scholarly journals Hallux valgus measurements using weight-bearing computed tomography: what changes?

2021 ◽  
Vol 15 (3) ◽  
pp. 259-264
Author(s):  
Samuel Braza ◽  
Nacime Salomão Barbachan Mansur ◽  
Vineel Mallavarapu ◽  
Kepler Alencar Mendes de Carvalho ◽  
Kevin Dibbern ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hallux Valgus ◽  
Case Control Study ◽  
Weight Bearing ◽  
Metatarsal Head ◽  
Case Control ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Mean Values ◽  
Control Study

Objective: To assess whether traditional hallux valgus (HV) measurements obtained with conventional radiography (CR) correspond to those obtained with weight-bearing computed tomography (WBCT). Methods: In this retrospective case-control study, 26 HV feet and 20 control feet were analyzed with CR and WBCT. Hallux valgus angle (HVA), intermetatarsal angle (IMA), interphalangeal angle (IPA), distal metatarsal articular angle (DMAA), sesamoid station (SS), and first metatarsal head shape were measured. Chi-square tests were used to compare hallux valgus and control patients. T-tests were used to compare CR and WBCT. P-values less than 0.05 were considered significant. Results: WBCT was capable of discriminating patients with HV from controls, showing higher mean values for HV patients than controls in HVA (35.29 and 9.02, p < 0.001), IMA (16.01 and 10.01, p < 0.001), and DMAA (18.90 and 4.10, p < 0.001). When comparing the two methods, differences were not significant between CR and WBCT measurements in HVA (-0.84, p = 0.79), IMA (-0.93, p = 0.39), IPA (1.53, p = 0.09), or SS (p = 0.40), but were significant for DMAA (13.43, p < .0001). CR analysis yielded varied metatarsal head shapes, while all WBCT shape classifications were round.  Conclusion: Unidimensional HV measurements were similar between WBCT and CR, while more three-dimensional findings were not. CR may be used to assess the axial aspects of HV, but multidimensional aspects of the deformity may not be accurately assessed with plain radiographs. Level of Evidence III; Therapeutic Studies; Retrospective Case-Control Study.

An intact bony tympanic facial canal does not protect from secondary facial paresis in adult acute otitis media

2020 ◽  
Vol 134 (5) ◽  
pp. 409-414
Author(s):  
C Meerwein ◽  
S Pazahr ◽  
T M Stadler ◽  
N Nierobisch ◽  
A Dalbert ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Otitis Media ◽  
Case Control Study ◽  
Acute Otitis Media ◽  
Case Control ◽  
Facial Canal ◽  
Facial Paresis ◽  
Retrospective Case ◽  
Control Study

AbstractObjectiveTo investigate the prevalence of bony dehiscence in the tympanic facial canal in patients with acute otitis media with facial paresis compared to those without facial paresis.MethodA retrospective case–control study was conducted on acute otitis media patients with facial paresis undergoing high-resolution temporal bone computed tomography.ResultsForty-eight patients were included (24 per group). Definitive determination of the presence of a bony dehiscence was possible in 44 out of 48 patients (91.7 per cent). Prevalence of bony dehiscence in acute otitis media patients with facial paresis was not different from that in acute otitis media patients without facial paresis (p = 0.21). Presence of a bony dehiscence was associated with a positive predictive value of 66.7 per cent in regard to development of facial paresis. However, an intact bony tympanic facial canal did not prevent facial paresis in 44.8 per cent of cases (95 per cent confidence interval = 34.6–55.6).ConclusionPrevalence of bony dehiscence in acute otitis media patients with facial paresis did not differ from that in acute otitis media patients without facial paresis. An intact tympanic bony facial canal does not protect from facial paresis development.

scholarly journals Three-Dimensional Weightbearing Assessment of the First Ray in Hallux Valgus: A Case-Control Study

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0005
Author(s):  
Francois Lintz ◽  
Alessio Bernasconi ◽  
Celine Fernando ◽  
Matthew Welck ◽  
Cesar de Cesar Netto
Keyword(s):  
Hallux Valgus ◽  
Case Control Study ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Case Control ◽  
Rotational Deformity ◽  
Intermetatarsal Angle ◽  
First Ray ◽  
3D Architecture ◽  
Control Study

