Defining reference values for the normal tibiofibular syndesmosis in adults using weight-bearing CT

2019 ◽  
Vol 101-B (3) ◽  
pp. 348-352 ◽  
Author(s):  
S. Patel ◽  
K. Malhotra ◽  
N. P. Cullen ◽  
D. Singh ◽  
A. J. Goldberg ◽  
...  
Keyword(s):  
Cone Beam Ct ◽  
Weight Bearing ◽  
Cone Beam ◽  
Syndesmotic Injury ◽  
Tibiofibular Syndesmosis ◽  
Cross Sectional ◽  
Female Patients ◽  
Normal Ranges ◽  
Anteroposterior Translation ◽  
The Mean

Aims Cone beam CT allows cross-sectional imaging of the tibiofibular syndesmosis while the patient bears weight. This may facilitate more accurate and reliable investigation of injuries to, and reconstruction of, the syndesmosis but normal ranges of measurements are required first. The purpose of this study was to establish: 1) the normal reference measurements of the syndesmosis; 2) if side-to-side variations exist in syndesmotic anatomy; 3) if age affects syndesmotic anatomy; and 4) if the syndesmotic anatomy differs between male and female patients in weight-bearing cone beam CT views. Patients and Methods A retrospective analysis was undertaken of 50 male and 50 female patients (200 feet) aged 18 years or more, who underwent bilateral, simultaneous imaging of their lower legs while standing in an upright, weight-bearing position in a pedCAT machine between June 2013 and July 2017. At the time of imaging, the mean age of male patients was 47.1 years (18 to 72) and the mean age of female patients was 57.8 years (18 to 83). We employed a previously described technique to obtain six lengths and one angle, as well as calculating three further measurements, to provide information on the relationship between the fibula and tibia with respect to translation and rotation. Results The upper limit of lateral translation in un-injured patients was 5.27 mm, so values higher than this may be indicative of syndesmotic injury. Anteroposterior translation lay within the ranges 0.31 mm to 2.59 mm, and -1.48 mm to 3.44 mm, respectively. There was no difference between right and left legs. Increasing age was associated with a reduction in lateral translation. The fibulae of men were significantly more laterally translated but data were inconsistent for rotation and anteroposterior translation. Conclusion We have established normal ranges for measurements in cross-sectional syndesmotic anatomy during weight-bearing and also established that no differences exist between right and left legs in patients without syndesmotic injury. Age and gender do, however, affect the anatomy of the syndesmosis, which should be taken into account at time of assessment. Cite this article: Bone Joint J 2019;101-B:348–352.

scholarly journals Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study

Urolithiasis ◽  
2021 ◽  
Author(s):  
R. A. Kingma ◽  
M. J. H. Voskamp ◽  
B. H. J. Doornweerd ◽  
I. J. de Jong ◽  
S. Roemeling
Keyword(s):  
Computed Tomography ◽  
Percutaneous Nephrolithotomy ◽  
Cone Beam Computed Tomography ◽  
University Hospital ◽  
Cone Beam ◽  
Cross Sectional ◽  
The Mean ◽  
Residual Stones ◽  
Residual Fragments

AbstractCone beam computed tomography (CBCT) provides multiplanar cross-sectional imaging and three-dimensional reconstructions and can be used intraoperatively in a hybrid operating room. In this study, we investigated the feasibility of using a CBCT-scanner for detecting residual stones during percutaneous nephrolithotomy (PCNL). Intraoperative CBCT-scans were made during PCNL procedures from November 2018 until March 2019 in a university hospital. At the point where the urologist would have otherwise ended the procedure, a CBCT-scan was made to image any residual fragments that could not be detected by either nephroscopy or conventional C-arm fluoroscopy. Residual fragments that were visualized on the CBCT-scan were attempted to be extracted additionally. To evaluate the effect of this additional extraction, each CBCT-scan was compared with a regular follow-up CT-scan that was made 4 weeks postoperatively. A total of 19 procedures were analyzed in this study. The mean duration of performing the CBCT-scan, including preparation and interpretation, was 8 min. Additional stone extraction, if applicable, had a mean duration of 11 min. The mean effective dose per CBCT-scan was 7.25 mSv. Additional extraction of residual fragments as imaged on the CBCT-scan occurred in nine procedures (47%). Of the follow-up CT-scans, 63% showed a stone-free status as compared to 47% of the intraoperative CBCT-scans. We conclude that the use of CBCT for the detection of residual stones in PCNL is meaningful, safe, and feasible.

