 27 (1) ◽  
pp. 55-60 ◽  
Author(s):  
K. J. PROMMERSBERGER ◽  
J. VAN SCHOONHOVEN ◽  
U. B. LANZ
Keyword(s):  
Retrospective Study ◽  
Clinical Outcome ◽  
Range Of Motion ◽  
Grip Strength ◽  
Distal Radius ◽  
Corrective Osteotomy ◽  
Ulnar Variance ◽  
Residual Deformity ◽  
Distal Radial Fractures ◽  
Radial Inclination

This retrospective study evaluated the outcome of corrective osteotomy for malunited distal radial fractures and investigated the influence of the radiological result on the clinical outcome. Twenty-nine patients underwent corrective osteotomy for malunited, dorsally tilted fractures of the distal radius and 20 underwent corrective osteotomy for malunited, palmarly angulated distal radial fractures. All were surveyed at an average of 18 months after surgery and assessed for: pain; grip strength; range of motion; radial tilt; radial inclination; and ulnar variance. Postoperative radial tilt, radial inclination and ulnar variance were significantly improved by corrective osteotomy. Patients with no, or only minor residual deformity after corrective osteotomy had significantly better results than those with gross residual deformity.

scholarly journals Dynamic monitor of CT scan within short interval in invasive pulmonary aspergillosis for nonneutropenic patients: a retrospective analysis in two centers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Chen ◽  
Yonghong Zhong ◽  
Na Li ◽  
Huijie Wang ◽  
Yanbin Tan ◽  
...  
Keyword(s):  
Ct Scan ◽  
Respiratory Diseases ◽  
Short Interval ◽  
Invasive Pulmonary Aspergillosis ◽  
Host Factors ◽  
Antifungal Treatment ◽  
Ct Scans ◽  
Pulmonary Aspergillosis ◽  
European Organization ◽  
Life Threatening

Abstract Background In nonneutropenic patients with underlying respiratory diseases (URD), invasive pulmonary aspergillosis (IPA) is a life-threatening disease. Yet establishing early diagnosis in those patients remains quite a challenge. Methods A retrospective series of nonneutropenic patients with probable or proven IPA were reviewed from January 2014 to May 2018 in Department of Respiratory Medicine of two Chinese hospitals. Those patients were suspected of IPA and underwent lung computed tomography (CT) scans twice within 5–21 days. The items required for IPA diagnosis were assessed by their host factors, mycological findings and CT scans according to the European Organization for Research and Treatment of Cancer (EORTC) and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) criteria (EORTC/MSG criteria). Results Together with the risk factors, mycological findings and nonspecific radiological signs on first CT, ten patients were suspected of IPA. With the appearance of cavities on second CT scan in the following days, all patients met the criteria of probable or possible IPA. Except one patient who refused antifungal treatment, nine patients received timely antifungal treatment and recovered well. One of the nine treated IPA cases was further confirmed by pathology, one was confirmed by biopsy. Conclusions Dynamic monitor of CT scan provided specific image evidences for IPA diagnosis. This novel finding might provide a noninvasive and efficient strategy in IPA diagnosis with URD.

Diagnostic Accuracy of Magnetic Resonance Imaging and Computed Tomography Scan in Young Athletes With Spondylolysis

2019 ◽  
Vol 58 (6) ◽  
pp. 671-676
Author(s):  
Amy M. West ◽  
Pierre A. d’Hemecourt ◽  
Olivia J. Bono ◽  
Lyle J. Micheli ◽  
Dai Sugimoto
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Ct Scan ◽  
False Negative ◽  
False Negative Rate ◽  
Ct Scans ◽  
Resonance Imaging ◽  
Young Athletes ◽  
Negative Rate

The objective of this study was to determine diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) scans in young athletes diagnosed with spondylolysis. A cross-sectional study was used. Twenty-two young athletes (14.7 ± 1.5 years) were diagnosed as spondylolysis based on a single-photon emission CT. Following the diagnosis, participants underwent MRI and CT scan imaging tests on the same day. The sensitivity and false-negative rate of the MRI and CT scans were analyzed. MRI test confirmed 13 (+) and 9 (−) results while CT test showed 17 (+) and 5 (−) results. The sensitivity and false-negative rate of MRI were, respectively, 59.1% (95% confidence interval [CI] = 36.7% to 78.5%) and 40.9% (95% CI = 21.5% to 63.3%). Furthermore, the sensitivity and false-negative rate of CT scan were 77.3% (95% CI = 54.2% to 91.3%) and 22.7% (95% CI = 0.09% to 45.8%). Our results indicated that CT scan is a more accurate imaging modality to diagnose spondylolysis compared with MRI in young athletes.

Incidence of silent hemorrhage and delayed deterioration after stereotactic brain biopsy

1998 ◽  
Vol 89 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Abhaya V. Kulkarni ◽  
Abhijit Guha ◽  
Andres Lozano ◽  
Mark Bernstein
Keyword(s):  
Ct Scan ◽  
Neurological Deficit ◽  
Stereotactic Biopsy ◽  
Brain Biopsy ◽  
Ct Scanning ◽  
Ct Scans ◽  
Stereotactic Brain Biopsy ◽  
Content Type ◽  
Fine Print

Object. Many neurosurgeons routinely obtain computerized tomography (CT) scans to rule out hemorrhage in patients after stereotactic procedures. In the present prospective study, the authors investigated the rate of silent hemorrhage and delayed deterioration after stereotactic biopsy sampling and the role of postbiopsy CT scanning. Methods. A subset of patients (the last 102 of approximately 800 patients) who underwent stereotactic brain biopsies at the Toronto Hospital prospectively underwent routine postoperative CT scanning within hours of the biopsy procedure. Their medical charts and CT scans were then reviewed. A postoperative CT scan was obtained in 102 patients (aged 17–87 years) who underwent stereotactic biopsy between June 1994 and September 1996. Sixty-one patients (59.8%) exhibited hemorrhages, mostly intracerebral (54.9%), on the immediate postoperative scan. Only six of these patients were clinically suspected to have suffered a hemorrhage based on immediate postoperative neurological deficit; in the remaining 55 (53.9%) of 102 patients, the hemorrhage was clinically silent and unsuspected. Among the clinically silent intracerebral hemorrhages, 22 measured less than 5 mm, 20 between 5 and 10 mm, five between 10 and 30 mm, and four between 30 and 40 mm. Of the 55 patients with clinically silent hemorrhages, only three demonstrated a delayed neurological deficit (one case of seizure and two cases of progressive loss of consciousness) and these all occurred within the first 2 postoperative days. Of the neurologically well patients in whom no hemorrhage was demonstrated on initial postoperative CT scan, none experienced delayed deterioration. Conclusions. Clinically silent hemorrhage after stereotactic biopsy is very common. However, the authors did not find that knowledge of its existence ultimately affected individual patient management or outcome. The authors, therefore, suggest that the most important role of postoperative CT scanning is to screen for those neurologically well patients with no hemorrhage. These patients could safely be discharged on the same day they underwent biopsy.

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