Category: Bunion Introduction/Purpose: Coronal plane rotational deformity of the first ray has been implicated with the developmental pathologic process of hallux valgus (HV). Weight Bearing CT (WBCT) is an imaging technology that can support the assessment of this complex three-dimensional (3D) deformity. The objective of the study was to analyze the 3D architecture of the first ray in patients with HV when compared to controls using WBCT images and a 3D biometric algorithm analyzing the deformity in all three planes. We hypothesized that WBCT would confirm the rotational deformity in HV patients, and that the 3D algorithm would demonstrate increased specificity and sensitivity for the pathology when compared to traditional two-dimensional (2D) HV measurements such as the 1-2 intermetatarsal angle. Methods: Retrospective case-control study, ethics committee approved. Twenty-one feet of patients with clinically symptomatic HV and 20 feet of asymptomatic controls were included. Exclusion criteria applied were previous trauma or surgery affecting first ray or forefoot morphology. All patients were assessed using WBCT. First ray 3D coordinates (x, y, z) were harvested including: center-points of the heads and bases of the first and second metatarsals, center-point of the medial and lateral sesamoids, distal condyles of the proximal phalanx (PP) of the first toe, as well as the medial and lateral borders of the first metatarsal head and diaphysis. The 2D measurements (dorsoplantar 1-2 intermetatarsal (IMA) and metatarsophalangeal (MPA) angles) were obtained using digitally reconstructed radiographs (DRR). The Sesamoid Rotation Angle (SRA) was measured in the coronal plane. Using these coordinates, all 2D, 3D axes, distances, angulations and 3D biometric for HV (HV-3DB) could be calculated. Results: Mean ages were respectively 62.2y in the HV group and 48.8y in the control group (p<0.05). In 2D, the mean IMA and MPA for HV/controls were respectively 14.9/9.3 (p<0.001) and 30.1/13.1 (p<0.001). The SRA were respectively 29.1/7.1 (p<0.001). We found an almost perfect positive correlation between P1 rotation and sesamoid rotation, good correlation between IMA, MPA and SRA angles. There was poor correlation between pronation angles of the 1st phalanx and the 1st metatarsal. The 3D biometric algorithm combining IMA, MPA and SRA had a sensitivity of 95% and a specificity of 95.2% for the diagnosis of HV, compared to 90%/85.6% for the IMA and 90%/90.5% for the SRA. Conclusion: This original study confirmed our hypotheses. Weight Bearing CT efficiently analyzed the 3D architecture of the 1st ray in HV patients compared to asymptomatic controls. We concur with previous findings described in the literature concerning increased pronation of the 1st ray in HV. A novel biometric for HV using a specific multidimensional algorithm which combined IMA, HVA and SRA in a single 3D measurement, demonstrated increased sensitivity and specificity compared to the conventional 2D 1-2 intermetatarsal angle for the diagnosis of HV.

Gout As a Predictor of Total Knee Arthroplasty Outcomes and Costs

2020 ◽  
Author(s):  
Samuel Rosas ◽  
Andrey Zuskov ◽  
Tianyi David Luo ◽  
Martin W. Roche ◽  
Cynthia L. Emory ◽  
...  
Keyword(s):  
Case Control Study ◽  
Population Level ◽  
The United States ◽  
Case Control ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Post Surgery ◽  
Medicare Patients ◽  
Total Knee ◽  
Control Study

