scholarly journals Is Dental Panoramic Radiography Reliable to Assess Position of Bicortical Fixation Screws in Mandibular Fractures? Case Report

2021 ◽  
Vol 15 (1) ◽  
pp. 672-673
Author(s):  
Ahmad Albassal ◽  
Nuraldeen Maher Al-Khanati ◽  
Munir Harfouch
Keyword(s):  
Lower Cost ◽  
Panoramic Radiography ◽  
Panoramic Radiograph ◽  
Mandibular Fractures ◽  
Radiographic Findings ◽  
Extreme Caution ◽  
Treatment Plans ◽  
Diagnostic Thinking ◽  
Diagnostic Changes

Background: Panoramic radiography is widely used as a diagnostic tool before oral surgeries and can be considered the foremost follow-up image after. It provides a broad observation of the maxillomandibular complex at a lower cost and radiation dose. But cone-beam computed tomography (CBCT) examination, after panoramic radiograph evaluation, can produce a change in the diagnostic thinking of maxillofacial surgeons leading to alterations in treatment plans. Objective: We aim to report a case with incidentally discovered radiographic findings where diagnostic changes were caused by switching from panoramic to CBCT imaging. Conclusion: Radiographic assessment of the position and angulation of screws by panoramic x-ray should be approached with extreme caution. The image of choice is CBCT if nerve injury is suspected.

scholarly journals An Ambiguous Entity-A Case Report

2021 ◽  
Vol 7 (2) ◽  
pp. 01-06
Author(s):  
Rinisha Sinha
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Bone Regeneration ◽  
Male Patient ◽  
Panoramic Radiograph ◽  
Guided Bone Regeneration ◽  
Radiographic Findings ◽  
Management Method

Purpose: This report discusses the literature review in comparison with the current case’s findings in detail as well as the indications for guided bone regeneration to be done in the same patient after a follow-up of 6 months. We reported this case due to its uniqueness in terms of the etiology, clinical and radiographic findings, and management. Method: We account a case of 24-year-old male patient who reported significant swelling in the upper right region of the mouth that slowly increased to the present size. On evaluating the panoramic radiograph, there was well-defined radiolucency seen. Result: Complete enucleation of the cyst along with the extraction of the involved teeth was done and the healing was satisfactory.

Efficacy of Panoramic Radiography in Dental Diagnosis and Treatment Planning

1989 ◽  
Vol 68 (5) ◽  
pp. 810-812 ◽  
Author(s):  
M.L. Kantor ◽  
B.A. Slome
Keyword(s):  
Clinical Examination ◽  
Panoramic Radiography ◽  
Diagnostic Yield ◽  
Treatment Plan ◽  
Panoramic Radiograph ◽  
Diagnostic Assessment ◽  
Final Treatment ◽  
Treatment Plans ◽  
Diagnostic Work ◽  
Work Up

We compared treatment decisions based on a clinical examination alone with decisions based on an examination plus a panoramic radiograph to determine whether the panoramic radiograph increased the diagnostic yield and consequently affected treatment. Provisional treatment plans, based on a screening clinical examination alone (n = 33), or on a screening clinical examination plus panoramic radiograph (n = 43), were compared with final treatment plans based on a complete diagnostic assessment (including all necessary radiographs). For this analysis, the final treatment plan was considered correct and used as the gold standard. The two groups used in the comparison were equivalent in age, gender, and final treatment plan needs. The availability of a panoramic radiograph did not improve the accuracy with which provisional treatment plans predicted the number of teeth requiring composites, amalgams, crowns, or extraction, nor did it improve the accuracy of the assessment of the periodontal status (Wilcoxon rank sum, alpha = 0.05). The proportion of patients who had an intra-oral full-mouth series as part of the complete diagnostic work-up was essentially the same for both groups (58% and 60%, respectively); the availability of the panoramic film did not reduce the need for full-mouth series radiographs for the development of the final treatment plans.

scholarly journals Automatic Detection of Mandibular Fractures in Panoramic Radiographs Using Deep Learning

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 933
Author(s):  
Dong-Min Son ◽  
Yeong-Ah Yoon ◽  
Hyuk-Ju Kwon ◽  
Chang-Hyeon An ◽  
Sung-Hak Lee
Keyword(s):  
Deep Learning ◽  
Panoramic Radiography ◽  
Imaging Modality ◽  
Panoramic Radiograph ◽  
Learning System ◽  
Mandibular Fractures ◽  
Detection Accuracy ◽  
Panoramic Radiographs ◽  
Single Scale ◽  
Bounding Boxes