scholarly journals Weight Bearing CT and Relative Orientation of Foot Bones: Effect of Loading and Heeled Shoes

2020 ◽  
pp. 10-14
Author(s):  
Sandu Elena Cerasela ◽  
Caravaggi Paolo ◽  
Durante Stefano
Keyword(s):  
Sagittal Plane ◽  
Cone Beam Ct ◽  
Young Subject ◽  
Weight Bearing ◽  
Cone Beam ◽  
Non Invasive ◽  
Foot Bones ◽  
Healthy Young Subject ◽  
Foot Posture ◽  
Metatarsophalangeal Joints

The purpose of this article is to determine the orientation and relative position of the foot bones in Weight Bearing CT, highlighting the effect of the load and the shoe with the heel. Thanks to a Cone Beam CT (OnSight 3D Extremity System, Carestream) equipment, three scans of the foot of a healthy young subject were carried out in three conditions: "unloading", "loading", and wearing a shoe with "heel". In order to assess the accuracy of the articular angles of the foot through non-invasive measurements, a measurement was performed by Gait-Analysis with passive markers in the same conditions. The effect of the "load" resulted in a significant alteration of the foot posture especially in the sagittal plane, with crushing of the longitudinal medial arch. The heeled shoe involves enormous deformations at the level of the metatarsophalangeal joints and the ankle.

scholarly journals Measurement of pharyngeal segments in Obstructive Sleep Apnea

2018 ◽  
Vol 21 (1) ◽  
pp. 64
Author(s):  
Marcos Marques Rodrigues ◽  
Lucas Borin Moura ◽  
Ariane De Souza Oliveira ◽  
Marisa Aparecida Cabrini Gabrielli ◽  
Valfrido Antonio Pereira Filho ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cone Beam Ct ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Cone Beam ◽  
Obstructive Sleep ◽  
Intimate Relation ◽  
The Mean ◽  
Cephalometric Measurements

<p><strong>Objective</strong>: Obstructive Sleep Apnea (OSA) occurs by recurrent collapse of the upper airway during sleep. It results in complete (apnea) or partial (hypopnea) reduction of airflow and has intimate relation with the upper airway anatomy. Cephalometric analysis has been used to quantify airway dimensions. The aim of this study is evaluate the correlation between the anteroposterior dimension of the upper airway and the severity of obstructive sleep apnea. <strong>Material and Methods</strong>: A retrospective analysis was performed reviewing polysomnographic data (AHI) and anteroposterior cephalometric measurements of pharynx subregions: nasopharynx, oropharynx, hypopharynx. <strong>Results</strong>: The sample consisted of 30 patients. The mean body mass index was 29.60 kg/m<sup>2</sup> and the average age was 46.8 years. Nine patients presented severe OSA, seven had moderate OSA , seven had mild OSA, and seven were healthy.  The Pearson's correlation index between the anteroposterior dimension of the nasopharynx, oropharynx and hypopharynx and AHI was respectively -0.128 (p=0.517), -0.272 (p=0.162) and -0.129 (p=0.513).<strong> Conclusion: </strong>The correlation between anteroposterior linear dimension of the airway and OSA severity, assessed by AHI, was not positive. As an isolated parameter it did not correlate to the severity of the obstrucive sleep apnea syndrome and should be evaluated in conjunction with other factors.</p><p><strong> </strong></p><p><strong>Keywords</strong></p><p>Upper Airway; Obstructive sleep apnea; Cone beam CT.</p>

scholarly journals The correlation between the three-dimensional radiolucency area around the crown of impacted maxillary canines and dentigerous cysts

2020 ◽  
Vol 49 (4) ◽  
pp. 20190402
Author(s):  
Junliang Chen ◽  
Dongmei Lv ◽  
MingXia Li ◽  
Wei Zhao ◽  
Yun He
Keyword(s):  
Cone Beam Ct ◽  
Dentigerous Cyst ◽  
Three Dimensional ◽  
Cone Beam ◽  
Hard Tissue ◽  
Mean Values ◽  
Dentigerous Cysts ◽  
Impacted Canine ◽  
The Mean ◽  
Surgical Operations

