Templating in uncemented THA. On accuracy and postoperative leg length discrepancy. This study examines the accuracy of digital templating in uncemented total hip arthroplasty THAi. The surgical outcome was evaluated on the basis of limb length equality.
DT-SFP, digital tomosynthesis at special functional position. SPSS software version As the cross-over sign and pistol-grip deformity were only visible in the conventional radiographs, these two radiographic abnormalities were not included to be analyzed.
Results There were symptomatic hips in a total of 94 patients. The statistical analysis for the detection rates of abnormalities in DT-SFP and conventional radiography are summarized in Table 1. The other osseous abnormalities of the acetabulum are located on the outer edge, and this is the area where the acetabulum and the proximal femur come in contact with each other in the special functional position.
In addition, due to the position of the patient, cross-over sign and pistol-grip deformity were only visible in the conventional radiographs.
A 31 year old male with left groin pain for 2 years. A, Conventional radiograph shows a round lucency in the femoral neck arrowheadand acetabular fossa white dotted Tomosynthesis femoral head touching the ilioischial line black dotted linewhich refers to coxa profunda; B, Digital tomosynthesis at special functional position DT-SFP image shows an oval lucency in the anterosuperior femoral neck arrowheadjust corresponding to the outer edge of the acetabulum, and a coxa profunda black and white dotted line.
A year-old female with left groin pain for 1. A, Conventional radiograph shows coxa profunda and acetabular osteophytes long arrow with a sharp edge, and pincer-like deformity; B and C, Digital tomosynthesis at special functional position DT-SFP images show sharp osteophytes in the rim of the Tomosynthesis femoral head short arrow and coxa profunda.
Herniation pit is not shown on the conventional radiograph it is clear on DT-SFP located in the junction of the femoral head and neck arrow head. A year-old male with left hip pain for eight months.
A, Conventional radiograph shows an aspherical femoral head; B, Digital tomosynthesis at special functional position DT-SFP shows bony protrusion at the femoral head-neck junction arrowhead and a small acetabular labrum ossification arrow.
A year-old male with bilateral groin pain for 5 years. A, Conventional radiograph does not show any obvious abnormality; B, Digital tomosynthesis at special functional position DT-SFP shows a prominent separated acetabular labrum ossification at the right acetabulum arrowhead and a cyst located at the junction of the head and neck in the area contacting with the acetabulum rim arrowhead and a very small ossification of labral basis arrow.
Most of the signs with a higher detection rate using DT-SFP were acquired osseous abnormalities except for the femoral head-neck junction bone protrusion. The acquired osseous abnormalities are closely related with an abnormal contact during hip joint motion between the skeletal prominences of the acetabulum and the proximal femur 16 - The recurrent impingement can lead to microtrauma of abnormal developmental osseous convexities, acetabular labral tear and cartilage damage, that progresses and results in degenerative disease of the hip joint if the underlying cause of impingement is not eliminated 19 In the initial phase of this entity, patients do not have obvious radiographic signs, such as joint space narrowing, osteophyte formation, subchondral sclerosis, or cyst formation 1617 Therefore observing the early stage of radiographic features is helpful for the correct diagnosis and evaluation before potential surgical treatment.
When patients with acetabular and proximal femoral radiographic abnormalities complain of groin pain radiating to the lateral thigh, labral tear and cartilage damage might exist and lead to corresponding osseous changes 1619 The application of the tomography technology can show the lesion clearly by removing the overlap of the anatomical structures.
DT refers to the technique of collecting a number of projection radiographs with very low dose at different angles in order to reconstruct sections of the target 9 These reconstructed sectional images demonstrate much less of the overlying anatomical structures than the conventional radiographs, thus improving detection rate of tiny lesions 9 - 13 HPs refers to an oval or round lucency in the anterosuperior aspect of the femoral neck, just distal to the articular surface, and a cortical defect is always found in the side of the articular surface In our research the scene of the abnormal impact between acetabular and proximal femur was induced through the special functional position, full flexion abduction and external rotation.
The imaging sequence of DT-SFP was from the near detector side to the far detector side and the bone abnormalities can be clearly observed layer by layer in the area of space. The HPs and the acetabulum abnormalities are just located in the area in which the acetabulum and the proximal femur contact with each other in the special functional position, which represent the abnormal impingement.
This is a powerful objective supported by other authors on the theory of HPs at the femoral head neck junction Hence the results of our research show that conventional radiography is suitable for observation of anatomical abnormalities and obvious osteoarthritis of the hip, but is not suitable for diagnosis of early osteoarthritis.
For coxa profunda, hip joint space narrowing and posterior wall sign, DT-SFP and conventional radiography almost show the same demonstrating ability.
Therefore, the two imaging techniques have the same efficacy in the detection of these three radiographic abnormalities. In our research, we use lead barrier shield to protect the gonads during the DT-SFP scan, which can strengthen the radiation protection.
It should be noted that some types of developmental abnormalities such as cross-over sign and pistol-grip deformity cannot be shown on DT-SFP images due to the changing position of the projection.
Digital tomosynthesis (DTS) provides slice images of an object using conventional radiographic methods with high in-plane resolution. The objective of this study was to explore the potential of DTS for describing microstructural, stiffness and stress distribution properties of vertebral cancellous bone. PubFacts seeks to make the world's scientific research easy to locate, access, and collaborate on. Inspired by vertebroplasty's success, researchers have shown that percutaneous cement injections can also successfully stabilize arthritic and neoplastic lesions affecting the femoral head. The technique offers pain relief and an alternative to surgery for selected patients.
This suggests that conventional radiography is essential and irreplaceable in certain cases for diagnosis of acetabular and proximal femoral radiographic abnormalities.see entire pelvis, femoral head, neck and trochanters. 1/4 to 1/3 of femoral shafts, lesser trochanter on medial border, greater trochanter in profile, hip bones and obturator foramen are symmetric Routine projections of the hip.
women’s imaging breast ultrasound limited .. breast ultrasound complete .. c: Post-imaging tomosynthesis image, able to measure thickness of inside of femoral head, joint space, articular lip and articular cartilage, as well as to observe the ligament of the femoral head (swing angle at 40 degrees, slow speed FBP method, mm thickness ++ %).
Nov 14, · The simple bone cyst is a common, benign, fluid-containing lesion, usually occurring in the metaphysis of long bones. The cause of the lesion is unknown. Scintigraphic Evaluation of Hip Pain: Part II—Approach to Image Analysis of Common and Uncommon Etiologies of the Hip Joint and Femoral Head and Neck Banks, Kevin P.; Clemenshaw, Michael N.; Anderson, Shane B.
B, On tomosynthesis image, bone erosion seems to be evident on lateral aspect of 5th metatarsal head (arrowhead), subsequently determined to be false-positive on CT. View larger version (K) Fig. 4C —False-positive bone erosion on tomosynthesis.