Mandibular fracture is one of the most frequent injuries in oral and maxillo-facial surgery. Radiologists diagnose mandibular fractures using panoramic radiography and cone-beam computed tomography (CBCT). Panoramic radiography is a conventional imaging modality, which is less complicated than CBCT. This paper proposes the diagnosis method of mandibular fractures in a panoramic radiograph based on a deep learning system without the intervention of radiologists. The deep learning system used has a one-stage detection called you only look once (YOLO). To improve detection accuracy, panoramic radiographs as input images are augmented using gamma modulation, multi-bounding boxes, single-scale luminance adaptation transform, and multi-scale luminance adaptation transform methods. Our results showed better detection performance than the conventional method using YOLO-based deep learning. Hence, it will be helpful for radiologists to double-check the diagnosis of mandibular fractures.

Follow-up of Osteomyelitis of Infants with Systemic Serum Parameters and Bone Scintigraphy

1996 ◽  
Vol 35 (04) ◽  
pp. 116-121 ◽  
Author(s):  
G. E Fueger ◽  
M. Vejda ◽  
R. M. Aigner
Keyword(s):  
Bone Scintigraphy ◽  
Antibiotic Treatment ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Radiographic Findings ◽  
Serum Parameters ◽  
Wbc Count ◽  
Differential White Blood Cell

Summary Aim: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). Methods: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. Results: CRP was the most effective serum parameter for follow- up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. Conclusion: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.

scholarly journals Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review

2021 ◽  
pp. 219256822098227
Author(s):  
Max J. Scheyerer ◽  
Ulrich J. A. Spiegl ◽  
Sebastian Grueninger ◽  
Frank Hartmann ◽  
Sebastian Katscher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Treatment Failure ◽  
Patient Specific ◽  
Mineral Density ◽  
Radiographic Findings ◽  
Specific Risk ◽  
Fracture Development ◽  
Predict Treatment Failure

Study Design: Systematic review. Objectives: Osteoporosis is one of the most common diseases of the elderly, whereby vertebral body fractures are in many cases the first manifestation. Even today, the consequences for patients are underestimated. Therefore, early identification of therapy failures is essential. In this context, the aim of the present systematic review was to evaluate the current literature with respect to clinical and radiographic findings that might predict treatment failure. Methods: We conducted a comprehensive, systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist and algorithm. Results: After the literature search, 724 potentially eligible investigations were identified. In total, 24 studies with 3044 participants and a mean follow-up of 11 months (range 6-27.5 months) were included. Patient-specific risk factors were age >73 years, bone mineral density with a t-score <−2.95, BMI >23 and a modified frailty index >2.5. The following radiological and fracture-specific risk factors could be identified: involvement of the posterior wall, initial height loss, midportion type fracture, development of an intravertebral cleft, fracture at the thoracolumbar junction, fracture involvement of both endplates, different morphological types of fractures, and specific MRI findings. Further, a correlation between sagittal spinal imbalance and treatment failure could be demonstrated. Conclusion: In conclusion, this systematic review identified various factors that predict treatment failure in conservatively treated osteoporotic fractures. In these cases, additional treatment options and surgical treatment strategies should be considered in addition to follow-up examinations.

scholarly journals Clinical and Radiographic Findings of Septic Physitis in Foals

VCOT Open ◽  
2020 ◽  
Vol 03 (02) ◽  
pp. e134-e139
Author(s):  
David G. Suarez-Fuentes ◽  
Dane M. Tatarniuk
Keyword(s):  
Medical Records ◽  
Radiographic Feature ◽  
Radiographic Findings ◽  
Radiographic Features

AbstractThe objective of this review is to detail the clinical and radiographic features of septic physitis in foals. Medical records were evaluated from 2008 to 2018 of cases that had septic physitis based on a combination of clinical and radiographic findings. Ten foals were diagnosed with septic physitis. In 8 of 10 foals, presence of a discrete, focal, irregular radiolucency centred on the physis and extending into the epiphysis and metaphysis was present. In the remaining two foals, subtle irregularity and diffuse radiolucency along the length of the physis was present. Three foals were able to later perform athletic function and two were sound but not in training (mean follow-up = 12 months). Overall, a distinguishing radiographic feature of septic physitis in foals is the presence of a focal radiolucency centred on the physis which is associated with the epiphysis and metaphysis consistent with osteolysis.

