On the use of knee functional calibration to determine the medio-lateral axis of the femur in gait analysis: Comparison with EOS biplanar radiographs as reference

Accurate calibration of the medio-lateral axis of the femur is crucial for clinical decision making based on gait analysis. This study proposes a protocol utilizing biplanar radiographs to provide a reference medio-lateral axis based on the anatomy of the femur. The biplanar radiographs allowed 3D modelling of the bones of the lower limbs and the markers used for motion capture, in the standing posture. A comprehensive analysis was performed and results from biplanar radiographs were reliable for 3D marker localization (±0.35 mm) and for 3D localization of the anatomical landmarks (±1 mm), leading to a precision of 1° for the orientation of the condylar axis of the femur and a 95% confidence interval of ±3° after registration with motion capture data. The anatomical condylar axis was compared to a conventional, marker-based, axis and three functional calibration techniques (axis transformation, geometric axis fit and DynaKAD). Results for the conventional method show an average difference with the condylar axis of 15° (SD: 6°). Results indicate DynaKAD functional axis was the closest to the anatomical condylar axis, mean: 1° (SD: 5°) when applied to passive knee flexion movement. However, the range of the results exceeded 15° for all methods. Hence, the use of biplanar radiographs, or an alternative imaging technique, may be required to locate the medio-lateral axis of the femur reliably prior to clinical decision making for femur derotational osteotomies.     

不同骨面型错牙合畸形与颈椎异常发生之间的研究

错牙合畸形是指牙齿在结构和功能上异常的状况,为口腔领域的重要疾病。目前,错牙合畸形可分为 牙性和骨性错牙合畸形。骨性错牙合畸形是指口腔颌面部骨骼（包括上颌骨和下颌骨等）在生长发育过程中受 到先天或后天因素的影响而发生的病理性结构异常。骨性错牙合畸形在生长发育过程中与其他个体部位的解 剖结构相互影响,尤其是与颈椎的异常解剖结构之间存在密切关联。本文通过对骨性错牙合畸形分类进行概 述,分析矢状骨面型及垂直骨面型错牙合畸形与颈椎异常的相关性,以期为临床治疗提供参考。     

CBCT转化的二维平片与头颅侧位片对上气道二维测量的比较研究

目的: 研究三维CBCT转化的二维侧位片(CCB)和数值化头颅侧位片(LCR)对于上气道相同解剖部位的测量结果是否有差异,并且进行两种测量方法的可靠性分析。方法: 将个别正常牙合志愿者的CCB和LCR分别导入Winceph8.0中进行上气道矢状面的距离测量;同一测试者分别进行3次测量; 采用SPSS24.0统计软件,进行组内相关系数、配对t检验来检验不同测量的可靠性和统计学差异。结果: 个别正常牙合志愿者的CCB和LCR分别对上气道进行测量,测量结果符合正态分布后,用配对t检验发现两组不同测量方法所得的PNS-Ba、PNS-Ad1、H-C3、H-FH有统计学差异;每项测量项目都进行3次测量,发现ICC值均大于0.75,说明两种测量方法可靠性均较高,但CBCT转化的二维平片ICC平均值为0.930,而头颅侧位片的ICC平均值为0.830,说明CBCT转化所得的二维平片可靠性高于头颅侧位片。结论: 个别正常牙合的CCB和LCR在骨性标志点的测量值有统计学差异,而软组织标志点的测量值则没有统计学差异;两种测量方法可靠性均较高,但CCB可重复性高于LCR。     

Routine postoperative radiographs after tibia plateau fixation have minimal impact on patient care

