Selenium-based digital radiography versus conventional film-screen radiography of the hands and feet: a subjective comparison.

Objective: The purpose of this study was to subjectively compare the visibility of normal anatomy of the hands and feet using selenium-based digital radiography versus conventional film-screen (100-speed) radiography.

Subjects And Methods: Digital and film-screen images of the hands and feet of 24 patients were obtained without an antiscatter grid using identical X-ray exposure. Each pair of images was evaluated independently by five experienced radiologists for visibility of normal anatomy using a six-point rating scale.

Imaging modalities for study of the distal ulnar region.

Judicious use of diagnostic imaging maximizes the diagnostic capabilities of the surgeon treating the distal radio-ulnar joint (DRUJ). A good clinical history and clinical examination are necessary to direct the selection of appropriate imaging studies. Plain radiographs are almost always the first imaging examination.

Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging in the detection of patellofemoral articular cartilage abnormalities.

Purpose: To determine the accuracy of T1-weighted fat-suppressed (FS) three-dimensional (3D) fast low-angle shot (FLASH) magnetic resonance (MR) imaging for the detection of articular cartilage abnormalities of the patellofemoral joint.

Materials And Methods: Forty-one patients with suspected internal derangement of the knee were examined with a T1-weighted FS 3D FLASH sequence and subsequently underwent arthroscopy. The patellofemoral articular cartilage was graded blindly on both the MR and arthroscopic images with a modification of the Noyes classification scheme.

Fast spin-echo imaging of the knee: factors influencing contrast.

Conventional T2-weighted spin-echo magnetic resonance imaging of the knee requires a long TR. Fast spin-echo (FSE) imaging can improve acquisition efficiency severalfold by collecting multiple lines of k space for each TR. Compromises in resolution, section coverage, and contrast inevitably result.

Stress fractures of the tarsal navicular. A case report.

In summary, the diagnosis of a tarsal navicular stress fracture should be entertained in the athlete with ill-defined midfoot pain. Technetium bone scans will often point the clinician in the right direction; biplanar CT scans will pin-point the diagnosis and can be invaluable in perioperative planning. Subsequent treatment, however, must be determined on a clinical rather than a radiographic basis.

Medial malleolar stress fractures in seven patients: review of the clinical and imaging features.

Stress fractures of the medial malleolus were discovered in seven patients, five male and two female subjects aged 16-34 years. All except one were involved in running and jumping athletic activities. Gradual onset of pain over the medial malleolus occurred with repetitive activity.

Transient osteoporosis of the hip: clinical and imaging features.

Transient osteoporosis of the hip is a form of reflex sympathetic dystrophy characterized by pain, limping, limitation of hip joint motion, and delayed radiographic patchy osteoporosis of the proximal femur. Spontaneous resolution is usually paralleled by radiographic recovery, usually within a few months. We present clinical and imaging features in seven cases of unilateral transient osteoporosis of the hip.

Arthroscopic elbow findings: correlation with preoperative radiographic studies.

Correlation between arthroscopic findings and preoperative radiographic studies (plain radiographs and arthrotomograms) was performed in a consecutive series of 37 elbows. Arthrotomograms added significant diagnostic information unavailable from plain radiographs alone, thereby improving the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic efficiency (accuracy) in the evaluation of elbow joint surface changes, marginal spurs, and loose bodies. Arthrotomograms gave 85% accuracy for bone spurs, 89% accuracy for joint surface abnormalities, and 89% accuracy for loose bodies (88% accuracy overall), whereas plain radiographs demonstrated 69% accuracy for bone spurs, 71% accuracy for joint surface abnormalities, and 75% accuracy for loose bodies (72% accuracy overall).

Application of an artificial neural network in radiographic diagnosis.

The description of 44 cases of bone tumors was used by an artificial neural network to rank the likelihood of 55 possible pathologic diagnoses. The performance of the artificial neural network was compared with the performance of experienced (3 or more years of radiology training) residents and inexperienced (less than 1 year of radiology training) residents. The artificial neural network was trained using descriptions of 110 radiographs of bone tumors with known diagnoses.

Juxta-articular osteoid osteoma.

Osteoid osteomas that arise at the end of a long bone, within the insertion of the joint capsule (juxta-articular, intra-articular), may cause misleading clinical, radiographic, and histologic findings, resulting in unnecessary diagnostic tests and a delay in definitive treatment. To clarify optimum diagnostic procedures, we reviewed 20 cases of juxta-articular osteoid osteomas and found a mean delay from presentation to correct diagnosis of 24 months. Plain radiographs were either negative or showed only secondary changes.

Making core decompression work.

