scholarly journals Simulated weightbearing computed tomography for verification of radiographic staging of varus ankle osteoarthritis: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kiyonori Tomiwa ◽  
Yasuhito Tanaka ◽  
Hiroaki Kurokawa ◽  
Kunihiko Kadono ◽  
Akira Taniguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Articular Surface ◽  
Joint Space ◽  
Ankle Osteoarthritis ◽  
Cross Sectional ◽  
Distal Articular Surface ◽  
Posterior Subluxation ◽  
Varus Ankle Osteoarthritis ◽  
Anterior Subluxation ◽  
Anterior Posterior

Abstract Background Varus ankle osteoarthritis is classified using only weightbearing anteroposterior ankle radiographs; however, sagittal ankle alignment may also affect the position and extent of joint space obliteration. We hypothesized that the sagittal alignment of the ankle may also affect the position and extent of joint space obliteration visible on the coronal section; therefore, we identified the sites of joint space obliteration in patients with stage 3 varus ankle osteoarthritis for comparison with the sites observed on simulated weightbearing computed tomography and investigated the effects of anterior and posterior ankle subluxation. Methods Simulated weightbearing computed tomography scans of 83 ft with varus ankle osteoarthritis (26 stage 3a, 57 stage 3b) were performed to check for joint space obliteration in the ankle. Further classification as exhibiting either anterior, posterior, or no subluxation on weightbearing lateral radiographs was performed. Results Anterior, posterior, and no subluxation was seen in 5, 9, and 12 ankles among the 26 classified as stage 3a, respectively, and in 22, 12, and 23 ankles among the 57 classified as stage 3b, respectively. The mean tibial lateral surface angle on weightbearing lateral radiographs in stage 3a ankles was 75.6, 83.3, and 80.3 degrees in the anterior, posterior, and no subluxation groups, respectively; and 75.5, 86.6, and 82.7 degrees in stage 3b ankles (p < .05). In stage 3b ankles, widespread joint space obliteration was observed at the anterior distal articular surface of the tibia in all 22 ankles with anterior subluxation and at the posterior distal articular surface of the tibia in all 12 ankles with posterior subluxation. Conclusions Simulated weightbearing computed tomography revealed joint space obliteration at the anterior distal articular surface of the tibia in stage 3b ankles with anterior subluxation and at the posterior side in stage 3a and 3b ankles with posterior subluxation. In some patients with stage 3 varus ankle osteoarthritis, the obliteration of the joint space is difficult to evaluate accurately using only weightbearing anteroposterior radiographs; weightbearing lateral radiographs should also be performed.

scholarly journals Ten-Year Retrospective Study of Symptomatic Naviculo-Medial Cuneiform Coalition in 18 Young Adults: Hidden Features Observed on Computed Tomography

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0014
Author(s):  
Jun Young Choi ◽  
Jin Soo Suh
Keyword(s):  
Computed Tomography ◽  
Articular Surface ◽  
Joint Space ◽  
Loose Bodies ◽  
Radiographic Findings ◽  
Ct Findings ◽  
Medial Cuneiform ◽  
Mean Size ◽  
Pit Depth ◽  
Bony Spur

Category: Midfoot/Forefoot Introduction/Purpose: To the best of our knowledge, there are no previous reports comparing the radiographic findings to CT findings for symptomatic naviculo-medial cuneiform (NC) coalition. The purpose of this study was to demonstrate and compare the features of symptomatic naviculo-medial cuneiform coalition between radiography and computed tomography (CT). Methods: We retrospectively reviewed the radiographic and CT findings of 25 symptomatic naviculo-medial cuneiform coalition cases in 18 patients. The existence of a large pit (depth >3 mm), irregular articular surface, joint space narrowing, dorsal bony spur, subchondral sclerosis, multiple subchondral bony cysts, and intra-articular loose bodies were evaluated on radiograph or CT. The size of the largest subchondral bony cyst was also measured using CT. Results: The proportion of large pit observed on radiograph (52.0%) was significantly different (P = .001) from that on CT (72.0%). Similarly, intra-articular loose bodies were observed more frequently on CT (P = .001). The mean size of the largest subchondral bony cyst on CT was 4.25 mm. Conclusion: While evaluating CT in patients with naviculo-medial cuneiform coalition, physicians should focus on detecting a large pit and intra-articular loose bodies since differences in these features were frequently observed between radiograph and CT, with these findings being more evident on CT. We believe that a large subchondral bony cyst could also be related to the symptoms of naviculo-medial cuneiform coalition.