This study aimed to reveal the correlation between the radiolucency area around the crown of impacted maxillary canines and dentigerous cysts using cone beam CT (CBCT). CBCT data were obtained from patients with impacted maxillary canines. Three points of five areas (tooth cusp area and buccal, lingual, mesial and distal areas of the crown) were randomly selected, and the distance between the point and the surrounding hard tissue was measured respectively. The mean values were recorded as the radiolucency area. These results were compared with the occurrence of dentigerous cysts during surgery. 58 patients with 76 impacted maxillary canines were included. 14 of the 76 impacted canines were accompanied by cysts (18.42%). With the increase in the thickness of the radiolucency area, the incidence of cysts was significantly increased (p < 0.05). No cysts were found in the compacted canines with 0–1 mm thickness of the radiolucency area. The highest incidence (71.43%) was observed in canines with 3–4 mm thickness of the radiolucency area. This study found that the thickness of the radiolucency area around the crown of the maxillary impacted canine was closely related to the occurrence of dentigerous cysts. CBCT can be used to estimate the occurrence possibility of dentigerous cyst and guide surgical operations.

scholarly journals Taurodontism and Van der Woude Syndrome

2008 ◽  
Vol 78 (5) ◽  
pp. 832-837 ◽  
Author(s):  
Hiroyuki Nawa ◽  
Snehlata Oberoi ◽  
Karin Vargervik
Keyword(s):  
Clinical Sample ◽  
Cone Beam Ct ◽  
Three Dimensional ◽  
Panoramic Radiograph ◽  
Cross Sectional Study ◽  
Cone Beam ◽  
Linear Measurements ◽  
Van Der Woude Syndrome ◽  
Cross Sectional ◽  
Mandibular First Molar

Abstract Objective: To report the occurrence of taurodontism in a clinical sample of Van der Woude syndrome (VWS) and describe its association with hypodontia and cleft type. Materials and Methods: This retrospective, cross-sectional study was carried out on chart reviews and radiographs of 13 persons with VWS. Mean age was 10 years 11 months ± 1 year 5 months. Panoramic radiographs were used to confirm the presence or absence of teeth and to measure crown body and root lengths of mandibular first molars. Three-dimensional cone beam computed tomography (CT) scans were available on two persons with VWS. Both volumetric and linear measurements were obtained. Results: The occurrence of taurodontism of the mandibular first molar was 35%: 27% hypodont and 8% mesodont. Of the 13 subjects with VWS, 6 (4 males and 2 females) had at least one tooth identified with taurodontism. Half of the cases were unilateral and half were bilateral, and all of the unilateral cases were on the left side. Five of the six subjects with taurodontism had missing incisors and premolars. Taurodontism was two times more frequent in those who were missing their second premolars than in those who had their second premolars. There was no correlation between cleft type and presence of taurodontism. The cone beam CT pilot study on two persons showed very abnormal morphology of both crown and roots, which was not apparent on the standard panoramic radiograph. Both the volumetric and linear measurements of the ratio of crown body to root were highly indicative of taurodontism. Further genetic studies are needed. Conclusion: There is a likely association between VWS and taurodontism.

scholarly journals Cone Beam Computed Tomography-Based Anatomical Assessment of the Olfactory Fossa

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Andre Luiz Ferreira Costa ◽  
Aline Kataki Paixão ◽  
Bianca Costa Gonçalves ◽  
Celso Massahiro Ogawa ◽  
Thiago Martinelli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cross Sectional Study ◽  
Cone Beam ◽  
Type I ◽  
Type Ii ◽  
Sectional Study ◽  
Cross Sectional ◽  
Computed Tomography Images ◽  
The Mean

This study aimed to investigate the olfactory fossa according to the Keros classification using cone beam computed tomography. This cross-sectional study analysed cone beam computed tomography images selected from a database belonging to a radiology centre. The scans of 174 healthy patients were analysed by using the Xoran software. Gender, age, and side were correlated with the Keros classification. The mean age of the 174 patients was 45.3 years. The most prevalent Keros classification was type II (65.52%), followed by type III (20.69%) and type I (13.79%). No significant differences were found between Keros classification and the variables age, right side (pvalue = 0.4620), and left side (pvalue = 0.5709). There were also no significant differences between gender and the variables right side (pvalue = 0.1421) and left side (pvalue = 0.2136). Based on these results, we suggest that cone beam computed tomography can be recommended for analysis of the anterior skull base. Keros type II was the most prevalent type in our sample.