Meaningful assessment of a treatment modality for osteonecrosis (ON) must take into account a number of factors: (1) an accurate diagnosis, (2) consistent staging of the disease process, (3) understanding of the variability of the disease, (4) consistent application of the treatment modality (or the surgical technique), and (5) a clear understanding of the goal of the treatment used. This article reviews the important steps of a diagnostic algorithm that has been used to accurately diagnose and stage the disease process of ON. A consistent surgical technique with clearly defined goals is also outlined.

Total knee replacement: radiologic findings in failure of porous-coated metal-backed patellar component.

One technique for replacing the articular surface of the patella in total knee replacement is the use of a cementless porous-coated metal-backed polyethylene component. Anteroposterior, lateral, and Merchant or skyline radiographs in 10 cases of porous-coated metal-backed components that failed were evaluated for component alignment, component displacement, radiolucencies, loose beads, and integrity of the patellar component. Component failure was documented by surgery in all 10 cases.

Comparison of digital and conventional musculoskeletal radiography: an observer performance study.

Interpretations of 122 musculoskeletal radiographs were compared with interpretations of their digital counterparts at a resolution of 1,024 X 840 X 12 bits. Images were evaluated by four readers and included subtle and nonsubtle abnormalities and normal findings. Joint receiver operating characteristic (ROC) analysis results were averaged over all readers and demonstrated no statistically significant difference between the two imaging methods.

A diagnostic algorithm for osteonecrosis of the femoral head.

For patients considered at risk for osteonecrosis (ON) of the femoral head, an algorithm for the efficient and appropriate use of diagnostic tests can be developed. Such an algorithm requires a clear idea of the evolution of the disease process and an understanding of the limitations of each of the modalities by which the disease process can be identified. The role of each of the diagnostic tests available for the diagnosis of ON and the results of prospective evaluations to assess their sensitivity, specificity, and predictive values are reviewed.

Special diagnostic procedures in sports medicine.

In summary, there are a number of imaging procedures available to support the physician in his or her evaluation of sports injuries. Conventional radiographs remain the primary imaging examination. Specialized radiographic projections will often provide additional pertinent information.

Multimodality approach to osteonecrosis of the femoral head.

Treatment of osteonecrosis of the femoral head appears to be effective when the disease is identified and treated early. Forty-one patients were evaluated with prospective laboratory assessment, anteroposterior and frog-lateral roentgenograms of both hips, intraosseous pressure measurements (IOP), magnetic resonance imaging (MRI), and 99mTc methylene diphosphonate planar and single-photon emission computerized tomographic (SPECT) bone imaging. Pathologic specimens were obtained in most patients.

Problems in applying expert system technology to radiographic image interpretation.

A prototype expert system was developed to study the problems applying expert system technology to radiographic image interpretation. The Radiographic Image Interpretation System (RIIS) was developed on a microcomputer using Turbo Prolog, a low cost implementation of the prolog programming language. The present implementation of RIIS was developed to highlight potential problems in applying expert system technology in the evaluation of radiographic images.

Acute Posttraumatic Pubic Symphysis Instability in an Athlete.

In brief: A 16-year-old high school football player and wrestler began experiencing groin and pubic pain, and a popping sensation with abduction movements, after sustaining an abduction injury to his lower extremities. Stress roentgenographs revealed instability of the pubic symphysis; there was no evidence of fracture or gross instability of the sacroiliac joints or the posterior sacrum. The patient was treated conservatively for one year, with an initial period of limited weight-bearing and rest followed by progressive stretching and strengthening exercises and a gradual return to full sports activity.

Magnetic resonance imaging of musculoskeletal infections.

In summary, MRI has a high sensitivity for the detection of inflammatory disease involving the musculoskeletal system. Because of the usual anatomic pattern of involvement in the vertebral column, there is also a high specificity. In the appendicular skeleton and pelvis, it is unclear whether MRI can add to the sensitivity and specificity of radionuclide studies in uncomplicated cases of acute infection.

Elbow arthrography in the evaluation of posterior interosseous nerve compression in rheumatoid arthritis.

This is a case report of a fifty-nine-year-old rheumatoid arthritic woman who developed lack in finger extension bilaterally. These deficits had two completely different aetiologies, Posterior Interosseous Nerve (PIN) Syndrome and extensor tendon rupture. No previous report in the literature has used elbow arthrography as a diagnostic tool in a patient with PIN Syndrome.

Hyperparathyroidism, hyperthyroidism, and Cushing's disease.

In this article, normal and hyperactive states of parathyroid, thyroid, and cortisol production are examined. Their role in bone loss and the rationale for therapeutic intervention are also discussed.

Digital subtraction angiography for preoperative evaluation of extremity tumors.

A retrospective study was undertaken to evaluate the role of digital subtraction angiography (DSA) in the surgical planning of musculoskeletal neoplasms. Thirteen patients with primary bone and soft-tissue tumors were examined by CT and DSA. Three patients also had conventional angiography.