Plafond Malreduction and Talar Dome Impaction Accelerates Arthrosis After Supination-Adduction Ankle Fracture

2021 ◽  
pp. 107110072110060
Author(s):  
Michael F. Githens ◽  
Malcolm R. DeBaun ◽  
Kimberly A Jacobsen ◽  
Hunter Ross ◽  
Reza Firoozabadi ◽  
...  
Keyword(s):  
Case Series ◽  
High Energy ◽  
Ankle Fractures ◽  
Posttraumatic Arthritis ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Posttraumatic Arthrosis ◽  
Patient Reported

Background: Supination-adduction (SAD) type II ankle fractures can have medial tibial plafond and talar body impaction. Factors associated with the development of posttraumatic arthritis can be intrinsic to the injury pattern or mitigated by the surgeon. We hypothesize that plafond malreducton and talar body impaction is associated with early posttraumatic arthrosis. Methods: A retrospective cohort of skeletally mature patients with SAD ankle fractures at 2 level 1 academic trauma centers who underwent operative fixation were identified. Patients with a minimum of 1-year follow-up were included. The presence of articular impaction identified on CT scan was recorded and the quality of reduction on final intraoperative radiographs was assessed. The primary outcome was radiographic ankle arthrosis (Kellgren-Lawrence 3 or 4), and postoperative complications were documented. Results: A total of 175 SAD ankle fractures were identified during a 10-year period; 79 patients with 1-year follow-up met inclusion criteria. The majority of injuries resulted from a high-energy mechanism. Articular impaction was present in 73% of injuries, and 23% of all patients had radiographic arthrosis (Kellgren-Lawrence 3 or 4) at final follow-up. Articular malreduction, defined by either a gap or step >2 mm, was significantly associated with development of arthrosis. Early treatment failure, infection, and nonunion was rare in this series. Conclusion: Malreduction of articular impaction in SAD ankle fractures is associated with early posttraumatic arthrosis. Recognition and anatomic restoration with stable fixation of articular impaction appears to mitigate risk of posttraumatic arthrosis. Investigations correlating postoperative and long-term radiographic findings to patient-reported outcomes after operative treatment of SAD ankle fractures are warranted. Level of Evidence: Level IV, retrospective case series.

Willingness to Travel for Cellular Therapy: The Influence of Follow-Up Care Location, Oncologist Continuity, and Race

2021 ◽  
pp. OP.21.00312
Author(s):  
Zachary A. K. Frosch ◽  
Esin C. Namoglu ◽  
Nandita Mitra ◽  
Daniel J. Landsburg ◽  
Sunita D. Nasta ◽  
...  
Keyword(s):  
Travel Time ◽  
Cellular Therapy ◽  
Treatment Plan ◽  
Admission Rate ◽  
B Cell Lymphoma ◽  
Travel Times ◽  
Importance Weights ◽  
Follow Up Care ◽  
Treatment Plans

PURPOSE Patients weigh competing priorities when deciding whether to travel to a cellular therapy center for treatment. We conducted a choice-based conjoint analysis to determine the relative value they place on clinical factors, oncologist continuity, and travel time under different post-treatment follow-up arrangements. We also evaluated for differences in preferences by sociodemographic factors. METHODS We administered a survey in which patients with diffuse large B-cell lymphoma selected treatment plans between pairs of hypothetical options that varied in travel time, follow-up arrangement, oncologist continuity, 2-year overall survival, and intensive care unit admission rate. We determined importance weights (which represent attributes' value to participants) using generalized estimating equations. RESULTS Three hundred and two patients (62%) responded. When all follow-up care was at the center providing treatment, plans requiring longer travel times were less attractive ( v 30 minutes, importance weights [95% CI] of –0.54 [–0.80 to –0.27], –0.57 [–0.84 to –0.29], and –0.17 [–0.49 to 0.14] for 60, 90, and 120 minutes). However, the negative impact of travel on treatment plan choice was mitigated by offering shared follow-up (importance weights [95% CI] of 0.63 [0.33 to 0.93], 0.32 [0.08 to 0.57], and 0.26 [0.04 to 0.47] at 60, 90, and 120 minutes). Black participants were less likely to choose plans requiring longer travel, regardless of follow-up arrangement, as indicated by lower value importance weights for longer travel times. CONCLUSION Reducing travel burden through shared follow-up may increase patients' willingness to travel to receive cellular therapies, but additional measures are required to facilitate equitable access.

