scholarly journals Validation of the ReXSPA (Reductive X-ray Score for Psoriatic Arthritis) index in patients with Psoriatic Arthritis of the RAPSODIA cohort

2020 ◽  
pp. 10-17
Author(s):  
Carolina Isnardi ◽  
Fernando Dal Para ◽  
Eduardo Scheines ◽  
Marina Fornaro ◽  
Osvaldo Cerda ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Duration ◽  
Joint Damage ◽  
Cross Sectional Study ◽  
X Rays ◽  
Cross Sectional ◽  
X Ray ◽  
Anteroposterior View ◽  
Hands And Feet ◽  
Bone Proliferation

There are many scores available to measure radiographic joint damage in patients with Psoriatic Arthritis (PsA), but most of them were developed for Rheumatoid Arhtritis and then modified for PsA. These scores do not evaluate juxtaarticular bone proliferation. The aim of our study was to validate the Reductive X-Ray Score for Psoriatic Arthritis (ReXSPA), which was recently developed to be used in observational cohorts. Methods: A cross-sectional study was carried out. Consecutive patients ≥18 years old with sA according to CASPAR criteria were included. All patients underwent X-rays of the hands and feet in an anteroposterior view. Two blind readers for the clinical characteristics of the patients and previously trained, scored them by Sharp van der Heijde modified for PsA (PsA-SvdH) and ReXSPA indexes. Time to read and calculate both scores were measured. Results: A total of 66 patients were included, half of them were female, median (m) disease duration of 8 years (IQR: 4-14.3). 132 X-Rays were scored according to PsA-SvdH [m 35 (IQR: 16.3-72.5)] and ReXSPA [m 22 (IQR: 7-46.3)]. Time to read was significantly shorter for ReXSPA than PsA-SvdH [mean 5.8±2.1 vs mean 7.5±2.5 minutes, p<0.0001], as well as, time to calculate them [mean 26.5±14.7 vs mean 55.3±38.3 seconds, p<0.0001]. The correlation between both indexes was excellent (Rho: 0.93). In the multivariate analysis, using both radiographic scores as dependent variable, association of each of the indices with disease duration was observed, and ReXSPA also had association with age. Conclusion: The ReXSPA index has shown validity and a very good correlation with PsA-SvdH. It is quicker to read and to calculate than PsA-SvdH. Subsequent longitudinal evalua-tions will allow demonstrating the validity of these findings.

An investigation into the extent of Lodox imaging usage in South Africa: Radiographer’s perspective

2021 ◽  
Author(s):  
Julius Muchui Thambura ◽  
Jeanette G.E du Plessis ◽  
Cheryl M E McCrindle ◽  
Tanita Cronje
Keyword(s):  
South Africa ◽  
Waiting Times ◽  
Cross Sectional Study ◽  
Trauma Patients ◽  
X Rays ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Imaging Protocol ◽  
X Ray ◽  
X Ray Imaging

Abstract Introduction Anecdotal evidence suggests that medical professionals in trauma units are requesting additional regional images using conventional x-ray systems, even after trauma patients have undergone full-body Lodox scans. Patients are then exposed to additional radiation, additional waiting times and an increased medical bill. This study aimed at investigating the extent to which Lodox systems were used in trauma units (n=28) in South Africa. Method In this descriptive cross-sectional study, the researcher invited one radiographer from the 28 hospitals in South Africa that use Lodox systems. Radiographers who were most experienced in using the Lodox system completed an online questionnaire. Results Twenty (71.43% n=20) out of twenty-eight radiographers responded. Most hospitals (90%, n=18) were referring patients for additional conventional x-ray images. Radiographers indicated that conventional x-rays were requested for the chest (27.80%, 10/36), the abdomen (16.67%, 6/36), the spine (13.89%, 5/36) and the extremities and skull (19.44%, 7/36). Additionally, radiographers reported using Lodox to perform procedures and examinations usually performed on conventional x-ray systems when conventional x-ray systems were not operational. Conclusion Currently, it is not clear if the use of conventional x-ray imaging following Lodox is necessary, but the results suggest that the practice is commonplace, with healthcare workers in most hospitals (90%, n=18) requesting additional x-ray imaging. The researcher thus recommends that an imaging protocol for Lodox imaging systems should be developed to guide the referral of the patients for further imaging.