AbstractGout is the most common inflammatory arthritis and affects approximately 4% of the U.S. population. As the prevalence of gout and the number of total knee arthroplasties (TKAs) performed continue to increase, the literature on TKA in patients with gout remains scant. The purpose of this study was to evaluate the outcomes of patients with gout following TKA at a population level, that is, how patient with gout fair after TKA. We hypothesized that patients with gout have higher rates of complications and higher costs compared with controls. A case–control study was designed to evaluate two cohorts of Medicare patients who underwent TKA whose only distinguishing feature was the presence or absence of gout. Matching was performed to decrease confounding at a 1:1 ratio based on age, gender, and Charlson comorbidity index (CCI), (10-year survival predictor). The Medicare standard analytical files were queried through International Classification of Disease and current procedural terminology codes. A total of 15,238 patients were evaluated with 7,619 in each cohort. There were no age, gender, or CCI differences and 57.4% were females. Day of surgery and 90-day post-surgery costs were both significantly greater in those with gout (p < 0.001 for both). Multivariate analysis revealed that gout patients had increased odds of infection (odds ratio [OR] 1.229, p = 0.019), cardiac arrest (OR 1.354, p = 0.002), pneumonia (OR 1.161, p < 0.001), hematoma (OR 1.204, p = 0.002), and development of capsulitis (OR 1.208, p = 0.012). Nonetheless these patients had a decreased risk of pulmonary emboli (OR 0.835, p = 0.016). Our results support our hypothesis that patients with gout have higher rates of postoperative complications and increased day of surgery and 90-day costs of care after TKA. Given the high prevalence of gout in the United States, additional study on the utility of preoperative gout optimization for TKA patients is warranted. The level of evidence of this study is III, and it is a retrospective case–control study.

scholarly journals Evaluation of a Weightbearing CT Artificial Intelligence-based Automatic Measurement for Hallux Valgus: A Case-Control Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0003
Author(s):  
Jonathan Day ◽  
Francois Lintz ◽  
Martinus Richter ◽  
Céline Fernando ◽  
Scott J. Ellis ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Hallux Valgus ◽  
Case Control Study ◽  
Weight Bearing ◽  
Intraclass Correlation ◽  
Automatic Measurement ◽  
Case Control ◽  
Foot And Ankle ◽  
Beta Version ◽  
Control Study

Category: Bunion; Other Introduction/Purpose: Cone Beam Weight Bearing CT (WBCT) is gaining traction, particularly in the foot and ankle, due to the ability to perform natural stance weight bearing 3D scans. However, the resulting wealth of 3D data renders daily clinical use time consuming. Therefore, reliable automatic measurements are indispensable in order to make best use of the technology. The aim of this study was to evaluate a beta-version WBCT artificial intelligence (AI) automatic measurement system for the M1-M2 intermetatarsal angle (IMA), which is applicable in the absence of metallic hardware in the foot and ankle. We hypothesized that automatic measurements would correlate well with human measurements, and that software reproducibility would be better and close to perfect compared to manual measurements. Methods: In this retrospective case-control study, 90 feet were included from patients who underwent WBCT scans during routine follow up: 44 feet (90.9% female, mean age 54 years) with symptomatic hallux valgus (HV), 46 controls (76.1% female, mean age 49 years). Patients were excluded if they had history of surgery or trauma involving the first or second metatarsals, hallux rigidus, or presence of metal in their foot/ankle. IMA was measured manually on Digitally Reconstructed Radiographs (DRR IMA) and automatically with AI software producing auto 2D (ground plane projection) and 3D (multiplanar) measurements. Each IMA DRR was measured by two independent raters twice to calculate intraclass correlation coefficients (ICCs). To assess intra- software reliability, AI software measurements were made twice on each dataset. Manual and automatic measurements were compared between HV and control groups. Failures of the AI software to produce a measurement were recorded. Results: Mean values for controls were 8.6° +-1.8° (range, 5°-14°) for the manually measured DRR IMA, 9.3° +-2.8° (range, 3°- 17°) for auto 2D, and 9.2° +-2.6° (range, 3°-16°) for auto 3D IMA measurements. Compared to controls, HV patients demonstrated significantly increased IMA (p<0.0001): 14.2° +-2.7° (range, 8°-21°) for the manually measured DRR IMA, 15.4°+- 4.4° (range, 8°-26°) for auto 2D, and 15.1° +-4.1° (range 8°-28°) for auto 3D IMA measurements. There were strong correlations (r=0.75 and r=0.80) between manual and auto 2D and 3D measurements. Intraobserver and interobserver ICCs for DRR IMA were 0.96 and 0.90, respectively, and the intra-software ICCs for the AI were near 1.0 for both auto 2D and auto 3D IMA. The AI software failed in 32.3% cases. Conclusion: Our results demonstrated strong correlation between a WBCT Artificial Intelligence based automatic measurement for IMA with human measurements, with the ability to distinguish HV from control with close to 100% repeatability. However, the number of failures was still high due to the early stage beta-version of the algorithm tested. While these early results are promising, further developments are warranted in order to improve usability of this tool in daily practice, especially in the presence of metal hardware. [Figure: see text]

