scholarly journals Pelvic radiograph (checklist)

2020 ◽  
Author(s):  
Daniel Bell ◽  
Dai Roberts
Keyword(s):  
Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1209
Author(s):  
Gabriel Keller ◽  
Simon Götz ◽  
Mareen Sarah Kraus ◽  
Leonard Grünwald ◽  
Fabian Springer ◽  
...  

This study analyzed the radiation exposure of a new ultra-low dose (ULD) protocol compared to a high-quality (HQ) protocol for CT-torsion measurement of the lower limb. The analyzed patients (n = 60) were examined in the period March to October 2019. In total, 30 consecutive patients were examined with the HQ and 30 consecutive patients with the new ULD protocol comprising automatic tube voltage selection, automatic exposure control, and iterative image reconstruction algorithms. Radiation dose parameters as well as the contrast-to-noise ratio (CNR) and diagnostic confidence (DC; rated by two radiologists) were analyzed and potential predictor variables, such as body mass index and body volume, were assessed. The new ULD protocol resulted in significantly lower radiation dose parameters, with a reduction of the median total dose equivalent to 0.17 mSv in the ULD protocol compared to 4.37 mSv in the HQ protocol (p < 0.001). Both groups showed no significant differences in regard to other parameters (p = 0.344–0.923). CNR was 12.2% lower using the new ULD protocol (p = 0.033). DC was rated best by both readers in every HQ CT and in every ULD CT. The new ULD protocol for CT-torsion measurement of the lower limb resulted in a 96% decrease of radiation exposure down to the level of a single pelvic radiograph while maintaining good image quality.


2020 ◽  
Vol 4 (04) ◽  
pp. 155-157
Author(s):  
Michael Newman ◽  
David Hartwright

AbstractThe aim of this study was to assess a large, single-surgeon dataset of uncemented total hip arthroplasties that had been templated using software. This assessment compared preoperative templated predictions with what was implanted with regard to (1) femoral prosthesis size and (2) acetabular cup size. The operation notes for two types of uncemented total hip arthroplasty performed by a single surgeon between January 9, 2008, and March 21, 2019, were assessed. The data were refined so that only those that were fully templated on a correctly calibrated pelvic radiograph were included. This provided a total of 153 cases. The predicted software template was compared with actual implanted component sizes. With regard to the femoral stems, the templating software was exactly correct in 45.75% of cases and was accurate to within one size in 87.59% of cases. With regard to the acetabular component, the templating software was exactly correct in 52.94% of cases and was accurate to within one size (2 mm) in 86.94% of cases. Templating software offers an accurate prediction of the size of uncemented femoral and acetabular components. In addition, the benefits of templating include cognitive rehearsal, insight into potentially challenging aspects of surgery, and highlighting intraoperative issues where there is a large intraoperative deviation from what is templated. This study demonstrates the congruence and reproducibility of templating software when compared with other smaller studies performed in the literature.


2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Anne K. Misiura ◽  
Autumn D. Nanassy ◽  
Jacqueline Urbine

Trauma patients in a Level I Pediatric Trauma Center may undergo CT of the abdomen and pelvis with concurrent radiograph during initial evaluation in an attempt to diagnose injury. To determine if plain digital radiograph of the pelvis adds additional information in the initial trauma evaluation when CT of the abdomen and pelvis is also performed, trauma patients who presented to an urban Level I Pediatric Trauma Center between 1 January 2010 and 7 February 2017 in whom pelvic radiograph and CT of the abdomen and pelvis were performed within 24 hours of each other were analyzed. A total of 172 trauma patients had pelvic radiograph and CT exams performed within 24 hours of each other. There were 12 cases in which the radiograph missed pelvic fractures seen on CT and 2 cases in which the radiograph suspected a fracture that was not present on subsequent CT. Furthermore, fractures in the pelvis were missed on pelvic radiographs in 12 of 35 cases identified on CT. Sensitivity of pelvic radiograph in detecting fractures seen on CT was 65.7% with a 95% confidence interval of 47.79-80.87%. Results suggest that there is no added diagnostic information gained from a pelvic radiograph when concurrent CT is also obtained, a practice which exposes the pediatric trauma patient to unnecessary radiation.