IntroductionCommon practice in orthopedic surgery is to obtain postoperative radiographs to evaluate for healing or complications. Images obtained in the post-anesthesia care unit (PACU) have not been shown to positively impact patient care. This study plans to evaluate the clinical utility and cost-effectiveness of PACU postoperative radiographs following tibial plateau open reduction and internal fixation (ORIF).MethodsData from 211 patients who underwent a tibial plateau ORIF over a 5-year period at a single institution were retrospectively reviewed to determine if a patient received a postoperative radiograph in the PACU. Radiograph and clinical notes were reviewed to determine if postoperative radiograph resulted in management changes. Radiograph charges were calculated using CPT codes.ResultsA total of 142 of 211 patients (67.3%) who underwent tibial plateau ORIF received a postoperative radiograph while in the PACU. The majority of the radiographs had normal findings (88.7%). Of the 142 patients with postoperative imaging, subsequent management changes occurred for only one patient (0.7%). In this case, an incidental foot fracture was found which resulted in further CT imaging to assess the fracture. Other abnormal radiograph readings (11.3%) were generally due to incidental, chronic findings that did not require management changes. The average postoperative radiograph cost was $433.55 per patient, totaling $91,480 for 142 patients over a 5-year period.ConclusionsRoutine postoperative radiographs following tibial plateau ORIF resulted in minimal management change patients in this series. The substantial cost of postoperative radiographs yielding little clinical utility suggests the use of routine PACU imaging following tibial plateau ORIF should be discontinued. Imaging would only be indicated in situations where intraoperative complications are suspected, thus reducing unnecessary imaging and patient cost.     

参考桩钉修正曲面断层片垂直向的测量值*

背景：牙周病的诊断和治疗过程中常需测量牙槽骨高度和牙根长度,用曲面断层片对其进行定量测量的可靠性一直存在争议。 目的：验证用参考桩钉修正曲面断层片垂直向测量值的可行性。 方法：采用20例正畸患者的寄存模,在模型中的磨牙区、双尖牙区、尖牙区和切牙区嵌入5.00 mm钢珠作为测量对象,并在与钢珠相应的位置放置10.0 mm桩钉作参照物。拍摄模型的曲面断层片,测量钢珠影像垂直径,用桩钉校准和修正测量结果,比较钢珠影像测量值和真实值的差异。 结果与结论：用单一部位的参照物和1组参照物的平均值来校准,不同区域和不同桩钉放置方法测量结果的失真率不同,部分区域的失真率≥5%。在测量区域相应的部位放置完全垂直于牙合 平面的参考桩钉来修正测量值,可提高各区域测量结果的准确性,其失真率皆<1%,修正后的结果不受参照物的影响。而用贴在模型牙槽骨表面的参考桩钉来修正测量值,所得结果不理想。     

Technical quality of root fillings performed by dental students at the dental teaching centre in Reims, France

Aim  To evaluate the technical quality of root fillings performed by undergraduate students at a dental teaching centre in France.
Methodology  A random sample of 419 records of patients who received dental treatment at the dental service of the teaching Hospital, in Reims, France between 2005 and 2006 was investigated. Evaluation of root filled was based on radiographical criteria defined by the French National Health Service. The length of root fillings, the radiodensity and the presence of voids in the root filling or between root filling and root canal walls were recorded and scored. Chi-square analysis was used to determine statistically significant differences between the technical quality of root fillings and tooth type.
Results  Of the 304 teeth included in the study, 69% had an adequate length of root filling and 42.7% had a dense root filling without voids; only 30.3% of teeth fulfilled these criteria at the same time. The relationship between the technical quality of root fillings and tooth type was statistically significant ( P  < 0.001), the highest percentage of adequate root fillings occurred in single-rooted teeth (36.1%). The highest percentage of inadequate root fillings according to the criteria of root filling length and lateral adaptation was found in molar teeth (71.9%).
Conclusion  Overall, the technical quality of root fillings performed by undergraduate students was poor.     

儿童头位正常与颅面结构的相关性研究

 目的研究正常ND03F儿童头位与颅面结构的相关性。方法选取33例正常ND03F儿童拍摄自然头位时的头颅侧位片,对其颅面结构、颈椎姿势及头位进行分析。结果正常ND03F儿童的SN-VEL、SN-OPT、SN-CVT与SNA、SNB、SND、SNPo存在显著负相关,与SN-GoGn、SN-PP、SN-OP、NSGn等变量存在显著正相关。结论正常ND03F儿童头位变量与一些颅面结构变量间存在显著的相关关系,尤其是与代表面部生长趋势和下颌骨生长方向的若干变量显著相关。     

Magnetic resonance imaging and radiographic findings of seal finger

Purpose: To describe the magnetic resonance imaging (MRI) and radiographic findings of five patients with seal finger.

