Developmental Anatomy of the Radial Bow in Pediatric Patients Using 3D Imaging.

Background: While radial bow shape is well characterized in adults, its development in children is not well understood. Previous studies on the radial bow use radiographs, thus, rotational positioning of the forearm could alter bowing measurements. This study used 3D imaging to better assess the pediatric radial bow.

An MRI-based Study to Investigate If the Patella is Truly Centred between the Femoral Condyles in the Coronal Plane.

Background: An AP knee radiograph is considered adequate if the patella is centred between the femoral condyles. Our previous studies demonstrated a tendency for lateral patellar deviation on an AP view orthogonal to the posterior femoral condyles. However, findings were based on cadaveric samples limited by the lack of soft tissue effects on patellar positioning.

The Optimized Oxford Hip Skeletal Maturity System Proves Resilient to Rotational Variation.

Background: The recently described optimized Oxford skeletal maturity system utilizes anteroposterior (AP) hip radiographs to accurately, rapidly, and reliably estimate skeletal maturity. However, in the real-world setting, significant positional variation in AP hip radiographs may influence the accuracy of optimized Oxford skeletal age estimates. We sought to evaluate the consistency of skeletal age estimations using the optimized Oxford system between differently rotated radiographs.

An anatomical study defining the safe range of angles in percutaneous iliosacral and transsacral screw fixation.

Percutaneous iliosacral screw fixation and transsacral fixation are challenging procedures requiring extensive knowledge of sacral anatomy to avoid damaging nearby neurovascular structures. Greater knowledge of anatomical screw trajectory and size allowances would be helpful to guide surgical placement. An anatomical study of 40 cadaveric sacra in specimens ages 18-65 was performed.

Skeletal Maturity Using Knee X-rays: Understanding the Resilience of 7 Radiographic Parameters to Rotational Position.

Background: Recently, a skeletal maturity system using knee radiographs, named the modified Roche-Wainer-Thissen (RWT) system, has been developed using 7 discrete radiographic parameters. While the system has been shown to significantly outperform the Greulich and Pyle atlas, the effect of rotational variation of the knee radiograph on skeletal maturity determinations has not been studied.

Methods: Normal knee computed tomography scans of 12 male children ages 10 to 16 years and 8 female children ages 8 to 14 years were obtained retrospectively, converted into 3-dimensional reconstructions, and then used to simulate knee radiographs in 5 different rotational positions.

Is Bony Knee Alignment Representative of the True Joint Surface in Skeletally Immature Patients? A Magnetic Resonance Imaging Study.

Aim And Objective: In deformity correction around the knee, the mechanical lateral distal femoral angle (mLDFA) and medial proximal tibial angle (MPTA) are used in surgical planning routinely. While plain radiographs are generally adequate, some surgeons utilise intraoperative arthrograms to visualise the articular contours and assess a younger child's true joint alignment, often with findings that these are discrepant from that measured just using bone alignment. The age cutoff for a discrepancy between the two is not defined.

Greater Trochanter Height: A Quantitative Predictor of Skeletal Maturity.

Background: The purpose of this investigation was to develop a quantitative and reproductible method for estimating skeletal maturity based on measurements of the height of the bony greater trochanter (GT) using timing to 90% of final height as a gold standard.

Methods: Bony GT height was measured using serial anteroposterior pelvic radiographs in 76 healthy pediatric patients obtained from the Bolton-Brush (BB) Study with corresponding Greulich-Pyle (GP) bone ages. Chronologic age at 90% of final height was calculated.

Pelvic Incidence in Spines With 4 and 6 Lumbar Vertebrae.

Study Design: Anatomical study.

Objectives: This study was conducted to determine the prevalence of abnormal lumbar vertebrae (4 and 6) and note any differences in pelvic incidence (PI) between spines with 4, 5, and 6 lumbar vertebrae.

Methods: We screened 2980 dry cadaveric specimens from an osteological collection.

Incidence and Fusion of Os Trigonum in a Healthy Pediatric Population.

Background: Accessory ossicles off the talus (os trigonum) are a common radiographic finding seen within the foot with variable symptomatology in adult and pediatric patients. Although most studies have examined the incidence of these anatomic variants in a retrospective manner, few have longitudinally followed the behavior of os trigonum over time. The aim of this study was to investigate the incidence, mean age of appearance and fusion, and fusion rate of os trigonum in a large cohort of asymptomatic pediatric patients.

A quantitative method for the radiological assessment of skeletal maturity using the distal femur.

Aims: Using 90% of final height as a benchmark, we sought to develop a quick, quantitative and reproducible method of estimating skeletal maturity based on topographical changes in the distal femoral physis.

Patients And Methods: Serial radiographs of the distal femoral physis three years prior to, during, and two years following the chronological age associated with 90% of final height were analyzed in 81 healthy children. The distance from the tip of the central peak of the distal femoral physis to a line drawn across the physis was normalized to the physeal width.

Pelvic Incidence Is Associated With Sacral Curvature, Sacroiliac Joint Angulation, and Sacral Ala Width.

Study Design: Cross-sectional anatomical study in dry cadaveric specimens.

Objective: This study evaluates how the sacroiliac (SI) joint angulation, midsagittal sacral curvature, and sacral ala width relate to pelvic incidence (PI).

Summary Of Background Data: Numerous spinopelvic pathologies have been linked with pelvic incidence; however, the manner in which sacral morphology fits into this association is largely unknown.

A Cadaveric Analysis of the Optimal Radiographic Angle for Evaluating Trochlear Depth.

Disorders of the patellofemoral joint are common. Diagnosis and management often involves the use tangential imaging of the patella and trochlear grove, with the sunrise projection being the most common. However, imaging protocols vary between institutions, and limited data exist to determine which radiographic projections provide optimal visualization of the trochlear groove at its deepest point.

An Anatomic Study on Whether the Patella is Centered in an Ideal Anteroposterior Radiograph of the Knee.

Background: Currently, an anteroposterior radiograph of the knee is judged based on a centered position of the patella between the femoral condyles. We are not aware of any anatomic literature supporting this recommendation.

Questions/purposes: Orthogonal images are required for accurate assessment of knee deformity.