Weight-bearing computed tomography findings in varus ankle osteoarthritis: abnormal internal rotation of the talus in the axial plane

2017 ◽  
Vol 46 (8) ◽  
pp. 1071-1080 ◽  
Author(s):  
Ji-Beom Kim ◽  
Young Yi ◽  
Jae-Young Kim ◽  
Jae-Ho Cho ◽  
Min-Soo Kwon ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Internal Rotation ◽  
Weight Bearing ◽  
Axial Plane ◽  
Ankle Osteoarthritis ◽  
Varus Ankle Osteoarthritis

scholarly journals Relationship between talofibular impingement and increased talar tilt in incongruent varus ankle osteoarthritis

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110452
Author(s):  
Min Gyu Kyung ◽  
Yun Jae Cho ◽  
Junpyo Lee ◽  
Wonik Lee ◽  
Dae-Yoo Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Contralateral Side ◽  
Ankle Osteoarthritis ◽  
Lateral Process ◽  
Control Side ◽  
Bony Impingement ◽  
Talar Tilt ◽  
The Relationship ◽  
Varus Ankle Osteoarthritis ◽  
Axial View

Purpose This study aimed to evaluate the relationship between talofibular impingement and increased talar tilt in incongruent varus ankle osteoarthritis. Methods: Incongruent varus ankle osteoarthritis was defined as a talar tilt of more than 4° on standard ankle anteroposterior radiographs. We retrospectively reviewed 30 patients with unilateral incongruent varus ankle osteoarthritis with normal alignment of the contralateral ankle. All patients underwent bilateral weightbearing computed tomography and standing plain radiographs. The talar tilt and the distance between the talar lateral process and lateral malleolar tip were measured from a standing ankle anteroposterior radiograph of both sides. Talar and fibular spurs were assessed on the coronal and axial views of weightbearing computed tomography. After simulating the correction of the talar tilt in varus ankle osteoarthritis, talofibular bony impingement was reassessed. Results: On the varus side, the distance between the talar lateral process and the lateral malleolar tip was significantly shorter than that on the contralateral side ( p < .001). Talar spur was present in the varus side of all 30 patients on the axial view of weightbearing computed tomography and in the control side of 10 patients. After the simulation of talar tilt correction, talofibular impingement (overlap) occurred in all 30 patients with a larger extent in the severe talar tilt subgroup ( p < .001). Conclusion: Talofibular impingement by lateral gutter osteophytes is closely related to increased talar tilt in patients with incongruent varus ankle osteoarthritis. Therefore, lateral gutter osteophytes should be resected to stabilize mortise and improve clinical outcomes.

scholarly journals Weight-bearing anteroposterior radiograph of the ankle underestimates the severity of osteoarthritis when there is anterior subluxation of the talus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0028
Author(s):  
Ji-Beom Kim ◽  
Woo-Chun Lee
Keyword(s):  
Joint Space Narrowing ◽  
Weight Bearing ◽  
Joint Space ◽  
Ankle Osteoarthritis ◽  
Coronal Image ◽  
Posterior Aspect ◽  
Anteroposterior Radiograph ◽  
Clear Space ◽  
Lateral Width ◽  
Anterior Subluxation

Category: Ankle Arthritis Introduction/Purpose: On weight-bearing lateral radiograph, anterior aspect of the ankle shows more narrowing than posterior aspect in the ankle osteoarthritis with anterior subluxation of the talus. However, weight-bearing anteroposterior radiograph of the ankle osteoarthritis with anterior subluxation of the talus often shows less severe joint space narrowing than the joint space in the narrowest anterior aspect of the ankle joint. (Fig.1). The purposes of this study were to compare the degree and shape of joint space narrowing in the anterior, middle and posterior aspect of the ankle by using weight-bearing CT and to investigate which area of the ankle was shown on plain weight-bearing ankle anteroposterior radiograph in the ankle osteoarthritis with anterior subluxation of the talus. Methods: We retrospectively evaluated patients who underwent surgery for ankle osteoarthritis in our clinic from January, 2017 to May, 2017. We included patients who showed ankle osteoarthritis with anterior subluxation of the talus in weight-bearing lateral radiograph. We determined anterior, posterior and middle coronal images in sagittal image of the weight-bearing CT.(Fig.1) Talar tilt, medial width of superior clear space(SCS), lateral width of SCS, width of medial clear space and obliteration ratio were measured on plain weight-bearing anteroposterior ankle radiograph, and the three coronal images. The obliteration ratio was obtained by obliteration-width / talus-width * 100.(Fig.1) The radiographic parameters of the anterior coronal image were compared with those on the middle and the posterior coronal image by using paired T-test. The intraclass coefficient was used to investigate which of the three coronal images showed best match with degree and shape of ankle osteoarthritis on the plain weight-bearing ankle anteroposterior radiograph Results: Seventy-one ankles from 71 patients were included in this study. The average age of patients in this study was 62.6 years (range: 19-82). The talar tilt on the anterior coronal image was significantly lower than that on the middle and posterior coronal images. The lateral width of SCS and the width of medial clear space on the anterior coronal image was significantly narrower than those on the middle and the posterior coronal image. The obliteration ratio on the anterior coronal image was significantly higher than that of the middle and the posterior coronal images (Fig.2). The intraclass coefficients indicated that the radiographic parameters on plain weight-bearing anteroposterior radiograph was most reliable with those on the middle coronal image among the three coronal images. Conclusion: Anterior area of ankle shows the most severe osteoarthritis and plain weight-bearing anteroposterior radiograph shows the best match to the middle portion of the ankle, when ankle osteoarthritis has anterior subluxation of the talus. Because middle area of ankle has less severe ankle osteoarthritis than anterior area of ankle in that kind of ankle osteoarthritis, plain weight-bearing radiograph may underestimate the severity of ankle osteoarthritis.