scholarly journals SAT0562 ADDITIONAL BENEFIT OF ULTRASOUND TO THE EARLY DIAGNOSIS OF PSORIATIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1239.2-1239
Author(s):  
Y. Geng ◽  
A. Cope ◽  
S. Subesinghe ◽  
J. Galloway ◽  
Z. Zhang ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Bone Formation ◽  
Physical Examination ◽  
Disease Duration ◽  
Life Quality ◽  
Joint Inflammation ◽  
New Bone Formation ◽  
Cross Sectional ◽  
X Ray ◽  
Nail Change

Background:Being an inflammatory disease of joint, spine or enthesis is the premise of the CASPAR diagnostic criteria for psoriatic arthritis (PsA). Traditionally, the assessment of local inflammation in joint, enthesis and tendon relies on physical examinations. But multiple studies have demonstrated that ultrasound (US) is capable of detecting subclinical inflammation as well as non-inflammatory lesions.Objectives:To compare the capabilities of physical examination and US findings in the diagnosis of early PsA, and further identify the US features which are most valuable for the diagnosis of PsA.Methods:66 patients with suspected PsA or early PsA (disease duration< 2 years) due to psoriasis with joint pain or seronegative inflammatory arthritis were enrolled and further assessed by both physical examination and ultrasound (US).Tender and swollen joint counts based on 68/66 joints, tender tendons, enthesitis (14 entheses) and dactylitis (20 digits) count were collected by physical examination. Abnormalities of peripheral joints, entheses and tendons were also evaluated by US. New bone formation was evaluated by hand X-ray. The diagnostic capacity of CASPAR criteria based on US and based on physical examination were compared. The diagnosis value of US features as well as clinical characteristics were analyzed. The clinical diagnosis of PsA by the expert panel was taken as the standard.Results:CASPAR criteria based on US showed a higher specificity than those based on physical examination (96.7% vs. 53.3%) with a bit decrease of sensitivity (91.7% vs. 97.2%). 36 patients were eventually diagnosed as PsA and 30 patients were non-PsA. Gender distribution, mean age and disease duration were equally distributed in two groups of patients. Dermatology Life Quality Index (DLQI) was higher in PsA patients than non-PsA patients. Significantly more patients had nail change and new bone formation on hand X-ray in PsA patients than in non-PsA patients (69.4% vs. 26.7%,P=0.001 and 66.7% vs. 13.3%,P<0.001 respectively). Significantly higher frequencies of synovitis/synovium hypertrophy, tenosynovitis and enthesitis were found in PsA patients than non-PsA patients (58.3% vs 20.0%,P=0.002, 38.9% vs 3.3%,P=0.001 and 52.8% vs 13.3%,P=0.002, respectively). Logistic regression analysis showed that nail change (OR=25.1, P=0.007), new bone formation on X-ray (OR=33.1, P=0.003), tenosynovitis on US (OR=149.1, P=0.003) and enthesitis on US (OR=39.2, P=0.008) were independent risk factors for predicting the diagnosis of PsA.Conclusion:US increased the specificity of CASPAR criteria compared with physical examination. Combined nail change, new bone formation on X-ray, tenosynovitis and enthesitis on US improved the diagnosis of early PsA.References:[1]Polachek A, Cook R, Chandran V, et al. The association between sonographic enthesitis and radiographic damage in psoriatic arthritis. Arthritis Res Ther 2017; 19(1): 189.[2]Faustini F, Simon D, Oliveira I, et al. Subclinical joint inflammation in patients with psoriasis without concomitant psoriatic arthritis: a cross-sectional and longitudinal analysis. Ann Rheum Dis 2016; 75(12): 2068-74.Acknowledgments:The author thank all the colleagues in the department of Rheumatology of Guy’s hospital.Disclosure of Interests:None declared

scholarly journals CLINICAL SYMPTOMS AND CHEST X-RAY FINDINGS FOR EVALUATION OF CHEST X-RAY IN MANAGEMENT AND PREDICTION OF CLINICAL OUTCOME OF CONFIRM CASES OF COVID-19

2020 ◽  
Vol 70 (6) ◽  
pp. 1847-52
Author(s):  
Khawaja Muhammad Baqir Hassan ◽  
Tathir Baqir Hassan ◽  
Shakil Sarwar ◽  
Irfan Najam Sheen ◽  
Farrukh Islam ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Patient Management ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
X Rays ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray

Objective: To study clinical symptoms and chest X-ray findings for evaluation of chest X-ray in management ofconfirmed cases of COVID-19 and predicting the clinical outcome. Study Design: Cross sectional study. Place and Duration of Study: The departments of Radiology & Medicine of Combined Military Hospital Malir,from Mar to May 2020. Methodology: The sample used in this study consists of 73 patients. All the standard frontal projections of chest X-ray of PCR confirmed COVID-19 patients were studied on computer and findings were noted Results: At the aggregate, the study indicates that there is no Significant Connection in between the clinicalsymptoms, their severity and chest X-ray findings. Conclusion: There is no significant connection found between the severity of clinical symptoms and chest X-rays suggesting that chest X-Ray cannot be a reliable indicator to predict the clinical outcome of the patient and has limited role in management of patient. Clinical assessment is still the main stay of the patient management.

scholarly journals Relationship Between Fatigue and Inflammation, Disease Duration, and Chronic Pain in Psoriatic Arthritis: An Observational DANBIO Registry Study

2019 ◽  
Vol 47 (4) ◽  
pp. 548-552 ◽  
Author(s):  
Marie Skougaard ◽  
Tanja Schjødt Jørgensen ◽  
Signe Rifbjerg-Madsen ◽  
Laura C. Coates ◽  
Alexander Egeberg ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Psoriatic Arthritis ◽  
Disease Duration ◽  
Joint Damage ◽  
Principal Component ◽  
Inflammatory Factors ◽  
Tender Joint Count ◽  
Cross Sectional Survey ◽  
Tender Joint ◽  
Cross Sectional

Objective.Fatigue is one of the most significant symptoms, and an outcome of great importance, in patients with psoriatic arthritis (PsA), but associations between underlying components of fatigue experienced by patients in relation to the disease have been sparsely investigated. The objectives were to describe the degree of fatigue in patients with PsA, and to examine important components associated with fatigue.Methods.We performed a cross-sectional survey including patients registered in the Danish nationwide registry DANBIO from December 2013 to June 2014. Principal component analysis (PCA) was used to identify factors associated with fatigue.Results.A total of 1062 patients with PsA were included in the study. A PCA reduced co-variables into 3 components explaining 63% of fatigue in patients. The first component, contributing to 31% of fatigue, was composed of inflammatory factors including swollen and tender joints, physician’s global assessment, elevated C-reactive protein (CRP), and high Pain Detect Questionnaire (PDQ) score. The second component, contributing to 17% of fatigue, consisted of increasing age and long disease duration. The third component, contributing to 15% of fatigue, consisted of high PDQ score, tender joint count, increasing age, and concomitant low CRP, suggestive of a chronic pain component consisting of central pain sensitization or structural joint damage.Conclusion.Fatigue in patients with PsA may be driven by clinical inflammatory factors, disease duration, and chronic pain in the absence of inflammation.

scholarly journals AB0772 OSTEOPOROSIS AND ITS RELATIONSHIP WITH THE SERUM URIC ACID LEVEL IN PATIENTS WITH PSORIATIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1684.1-1684
Author(s):  
H. H. Gezer ◽  
D. Erdem Gürsoy ◽  
S. Acer Kasman ◽  
N. Öz ◽  
M. T. Duruöz
Keyword(s):  
Bone Mineral Density ◽  
Psoriatic Arthritis ◽  
Bone Mineral ◽  
Disease Duration ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score ◽  
Z Scores ◽  
The Mean