BMJ ◽  
2019 ◽  
pp. l5767 ◽  
Author(s):  
Tun Hing Lui ◽  
Kwok Fai Tam
Keyword(s):  

2020 ◽  
Vol 102-B (7_Supple_B) ◽  
pp. 41-46 ◽  
Author(s):  
Michael Ransone ◽  
Keith Fehring ◽  
Thomas Fehring

Aims Patients with abnormal spinopelvic mobility are at increased risk for instability. Measuring the change in sacral slope (ΔSS) can help determine spinopelvic mobility preoperatively. Sacral slope (SS) should decrease at least 10° to demonstrate adequate posterior pelvic tilt. There is potential for different ΔSS measurements in the same patient based on sitting posture. The purpose of this study was to determine the effect of sitting posture on the ΔSS in patients undergoing total hip arthroplasty (THA). Methods In total, 51 patients undergoing THA were reviewed to quantify the variability in preoperative spinopelvic mobility when measuring two different sitting positions using SS for planning. Results A total of 32 patients had standardized relaxed sitting radiographs, while 35 patients had standardized flexed sitting images. Of the 32 patients with relaxed sitting views, the mean ΔSS was 20.7° (SD 8.9°). No patients exhibited an increase in SS during relaxed sitting (i.e. anterior pelvic tilt or so-called reverse accommodation). Of the 35 patients with flexed sitting radiographs, the mean ΔSS was only 2.1° (SD 9.7°) with 16/35 (45.71%) showing anterior pelvic tilt, or so-called reverse accommodation, unexpectedly increasing the sitting SS compared to the standing SS. Overall, 18 patients had both relaxed sitting and flexed sitting radiographs. In patients with both types of sitting radiographs, the mean relaxed sit to stand ΔSS was 18.06° (SD 6.07°), while only a 3.00° (SD 10.53°) ΔSS was noted when flexed sitting. There was a mean ΔSS difference of 15.06° (SD 7.67°) noted in the same patient cohort depending on sitting posture (p < 0.001). Conclusion A 15° mean difference was noted depending on the sitting posture of the patient. Since decisions on component position can be made on preoperative lateral sit-stand radiographs, postural standardization is crucial. If using ΔSS for preoperative planning, the relaxed sitting radiograph is preferred. Cite this article: Bone Joint J 2020;102-B(7 Supple B):41–46.


2019 ◽  
Vol 03 (02) ◽  
pp. 059-061
Author(s):  
Michael Newman ◽  
Grant Shaw ◽  
Timothy Kane

AbstractThe main aim of this article was to assess a large, multisurgeon dataset of cemented total hip arthroplasties that had been templated using software. This assessment compared preoperative templated predictions with what was implanted with regard to (1) femoral prosthesis size, (2) offset, and (3) acetabular cup size. A database of total hip arthroplasties performed by four surgeons between the dates November 7, 2014 and October 31, 2017 was interrogated. The data was refined so that only primary cemented collarless polished tapered stem hip arthroplasties, fully templated on a correctly calibrated pelvic radiograph, were included. This provided 354 cases. The predicted software template was compared with actual implanted component sizes. With regard to the femoral stem, the software was exactly correct in 70.9% and accurate to within one size in 96.89% of cases. With regard to the femoral offset, the software was exactly correct in 87.01% and accurate to within one size in 99.72% of cases. With regard to the acetabular cup size, the software was exactly correct in 61.3% and accurate to within +/− 2 mm in 87.29% of cases. Templating software offers an accurate prediction of the femoral prosthesis size and offset, as well as acetabular cup size. Preoperative insight into likely component sizes and offset provides the operating surgeon with many benefits; templating the pelvic radiograph is a method of cognitive rehearsal, provides insight into potentially challenging aspects of the upcoming surgery, may highlight intraoperative issues where there is a large intraoperative deviation from what is templated, and enables efficient stock keeping for the healthcare institution.


2020 ◽  
Vol 9 (3) ◽  
pp. 728 ◽  
Author(s):  
Luise Sophie Ammer ◽  
Esmeralda Oussoren ◽  
Nicole Maria Muschol ◽  
Sandra Pohl ◽  
Maria Estela Rubio-Gozalbo ◽  
...  

Mucolipidosis type II (MLII) is a rare lysosomal storage disorder caused by defective trafficking of lysosomal enzymes. Severe skeletal manifestations are a hallmark of the disease including hip dysplasia. This study aims to describe hip morphology and the natural course of hip pathologies in MLII by systematic evaluation of plain radiographs, ultrasounds and magnetic resonance imaging (MRI). An international two-centered study was performed by retrospective chart review. All MLII patients with at least one pelvic radiograph were included. A total of 16 patients were followed over a mean of 3.5 years (range 0.2–10.7 years). Typical age-dependent radiographic signs identified were femoral cloaking (7/16), rickets/hyperparathyroidism-like changes (6/16) and constrictions of the supra-acetabular part of the os ilium (16/16) and the femoral neck (7/16). The course of acetabular and migration indexes (AI, MI) significantly increased in female patients. However, in the overall group, there was no relevant progression of acetabular dysplasia with a mean AI of 23.0 (range 5°–41°) and 23.7° (range 5°–40°) at the first and last assessments, respectively. Better knowledge on hip morphology in MLII could lead to earlier diagnosis, improved clinical management and enables assessment of effects of upcoming therapies on the skeletal system.


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