Weight-Bearing Cone-Beam CT Scan Assessment of Stability of Supination External Rotation Ankle Fractures in a Cadaver Model

2018 ◽  
Vol 39 (7) ◽  
pp. 850-857 ◽  
Author(s):  
Mark C. Lawlor ◽  
Melissa A. Kluczynski ◽  
John M. Marzo
Keyword(s):  
Ct Scan ◽  
Ankle Fracture ◽  
External Rotation ◽  
Imaging Modality ◽  
Cone Beam Ct ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Cone Beam ◽  
Clear Space ◽  
Supination External Rotation

Background: The utility of computed tomography (CT) for measuring medial clear space (MCS) for determination of the stability of supination external rotation (SER) ankle fractures and in comparison to standard radiographs is unknown. We compared MCS on gravity stress (GS) radiographs to GS and weight bearing (WB) cone-beam CT (CBCT). Methods: An AO SER 44B3.1 ankle fracture was simulated in 10 human cadavers, also serving as controls. MCS was measured on GS radiographs, GS CBCT, and a simulated WB CBCT scan. Specimens were stable if MCS was <5 mm and unstable if MCS was ≥5 mm. Paired t tests were used to compare MCS from each imaging modality for controls versus SER injuries and stable versus unstable specimens. Results: Compared with controls assessed by GS radiographs, MCS was greater for an SER injury when assessed by GS radiograph and GS CBCT scan within the stable group. Compared with controls assessed by GS radiographs, MCS was greater for SER injuries when assessed by GS radiograph, GS CBCT scan, and WB CBCT within the unstable group. MCS was reduced for stable versus unstable SER injuries assessed by WB CBCT. Conclusion: In a cadaveric model of SER ankle fracture, the medial clear space was statistically significantly greater for the experimental condition when assessed by gravity stress radiograph and gravity stress CBCT scan. Under weight-bearing conditions, the cone-beam CT scanner distinguished between stable and unstable ankles in the experimental condition. Clinical Relevance: This study suggests that a WB cone-beam CT scan may be able to distinguish between stable and unstable SER ankle fractures and influence operative decision making.

scholarly journals Comparative evaluation of mandibular canal visibility on cross-sectional cone-beam CT images: a retrospective study

2016 ◽  
Vol 45 (2) ◽  
pp. 20150296 ◽  
Author(s):  
Mahogany S Miles ◽  
Edwin T Parks ◽  
George J Eckert ◽  
Steven B Blanchard
Keyword(s):  
Retrospective Study ◽  
Comparative Evaluation ◽  
Cone Beam Ct ◽  
Mandibular Canal ◽  
Ct Images ◽  
Cone Beam ◽  
Cross Sectional

scholarly journals Urinary incontinence among female patients attending a selected public hospital in Bangladesh

2019 ◽  
Vol 5 (7) ◽  
pp. 160
Author(s):  
Shima Begum ◽  
Khondoker Mahmuda Akter Halim ◽  
Ratna Khatun ◽  
Sharmin Islam ◽  
A. B. M. Alauddin Chowdhury ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Uterine Prolapse ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Social Consequences ◽  
Urethral Injury ◽  
Care Seeking ◽  
Cross Sectional ◽  
Female Patients ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Urinary incontinence is a frequent public health problem with negative social consequences, particularly for women. Women are much more susceptible to urinary incontinence than men. Female susceptibility is the result of anatomical, social, economic and cultural factors.</p><p class="abstract"><strong>Methods:</strong> A cross sectional study was conducted to find out the factors related to urinary incontinence, distribution of types of incontinence among female patients and their health care seeking behavior and socio-demographic characteristics among 121 adult female patients who attended the outpatient department of Gynae and Obstetrics department and Urology department of Dhaka Medical College and Hospital during the period of January to June 2016. Data were collected through face to face interview.  </p><p class="abstract"><strong>Results:</strong> The mean age of the respondents was 43.42 years and the mean monthly income of the respondents was 17409.09 taka. Little above nine-tenths (91.7%) of the respondents were Muslim and the majority of the respondents (47.9%) were living in pacca house. More than seven-tenths (73.6%) of the respondents were married and over 35% of the respondents were illiterate. Among the respondents about 42.1% of them had pressure type of incontinence, followed by mixed incontinence (27.3%). Over 65% had some complication during delivery and little above six-tenths (61.2%) had gynecological problems.</p><p><strong>Conclusions:</strong> Female urinary incontinence is a frequent and a major embarrassing healthcare problem in Bangladesh. Patients who had complications during labor, having multipara, recurrent UTI, gynecological problem such as uterine prolapse, urethral injury, had high percentage of urinary incontinence. Patients with urinary incontinence should be encouraged to seek treatment early as the problem can be treated. </p>

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