Background:Although osteoporosis is an inherent comorbidity in inflammatory rheumatic disease and the risk of bone loss is high in patients with several rheumatic diseases, evidence is limited in psoriatic arthritis (PsA). One of the most prominent features in PsA is increased serum urate (SU) levels. Due to its antioxidant effects and protective role against osteoporosis, high SU levels are associated with increased bone mineral density (BMD) and reduced bone loss in the healthy population, and in patients with rheumatoid arthritis. However, whether this association is also present in patients with PsA has not been investigated.Objectives:The aim of this study was to evaluate PsA patients with respect to the presence of osteoporosis and its association with SU levels.Methods:This ongoing study included 86 patients (68 female, 18 male) who were diagnosed with PsA according to the CASPAR criteria and had indications for BMD testing according to the National Osteoporosis Foundation. Clinical characteristics including body mass index (BMI), pain VAS, patient global VAS, enthesitis, and tender and swollen joint counts were recorded. Evaluations included the PASI, PsAQoL, and HAQ. Disease activity was assessed using the DAPSA, BASDAI, and MDA. Osteoporosis was defined as a BMD T-score of -2.5 or less and osteopenia as a BMD T-score between -1 and -2.5 (WHO osteoporosis).Results:The mean age of the study group was 55.4 (SD:9.2) years and the mean disease duration was 84.5 (SD:91.6) months. Indicators of secondary osteoporosis were type-1 diabetes mellitus (1%), hyperthyroidism (2.3%), early menopause (<age 40) (8.1%), and chronic liver disease (9.3%). As for the steroid use, the rates of never, previous and current users were 33.7%, 20.9% and 22.1%, respectively. Osteoporosis was found in 9.3% and osteopenia in 33.7% of the patients. A history of vertebral compression fractures or any fracture was present in 20.9% of the patients, half of whom were in postmenopausal. BMD L1-L4T- and Z-scores were lower in female patients (p<0.05). DAPSA remission and MDA rates were 6% and 15%, respectively. Bone mineral density was similar across DAPSA disease activity categories (remission-low-moderate-high) (p>0.05). The frequency of osteoporosis did not differ significantly between patients with DAPSA remission and non-remission (p>0.05). The mean L1-L4T- and Z-scores, and BMD g/cm2were significantly higher in patients with MDA than those without MDA (p<0.05). The mean SU level was 5 (SD:1.3) mg/dl, and 18.6% of the patients had a SU level of 6 mg/dl or higher. There was no significant correlation between SU and BMD (p>0.05). BMI showed a weak correlation with femur total T-score (r=0.244). PASI showed weak inverse correlations with femur neck T-score (r=-0.286) and total femur T-score (r=-0.245). BMD variables showed no correlations with disease duration, acute phase reactants, BASDAI, PsAQoL, and cumulative steroid dose.Conclusion:Patients with PsA did not have an increased prevalence of low BMD despite fractures. Osteoporosis was associated with MDA and the severity of psoriasis, but not with DAPSA, SU level, functional impairment, and quality of life.References:[1]Gulati AM, Michelsen B, Diamantopoulos A, et al. Osteoporosis in psoriatic arthritis: a cross-sectional study of an outpatient clinic population. RMD Open 2018;4: e000631. DOI: 10.1136/rmdopen-2017-000631[2]Han W, Bai X, Wang N, Han L, Sun X, Chen X. Association between lumbar bone mineral density and serum uric acid in postmenopausal women: a cross-sectional study of healthy Chinese population. Arch Osteoporosis 2017; 12:50. DOI: 10.1007/s11657-017-0345-0.Disclosure of Interests:None declared

scholarly journals The Number of Traditional Cardiovascular Risk Factors Is Independently Correlated with Disease Activity in Patients with Psoriatic Arthritis

Medicina ◽  
2020 ◽  
Vol 56 (8) ◽  
pp. 415
Author(s):  
Iván Ferraz-Amaro ◽  
Diana Prieto-Peña ◽  
Natalia Palmou-Fontana ◽  
David Martínez-López ◽  
Laura de Armas-Rillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Smoking Status ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Related Data ◽  
Increased Risk ◽  
Activity Measurements

Background and objectives: Psoriatic arthritis (PsA) is associated with several comorbidities, including among others an increased risk of cardiovascular (CV) disease, atherosclerosis, metabolic syndrome, hypertension dyslipidemia, and diabetes. The purpose of the present study was to determine how the number of CV risk factors correlates with disease related data such as disease activity. Materials and Methods: Cross-sectional study that encompassed 305 patients who fulfilled the CASPAR criteria for PsA were assessed for lipid profile, disease activity measurements, and the presence of six traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, chronic kidney disease, and smoking status). A multivariable regression analysis, adjusted for age, sex, and disease duration, was performed to evaluate if the number of classic CV risk factors was independently related with specific features of the disease, including disease activity. Results: Disease duration was found to be higher, after adjustment for age and sex, in patients with 1 or 2, and 3 or higher CV factors, compared to those patients without CV risk factors. Similarly, DAPSA (Disease Activity in PSoriatic Arthritis score) was found to be independently upregulated in patients with a higher number of CV risk factors. In this sense, as DAPSA score increases the odds ratio (OR) of having 1 or 2 (OR 1.12 (95% confidence interval (CI) 1.03–1.21), p = 0.010), and 3 or higher (OR 1.15 (95% CI 1.04–1.26), p = 0.004) CV factors was significantly higher compared to no CV risk factors category. This was independently found after adjustment for age, sex, and disease duration. Conclusions: PsA patients with a higher number of CV risk factors exhibit an upregulated disease activity compared to those without them. This is independent of disease duration and other demographics factors.

scholarly journals Feeding tube placement: auscultatory method and x-ray agreement