Material and Methods: The MR images and radiographs of five patients with seal finger were retrospectively evaluated. MRI was performed on four patients in the subacute phase, and follow-up imaging was done on one of them at 5 months. One patient had MRI only at a later stage 5 years after onset. Radiographs were taken three times in the subacute phase and once at a later stage. One patient had had seal finger in another finger previously.

Results: Short-tau inversion-recovery (STIR) sequence showed extensive subcutaneous soft tissue edema in all four patients in the subacute phase and tenosynovitis of the flexion tendons in two cases. Three patients had edema in 2-3 phalanges, and effusion in the distal interphalangeal (DIP) joint was seen in one case. At the later stage, no signal pathology in soft tissues or bones was seen in STIR images. In the subacute phase, radiographs showed digital soft-tissue swelling in three patients, and one patient had a narrowed DIP joint, periarticular osteoporosis, and a periosteal reaction. At the later stage, flexion contracture of the finger was seen.

Conclusion: In addition to soft-tissue infection, seal finger causes bone marrow edema, tenosynovitis, and effusion in the interphalangeal joints visible as increased signal intensity in STIR images. Radiographs reveal periarticular osteoporosis with loss of cartilage in the subacute phase and flexion contracture at the later stage. MRI (STIR) allows more precise delineation of the inflammatory process compared to radiography.     

Evaluation of the usefulness of color digital summation radiography in temporally sequential digital radiographs: a phantom study

Purpose The purpose of this study was to assess the usefulness of color digital summation radiography (CDSR) for detection of nodules on chest radiographs by observers with different levels of experience. Materials and methods A total of 30 radiographs of chest phantoms with abnormalities and 30 normal ones were arranged at random. Set A was conventional radiographs only. Set B consisted of both conventional radiographs and CDSR images, which were colored with magenta. Five chest radiologists and five residents evaluated both image sets on a TFT monitor. The observers were asked to rate each image set using a continuous rating scale. The reading time for each set was also recorded. Results In set A, the performance of chest radiologists was significantly superior to that of the residents (P < 0.05). However, in set B, there was no significant difference in the performance of the chest radiologists and the residents. In both observer groups, the mean reading time per case in set B was significantly shorter than that in set A (P < 0.01). Conclusion By using CDSR, the detection capability of observers with little experience improves and is comparable to that of experienced observers. Moreover, the reading time becomes much shorter using CDSR.     

Effects of diagnostic threshold and overlapped approximal surfaces on reported caries status

The aims of this study were to examine the influence upon reported caries status of: 1) employing different diagnostic thresholds and 2) using differing conventions for treating approximal surfaces which appeared overlapped on posterior bitewing radiographs. Caries prevalence data from a group of 211 Scottish schoolchildren aged 5-15 yr studied during a trial of elective temporary tooth separation in general dental practice in Scotland were used. In this "moderate" caries group, values for dmft/DMFT rose significantly (P less than 0.001) when the D1 diagnostic threshold (all grades of lesion accepted) was applied in comparison with the D3 threshold (only caries into dentine recognised); dmft increasing from 3.9 to 5.4 and DMFT increasing from 1.7 to 4.7. This demonstrated that an over-optimistic impression of overall caries levels may be given when only the D3 threshold is used uncritically. In this study the status of approximal surfaces which were overlapped on bitewing radiographs was assessed by direct clinical examination using the temporary elective tooth separation technique. The investigation showed that, for this juvenile population, most (81.8% mesial, 93.1% distal) overlapped approximal surfaces were sound. Significantly more mesial than distal surfaces were found to be overlapped.