Periapical radiographic techniques during endodontic diagnosis and treatment

The objective of this article is to describe various radiographic projections which can be used during endodontic therapy. Changes to the angulation of the X-ray beam in relation to the teeth and film can help diagnosis and treatment by producing images which provide additional information not always visible on radiographs taken with standard angulations. For example, changes in angulation can be useful to determine the number and curvature of roots and canals, to identify superimposed roots and to distinguish between anatomical landmarks and apical pathology. Although use of such techniques increases the diagnostic yield of films, it must be appreciated that such views lead to images that are less distinct because of inherent image distortion. Nevertheless, use of the various techniques during endodontics can provide substantial benefit for clinicians in their daily practice.     

A Study on Extension－Flexion Dynamic Lumbar Spine Radiographsin Patients with Lumbar Intervertebral Disc Herniation

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Vanishing pleural fluid collections in cardiac failure simulating lung tumours

Vanishing fluid collections in interlobar fissures, associated with congestive cardiac failure, are uncommon but well-recognized. Previous studies have highlighted the occurrence of solitary vanishing ‘tumours’, but in the study reported here 7 out of 12 consecutive patients presented with more than one interlobar fluid collection simulating pulmonary tumours. In most cases a lateral radiograph confirmed the correct diagnosis and in all cases follow-up radiographs demonstrated resolution of all pleural fluid collections. In one case ultrasound was helpful. Making the correct diagnosis is very important inorder to prevent inappropriate investigations and treatment such as biopsy or surgery. It is suggested that unusual pleural fluid collections may be more common in communities where pleural disease following stab wounds or tuberculosis are more prevalent.     

Lacunar skull deformity and hydrocephalus in infants with myelomeningocele: is lacunar skull deformity a predictor of hydrocephalus development?

Objects We evaluated whether the presence of lacunar skull deformity (LSD) with myelomeningocele is a predictive factor for subsequent hydrocephalus development. Materials and methods We reviewed the clinical and radiological records of 18 infants with myelomeningocele, divided the patients into groups with (group A, n=9) and without (group B, n=9) ventriculomegaly at birth and assessed whether the presence of LSD was predictive of the necessity for ventriculoperitoneal shunt (VPS) placement. Results LSD was present in five group A patients. All nine group A patients underwent VPS placement. Among the group B patients, five had LSD; they underwent VPS placement. A significantly higher proportion of those with ventricle enlargement or LSD at birth required VPS placement (p=0.0001). Conclusion Adding to the ventriculomegaly at birth, the presence of LSD alerts to the necessity to monitor these infants closely to determine the necessity for VPS placement.     

Accuracy of Preoperative Templating in Total Hip Arthroplasty With Special Focus on Stem Morphology: A Randomized Comparison Between Common Digital and Three-Dimensional Planning Using Biplanar Radiographs

BackgroundAccurate preoperative planning is a key component of successful total hip arthroplasty (THA). The purpose of the present study was to compare the accuracy and reliability of three-dimensional (hipEOS) and common digital two-dimensional (TraumaCad) templating with special focus on stem morphology.Methods51 patients undergoing THA were randomized to two groups. Preoperative planning was performed on 23 patients with hipEOS (3D) and on 28 patients with TraumaCad (2D) planning software. Planning results were compared with the implanted component size. Inter- and intraobserver reliability as well as planning accuracy of both planning methods with special focus on straight and short stem design were recorded.ResultsIntraobserver reliability of both planning methods was good for component planning (ICC_2,1: 0.835-0.967). Interobserver ICC_2,1 for stem and cup planning were higher for 3D templating (3D ICC_2,1: 0.906-0.918 vs. 2D ICC_2,1: 0.835-0.843). Total stem and cup size predictions were within 2 sizes for 3D and within 3 sizes for 2D planning. Comparing short stem planning accuracy of both planning methods, absolute difference between implanted and planned component size was significantly lower in 3D planning (P = .029). There was no significant difference in straight stem (P = .935) and cup (P = .954) planning accuracy.ConclusionOur findings suggest that 3D templating with hipEOS software has a good overall reliability and may have a better planning accuracy of short stem prostheses than digital templating with TraumaCad software. Assuming that the number of implanted short stem prostheses will further increase in coming years, a more precise planning with 3D technique can contribute to improve surgery outcome.     

Measuring distortion of skeletal elements in Lodox Statscan‐generated images

Due to a scarcity of available skeletal material, anthropologists and other practitioners face difficulties with either the creation or validation of techniques used to estimate a biological profile in subadults. To address this problem, radiographic images of living individuals are often used in lieu of dry skeletal elements. However, radiographic images suffer from distortion. Some problems with metric analyses when using radiographic images may be addressed with the Lodox Statscan, an X‐ray machine that claims to produce minimal distortion along the scan‐axis due to a linear slot‐scanning design. The purpose of this research was to measure the distortion of skeletal elements in radiographic images generated from a Lodox Statscan. Skeletal elements subject to multiple imaging variables that affect distortion were radiographed, measured, and then compared to the dry bone measurements through multiple approaches. An 85% percent agreement within a ±1 mm range and a 97% agreement within a ±2 mm range was obtained. Percent difference results demonstrate that slot‐axis measurements incurred more distortion than scan‐axis measurements (11.8% and 2.7%, respectively). Inclusion of foam results in 4.5% more error than when foam is not included in the image. Angled scan‐axis measurements also incurred more distortion than either nonangled slot‐ and scan‐axis measurements. A Bland‐Altmanplot reveals an overall agreement between the radiographic and dry bonemeasurements, with most measurements falling within the upper and lower limits. Similar measurement error is found in Statscan radiographic and dry bone measurements; therefore, the Statscan offers a radiographic venue to collect metric data. Clin. Anat. 26:780–786, 2013. © 2013 Wiley Periodicals, Inc.     

Inter-observer and intra-observer reliability in the radiographic measurements of paediatric forefoot alignment

BackgroundFoot bones in children have more rounded shapes in radiograms than adults. Thus, the goal of this work was assessing inter- and intra-observer reliability in paediatric forefoot angle measurements.Material and methodsSix forefoot angles in 34 AP standing paediatric foot radiographs were measured by 5 researchers. A classic statistical analysis with use of IBM SPSS Statistics 25 was performed and a new method with two-way analysis of variance was applied.ResultsResults of statistical analysis revealed the properties of a subjective assessment related to specific angles. Kilmartin’s angle, calcaneus-fifth metatarsal angle and first ray angle are the most reliable; metatarsus adductus angle should be used with great caution in pediatric population. Engel’s angle is the most difficult for measuring and measurement error is the highest.ConclusionThe power of paediatric forefoot measurements is various. Several angles are reliable, while Engle’s angle is the most doubtful.