2015 ◽  
Vol 36 (4) ◽  
pp. 98-103 ◽  
Author(s):  
Mariur Gomes Beghetto ◽  
Franciele Anziliero ◽  
Dória Migotto Leães ◽  
Elza Daniel de Mello
Keyword(s):  
Enteral Feeding ◽  
Feeding Tube ◽  
Cross Sectional Study ◽  
Tube Placement ◽  
X Rays ◽  
Cross Sectional ◽  
X Ray ◽  
Clinical Nurses ◽  
Enteral Feeding Tube ◽  
The Right

Objective: to evaluate the correlation between the auscultation test and X-ray when detecting the position of an enteral feeding tube. Methods: cross-sectional study in an intensive care unit in southern Brazil, in 2011. Clinical nurse and nurse researcher performed auscultation test recording the impressions regarding the placement of an enteral feeding tube in 80 patients. A doctor evaluated the X-ray. Kappa coefficient and PABAK reviewed the agreements. Results: The X-ray showed that 70% of the enteral tubes were in the stomach, 27.4% in the duodenum, 1.3% in the esophagus, and 1.3% in the right lung. There was a weak correlation between clinical nurses and nurse researchers (PABAK = 0.054; P = 0.103), clinical nurses and X-rays (PABAK = 0.188; P = 0.111) and nurse researchers and X-rays (PABAK = 0.128; P = 0.107) . The auscultation test did not detect two risk conditions, enteral feeding tube in the esophagus and the bronchus. Conclusion: the auscultation test showed little agreement with the X-ray on the enteral feeding tube location.

scholarly journals Compliance with Radiation Protection Principles in Radiotherapy Units

2019 ◽  
Author(s):  
Ali Atamaleki ◽  
Rohollah Fallah Madvari ◽  
Mohammad Dolati ◽  
Meysam Faramarzi ◽  
Rajabali Hokmabadi ◽  
...  
Keyword(s):  
Ct Scan ◽  
Radiation Protection ◽  
Cross Sectional Study ◽  
Diagnostic Radiology ◽  
X Rays ◽  
Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
X Ray ◽  
Standard Limit

Background: One of the most harmful agents in hospital settings is ionizing radiation such as X-rays that physicians and other staff expose in surgeries and diagnostic tests. Therefore, the aim of this study was to measure X-ray dose in the diagnostic radiology units of hospitals affiliated to North Khorasan University of Medical Sciences. Methods: This is a descriptive-analytical, cross-sectional study, in which all of the hospitals' diagnostic radiology units including CT scan, mammography, fluoroscopy and radiography were studied. X-ray dose was measured by a dosimeter-radiometer device (MKS-05 Terra-P). The International Radiation Protection Association (IAEA) checklist was used to check the observance of the Radiation Protection Principles. Results: The results of this study showed that the X-ray doses in the CT scan, mammography, and fluoroscopy units of Bojnord Imam Ali Hospital were 0.16, 0.08 and 0.01 μSv/h, respectively. The doses of X-ray in the radiology units of Imam Ali (PBUH), Imam Reza (PBUH), Esfarayen and Shirvan Hospitals were 0.12, 0.12, 0.11, and 0.11 μSv/h, respectively. Conclusion: According to the results, the X-ray doses in the diagnostic radiology units of hospitals were lower than the standard limit proposed by the International Radiation Protection Association. However, it is proposed to use appropriate protective lead aprons to further protect the exposed staff in the units in question.

X-ray micro tomography in the scanning electron microscope

1978 ◽  
Vol 36 (1) ◽  
pp. 106-107 ◽  
Author(s):  
W. Brünger
Keyword(s):  
Electron Beam ◽  
Electron Microscope ◽  
Scanning Electron Microscope ◽  
Target Surface ◽  
The Body ◽  
X Rays ◽  
Cross Sectional ◽  
X Ray ◽  
Micro Tomography ◽  
Scanning Electron

Reconstructive tomography is a new technique in diagnostic radiology for imaging cross-sectional planes of the human body /1/. A collimated beam of X-rays is scanned through a thin slice of the body and the transmitted intensity is recorded by a detector giving a linear shadow graph or projection (see fig. 1). Many of these projections at different angles are used to reconstruct the body-layer, usually with the aid of a computer. The picture element size of present tomographic scanners is approximately 1.1 mm2.Micro tomography can be realized using the very fine X-ray source generated by the focused electron beam of a scanning electron microscope (see fig. 2). The translation of the X-ray source is done by a line scan of the electron beam on a polished target surface /2/. Projections at different angles are produced by rotating the object.During the registration of a single scan the electron beam is deflected in one direction only, while both deflections are operating in the display tube.

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