Computed Tomography Angiography (CTA) Evaluation of Spontaneous Subarachnoid Hemorrhage

2020 ◽  
Vol 6 (2) ◽  
pp. 78-81
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Chowdhury ◽  
Mohammad Sadekur Rahman Sarkar ◽  
KM Ahasan Ahmed ◽  
Md Nazmul Kabir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Computed Tomography Angiography ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multiple Aneurysm ◽  
Traumatic Subarachnoid Hemorrhage ◽  
One Year ◽  
Spontaneous Subarachnoid Hemorrhage

Background: In evaluation of non-traumatic subarachnoid hemorrhage CT angiography (CTA) has 97-98% sensitivity and near 100% specificity. Objective: This study was conducted to evaluate the CTA findings of CT positive non traumatic subarachnoid hemorrhage. Methodology: This is an observational cross sectional study performed in Neurology department of National Institute of Neurosciences and Hospital, Dhaka over one year period (January 2019 to December 2019). Total 87 CT positive subarachnoid hemorrhage cases were purposively included in this study. All CT positive patients underwent CTA of Cerebral vessels for further evaluation. The angiography were evaluated by competent neuro-radiologists blinded about the study. Result: Among 87 patients, 40.2% were male and 59.8% were female. The average age was 53.33±11.1 years. Among the studied patient the source of bleeding was found 78.16% aneurysmal and 21.84% non-aneurysmal. 85.30% patients had single aneurysm and 14.70% had multiple aneurysm. The highest number of patient had Acom aneurysm (41.17%) followed by MCA (22.05%), ICA (13.23%), ACA (7.35%) and vertebral artery (1.14%) in order of frequency. Among the multiple aneurysm group most of the patients had combination of Acom, MCA and ICA aneurysm. Conclusion: From this study, we can conclude that CTA can be used as the primary diagnostic tool in evaluation of spontaneous SAH. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 78-81

scholarly journals Accuracy and Reproducibility of Facial Measurements of Digital Photographs and Wrapped Cone Beam Computed Tomography (CBCT) Photographs

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 757
Author(s):  
Maged Sultan Alhammadi ◽  
Abeer Abdulkareem Al-mashraqi ◽  
Rayid Hussain Alnami ◽  
Nawaf Mohammad Ashqar ◽  
Omar Hassan Alamir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Cone Beam Computed Tomography ◽  
High Reliability ◽  
Three Dimensional ◽  
Cone Beam ◽  
Cross Sectional ◽  
Facial Profile ◽  
Digital Photographs ◽  
Gonial Angle

The study sought to assess whether the soft tissue facial profile measurements of direct Cone Beam Computed Tomography (CBCT) and wrapped CBCT images of non-standardized facial photographs are accurate compared to the standardized digital photographs. In this cross-sectional study, 60 patients with an age range of 18–30 years, who were indicated for CBCT, were enrolled. Two facial photographs were taken per patient: standardized and random (non-standardized). The non-standardized ones were wrapped with the CBCT images. The most used soft tissue facial profile landmarks/parameters (linear and angular) were measured on direct soft tissue three-dimensional (3D) images and on the photographs wrapped over the 3D-CBCT images, and then compared to the standardized photographs. The reliability analysis was performed using concordance correlation coefficients (CCC) and depicted graphically using Bland–Altman plots. Most of the linear and angular measurements showed high reliability (0.91 to 0.998). Nevertheless, four soft tissue measurements were unreliable; namely, posterior gonial angle (0.085 and 0.11 for wrapped and direct CBCT soft tissue, respectively), mandibular plane angle (0.006 and 0.0016 for wrapped and direct CBCT soft tissue, respectively), posterior facial height (0.63 and 0.62 for wrapped and direct CBCT soft tissue, respectively) and total soft tissue facial convexity (0.52 for both wrapped and direct CBCT soft tissue, respectively). The soft tissue facial profile measurements from either the direct 3D-CBCT images or the wrapped CBCT images of non-standardized frontal photographs were accurate, and can be used to analyze most of the soft tissue facial profile measurements.