Abdominal Fat Accumulation, as Measured by Computed Tomography, Increases the Risk of Ischemic Colitis: A Retrospective Case–Control Study

2015 ◽  
Vol 60 (7) ◽  
pp. 2104-2111 ◽  
Author(s):  
Tomonori Aoki ◽  
Naoyoshi Nagata ◽  
Kayo Sakamoto ◽  
Tomohiro Arai ◽  
Ryota Niikura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ischemic Colitis ◽  
Case Control Study ◽  
Case Control ◽  
Abdominal Fat ◽  
Retrospective Case ◽  
Fat Accumulation ◽  
Control Study

scholarly journals Salivary Metabolic Hormones as Biomarkers of Childhood Obesity

2021 ◽  
Author(s):  
Shiny Lizia Manohar ◽  
Hemamalini Arambakkam Janardhanam ◽  
Latha Ravichandran
Keyword(s):  
Childhood Obesity ◽  
Case Control Study ◽  
Case Control ◽  
Obese Children ◽  
Level Of Evidence ◽  
Mean Values ◽  
Metabolic Hormones ◽  
Obesity Research ◽  
The Mean ◽  
Control Study

Abstract PurposeObesity is a major threat to the health and development of children. While hormones in serum samples have been extensively investigated in childhood obesity research, our study attempts to explore salivary metabolic hormones as biomarkers of childhood obesity.MethodsObese (n=83) and non-obese (n=83) school children aged 6-11 years were recruited as cases and controls, respectively, for this case-control study. Salivary concentrations of the hormones, Ghrelin, Leptin, Adiponectin and Insulin were assessed and compared between obese and non-obese children to evaluate their role in childhood obesity.Results The mean ghrelin (1.69 ± 0.38) and adiponectin (95627.56 ± 64915.04) levels of the non-obese children were higher than the mean values of the obese, while the mean values of the hormones leptin (265.95 ± 83.16) and insulin (224.56 ± 184.86) were found to be higher among the obese. Higher levels of the hormones insulin (OR: 1.09; 95% CI: 1.05-1.12) and leptin (OR: 1.03; 95% CI: 1.02-1.04) posed higher risks for childhood obesity, followed by adiponectin, which was found to be lower among the cases (OR: 0.99; 95% CI: 0.99995-0.99998) which increased the risk of childhood obesity.ConclusionThis study demonstrates the efficacy of saliva as a promising non-invasive tool in childhood obesity research and highlights the significance of appetite regulatory hormones as biomarkers of childhood obesity.Level of evidenceLevel III, Case-control study.

Synchronous microsurgical anastomosis in complex replantation surgery

2018 ◽  
Vol 43 (10) ◽  
pp. 1044-1049 ◽  
Author(s):  
Szu-Han Wang ◽  
Chung-Chen Hsu ◽  
Chieh-Han John Tzou ◽  
Ching-Hsuan Hu
Keyword(s):  
Case Control Study ◽  
Operation Time ◽  
Case Control ◽  
The Other ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Microsurgical Technique ◽  
Total Operation Time ◽  
The Mean ◽  
Control Study

We conducted a retrospective case control study of digital replantations in 16 patients from September 2015 to January 2017. Half of the patients were treated by a synchronous microsurgical technique and the other half underwent conventional micro-anastomoses. The total time for anastomoses, total operation time and survival of digits were the major endpoints in this study. The number of digits replanted and the anastomosis method had significant effects on total anastomosis time. The mean anastomosis time for each digit was 46 min and 70 min in the synchronous and conventional groups, respectively, a 34% reduction in anastomosis time in the synchronous group when compared with the conventional group. Patency rates were 87% (13/15) of all the digits replanted in each group. Level of evidence: IV

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