Prevalence of proximal tibia vara in Indonesian population with knee osteoarthritis

BackgroundProximal tibia vara has drawn interest since the concept of constitutional varus was introduced. Proximal tibia vara is a condition where the knee varus tilt the tibia condyle medially and shift the tibial articular surface medially. This condition affects medial proximal tibial angle measurements and the placement of the tibial implant in knee replacement surgery. Thus, it challenged the neutral knee arthroplasty alignment target because some people may present a proximal tibia vara. This study assesses the prevalence of the proximal tibia vara and the correlation to knee osteoarthritis grade.MethodsThis retrospective study was carried out from January 2021 to June 2021. Eighty-five limbs were included with the following inclusion criteria: knee osteoarthritis patients who received a long view lower extremity radiograph. The exclusions criteria were (1) patients who had undergone arthroplasty and lower extremity surgery before and (2) valgus knee deformity. The outcomes in this study were HKAA, MAD, TAD, MPTA, PTRP, LDFA, and PTS. Intraclass correlation (ICC) using two-way mixed was used to assess the reproducibility of the radiographic parameters. Multiple logistic regression was used to evaluate the correlation between knee osteoarthritis grade and radiographs parameters (MAD and TAD).ResultA total 85 limbs from 52 patients were assessed in this study. Proximal tibia vara was found in 18 knees (21%.). The logistic regression was performed to assess the correlation between the severity of the knee osteoarthritis and radiographic parameters (MAD, TAD, LDFA, and PTS) with an overall p-value < 0.001 and pseudo-R² = 0.29.ConclusionA significant portion of patients with knee osteoarthritis have proximal tibia vara, and it is a pre-existing condition. Since the pre-existing proximal tibia vara affects preoperative measurements, a long-standing lower extremity x-ray is recommended to be obtained as part of knee replacement preparation.     

Evaluating the use of anti-scatter grids in adult knee radiography

IntroductionAnti-scatter grids efficiently reduce scatter radiation from reaching the imaging receptor, enhancing image quality; however, the patient radiation dose increases in the process. There is disagreement regarding the thickness thresholds for which anti-scatter grids are beneficial. This study aims to establish a thickness threshold for the use of anti-scatter grids to optimise adult knee radiography.MethodsThe study consisted of two phases. In Phase 1 phantom knee radiographs were acquired at varying thicknesses (10–16 cm) and tube voltages (60–80 kV). For each thickness and tube voltage, images with and without an anti-scatter grid were obtained. In Phase 2, two radiologists and three radiographers, evaluated the image quality of these images. Visual Grading Analysis (VGA) scores were analysed using Visual Grading Characteristics (VGC) based on the visualisation of five anatomic criteria.ResultsThe average DAP decreased by 72.1% and mAs by 73.1% when removing the anti-scatter grid. The VGC revealed that overall images taken with an anti-scatter grid have better image quality (AUC ≥0.5 for all comparisons). However, the anti-scatter grids could be removed for thicknesses 10, 12 and 14 cm in conjunction with using 80 kVp,.ConclusionAnti-scatter grids can be removed when imaging adult knees between 10 and 12 cm using any kVp setting since the radiation dose is reduced without significantly affecting image quality. For thicknesses >12 cm, the use of anti-scatter grids significantly improves image quality; however, the radiation dose to the patient is increased. The exception is at 14 cm used with 80 kVp, where changes in image quality were insignificant.Implications for practiceOptimisation by removing anti-scatter grids in adult knee radiography seems beneficial below 12 cm thickness with any kVp value. Since the average knee thickness ranges between 10 and 13 cm, anti-scatter grid can be removed for most patients. Nevertheless, further studies are recommended to test if this phantom-based threshold applies to human subjects.     

Update on sports imaging

Sports Imaging has dramatically increased in the past decade with increasing number of adolescents, young and middle-aged adults participating in non-competitive/hobby sports. Therefore, sports injuries are no longer confined to elite athletes. Furthermore, newer forms of sports such as mountain climbing, pickle ball and curling etc. are gaining popularity. Majority of the injuries in sports medicine are from musculoskeletal trauma. Therefore, it is imperative that the musculoskeletal radiologist becomes familiar with various sports related injury patterns as these are commonly encountered in daily practice. This update aims to briefly encapsulate the major aspects of sports imaging. It includes the imaging manifestations of various types of musculoskeletal injuries on different modalities (commonly US and MRI) and briefly mentions the various image guided interventions, performed both on the sports field and in the hospital setting.     

儿童期创伤应对方式自动思维与大学生抑郁特质间的关系

目的探讨儿童期创伤与抑郁特质之间的中介和调节机制,为开展相关研究和干预提供参考。方法2017-2018年采用整群抽样的方法,抽取湖南某高校大一年级2 786名学生完成儿童期创伤问卷、状态特质抑郁问卷、自动思维问卷和特质应对方式问卷的调查。结果儿童期创伤、自动思维和消极应对对抑郁特质起正向的预测作用,积极应对对抑郁特质起负向的预测作用(β值分别为0.12,0.43,0.14,-0.33,P值均<0.05)。自动思维中介儿童期创伤与抑郁特质之间的关系(Bootstrapping法的95%CI为0.03~0.06)。消极应对分别调节了儿童期创伤与自动思维和儿童期创伤与抑郁特质之间的关系(P值均<0.05)。结论儿童期创伤影响抑郁特质,其关系受到应对方式和自动思维的影响。     

Epidemiologic Characteristics of Work-related Eye Injuries and Risk Factors Associated with Severe Eye Injuries: A Registry-based Multicentre Study

ABSTRACT

Purpose

Work-related eye injuries have been reported with a variety of epidemiologic and clinical characteristics. We aimed to identify epidemiologic characteristics of work-related eye injuries and risk factors associated with severe injury in a large metropolitan city.