scholarly journals Diagnostic accuracy of imaging brain vesicular monoamine transporter type 2 (VMAT2) in clinically uncertain parkinsonian syndrome (CUPS): a 3-year follow-up study in community patients

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e025533 ◽  
Author(s):  
San San Xu ◽  
Paschal K Alexander ◽  
Yenni Lie ◽  
Vincent Dore ◽  
Svetlana Bozinovski ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Diagnosis ◽  
Pet Scan ◽  
Vesicular Monoamine Transporter ◽  
Monoamine Transporter ◽  
Rubral Tremor ◽  
Diagnostic Changes ◽  
Community Patients

ObjectivesTo further validate the diagnostic utility of 18F-AV-133 vesicular monoamine transporter type 2 (VMAT2) positron emission tomography (PET) in patients with clinically uncertain parkinsonian syndromes (CUPS) by comparison to clinical diagnosis at 3 years follow-up.Design, setting and participantsIn a previous study, we reported that 18F-AV-133 PET in community patients with CUPS changed diagnosis and management and increased diagnostic confidence. The current diagnosis of this cohort was obtained from the patient and treating specialist and compared with the diagnosis suggested 3 years earlier by the 18F-AV-133 PET. A second 18F-AV-133 PET was available in those with a discordant or inconclusive final diagnosis.Study outcome measuresThe primary end point was the proportion of patients who had a follow-up clinical diagnosis, which was concordant with their initial 18F-AV-133 PET scan. Secondary end points were the proportion of patients who had the same diagnosis at follow-up as that reached after the initial scan and the stability of diagnostic changes made after the first scan.Results81 of the 85 patients previously recruited to the CUPS study had follow-up of which 79 had a clinical diagnosis and 2 remained CUPS. The diagnosis was in agreement with the initial 18F-AV-133 PET scan result in 74 cases. Five patients had a discordant diagnosis; one patient with rubral tremor had a severely abnormal scan that had worsened when rescanned; four cases with normal initial and repeat scans had a clinical diagnosis of Parkinson’s disease. Two patients with suspected genetic disorders remained classified as CUPS and both had normal scans. In the 24 CUPS cohort patients where 18F-AV-133 PET initially changed diagnosis, this change was supported by follow-up diagnosis in all but the one rubral tremor case.Conclusion18F-AV-133 PET is a useful tool in improving diagnostic accuracy in CUPS providing results and diagnostic changes that remain robust after 3 years follow-up.

scholarly journals Minimally angulated pediatric wrist fractures: Is immobilization without manipulation enough?

CJEM ◽  
2007 ◽  
Vol 9 (01) ◽  
pp. 9-15 ◽  
Author(s):  
Khalid Al-Ansari ◽  
Andrew Howard ◽  
Brian Seeto ◽  
Solina Yoo ◽  
Salma Zaki ◽  
...  
Keyword(s):  
Distal Radius ◽  
Sagittal Plane ◽  
Normal Function ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Post Injury ◽  
Radiographic Findings ◽  
Fractures In Children ◽  
Plaster Immobilization

ABSTRACT Background: Emergency department (ED) manipulation of complete minimally angulated distal radius fractures in children may not be necessary, due to the excellent remodeling potential of these fractures. Objectives: The primary objective of this study was to determine the proportion of minimally angulated distal radius fractures managed in the ED with plaster immobilization that subsequently required manipulation. Our secondary objective was to document, at follow-up, changes in angulation for each wrist fracture. Methods: This retrospective cohort study reviewed consecutive records of all children with bi-cortical minimally angulated (≤15° of angulation in the sagittal plane and ≤0.5 cm of displacement) distal metaphyseal radius fractures, alone or in combination with distal ulnar fracture. Details of treatment, radiographic findings, and clinical outcomes during the subsequent orthopedic follow up were recorded. Results: Of 124 patients included in the analysis, none required manipulation after their ED visit. All but 14 (11.3%) fractures were angulated ≤20° within the follow-up period. Two (1.6%) fractures that were initially angulated ≤15° progressed to 30°–35°, but remodeled within 2 years to nearly perfect anatomic alignment. By 6 weeks post-injury, no patients had clinically apparent deformity and all had normal function. Conclusions: Minimally angulated fractures of the distal metaphyseal radius managed in plaster immobilization without reduction in the ED are unlikely to require future surgical intervention.

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