scholarly journals FRI0499 ACROMEGALY ARTROPATHY: IS THERE SOMETHING MORE BEHIND THE PAIN? A CROSS-SECTIONAL STUDY TO EVALUATE RHEUMATIC DISEASE IN GROWTH HORMONE SECRETING TUMOR PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 848.1-848
Author(s):  
M. Scarati ◽  
S. Parisi ◽  
N. Prencipe ◽  
M. C. Ditto ◽  
E. Ghigo ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Logistic Regression ◽  
Rheumatic Disease ◽  
Power Doppler ◽  
Connective Tissue Diseases ◽  
Joint Damage ◽  
Joint Space ◽  
Tumor Patients ◽  
Cross Sectional ◽  
Significant Difference

Background:Acromegaly is a rare disease with a remarkable impact on patients, both in terms of life expectancy and quality of life. Osteo-articular complications are one of the most frequently reported bothers. The “acromegaly artropathy” characterizes more than 70% of patients at diagnosis. Artropathy affects both spine and peripheral joints. A recent prospective study documented progression of acromegalic arthropathy identified as a worsening of osteophytes and joint space narrowing in 72–74% of patients despite long-term biochemical control. In addiction the Literature has occasionally reported cases of simultaneous presence of rheumatic diseases (rheumatoid arthritis, polymyalgia rheumatica, undifferentiated connective tissue diseases) and acromegaly and in all these cases the treatment has been delayed, because of wrong symptoms attribution to acromegaly artropathy.Objectives:The primary goal of the study is to better characterize joint pain in acromegaly patients and to evaluate the prevalence of rheumatic disease in growth hormone (GH) secreting pituitary tumor patients.Methods:We enrolled 20 acromegaly subjects (AS) and 20 control subjects (CS). In each subject immunological pattern (rheumatoid factor – RF; antinuclear antibodies - ANA, ENA; anti-citrullinated protein antibodies - ACPA; erythrocyte sedimentation rate – ESR) has been evaluated; they, also, underwent bilateral joint ultrasound of hands and wrists and nail capillaroscopy. The Chi square test and the Fisher’s exact test were used to evaluate the association between binary variables, while the Spearman’s test to evaluate the correlation of continuous ones. A multiple or logistic regression model was calculated in order to define the association between the capillaroscopic alterations and other detected variables.Results:Articular pain emerged as significantly more frequent in AS (p = 0.0269). No statistically significant differences are detected regarding immunological pattern. ANA and ENA screening resulted positive in 10% in AS and in 5% in CS. No IgA ACPA were detected in AS or CS, while IgG ACPA were positive only in one AS subject. No significant differences were detected between IgM and IgG RFin the two groups (AS 5% and CS 0%). Three fold higher IgG FR in AS compared to CS were detected. ESR levels were significantly higher than CS (p = 0.0405), as well as increased power doppler (PWD) articular uptake (AS 30% vs CS 5% p 0.081). The capillaroscopic evaluation showed a significant difference in almost each parameter that has been evaluated (logistic regression: number of enlargement p 0.004, hemorragies p 0.01 and capillaries p 0.001), showing a moderate-severe microangiopathy in AS. Interestingly, analyzing only the acromegaly cohort, we noticed higher GH levels at the enrollment in patients which developed capillary enlargements (GH: 0.95 ng/ml IQ 0,6-1,6) compared to other ones (GH: 0.55 ng/ml IQ 0.4-0.7; p = 0.08) and a significant lower number of hemorrhages (p = 0.02) in patients treated with GH antagonist pegvisomant.Conclusion:Our results demonstrated that joint damage in acromegaly does not seem to have an autoimmune etiology. Therefore, articular damage is mechanical and increased ESR and PWD alterations seems to confirm the presence of an inflammatory component. In addition, acromegaly is characterized by a microvascular pattern of moderate-severe microangiopathy, without correlation to IGF-I, but GH levels. Although requiring further confirmatory studies, our preliminary results seem to indicate how the capillaroscopic examination could be useful to detect earlier microangiopathy and to identify patients with a greater risk of macroangiopathy development..References:[1]Claessen KMJA et al. Bone and joint disorders in acromegaly. Neuroendocrinology. 2016;103(1):86-95.[2]Örük G et al. Is every joint symptom related to acromegaly? Endocrine. 2013 Apr;43(2):404-11.Disclosure of Interests:None declared

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