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Age estimation in forensic odontology is mainly based on the development of permanent teeth. To register the developmental status of an examined tooth, staging techniques were developed. However, due to inappropriate calibration, uncertainties during stage allocation, and lack of experience, non-uniformity in stage allocation exists between expert observers. As a consequence, related age estimation results are inconsistent. An automated staging technique applicable to all tooth types can overcome this drawback. This study aimed to establish an integrated automated technique to stage the development of all mandibular tooth types and to compare their staging performances. Calibrated observers staged FDI teeth 31, 33, 34, 37 and 38 according to a ten-stage modified Demirjian staging technique. According to a standardised bounding box around each examined tooth, the retrospectively collected panoramic radiographs were cropped using Photoshop CC 2021® software (Adobe®, version 23.0). A gold standard set of 1639 radiographs were selected (n31 = 259, n33 = 282, n34 = 308, n37 = 390, n38 = 400) and input into a convolutional neural network (CNN) trained for optimal staging accuracy. The performance evaluation of the network was conducted in a five-fold cross-validation scheme. In each fold, the entire dataset was split into a training and a test set in a non-overlapping fashion between the folds (i.e., 80% and 20% of the dataset, respectively). Staging performances were calculated per tooth type and overall (accuracy, mean absolute difference, linearly weighted Cohen's Kappa and intra-class correlation coefficient). Overall, these metrics equalled 0.53, 0.71, 0.71, and 0.89, respectively. All staging performance indices were best for 37 and worst for 31. The highest number of misclassified stages were associated to adjacent stages. Most misclassifications were observed in all available stages of 31. Our findings suggest that the developmental status of mandibular molars can be taken into account in an automated approach for age estimation, while taking incisors into account may hinder age estimation. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) represents a major public health problem worldwide. Any tissue may be infected. Involvement of the musculoskeletal (MSK) system account for 1–3% of all tuberculous infections. MSK TB may manifest as tuberculous spondylitis, arthritis, osteomyelitis, and soft tissue infections. Although TB spondylitis may present with distinctive imaging features compared to pyogenic infections of the spine, the imaging semiology of extra-spinal TB infections is mostly nonspecific and may mimic other lesions. TB infections should therefore always be considered in the differential diagnosis, particularly in immunocompromised patients. The aim of this article is to review the imaging features of spinal and extra-spinal MSK TB. Magnetic resonance imaging is considered the modality of choice to make the diagnosis and to evaluate the extent of the disease. [ABSTRACT FROM AUTHOR]

Background: The management of patients with slipped capital femoral epiphysis (SCFE) requires imaging diagnostics of good quality and accurate measurement of the degree of slippage. In Sweden, three different radiological methods are commonly used: the calcar femorale method; the Billing method; and the Head-shaft angle described by Southwick. Purpose: To evaluate whether any of the three most common methods used in Sweden to measure the slip angle was more useful and reproducible than the others. Material and Methods: Two experienced orthopaedists measured the slip angle in preoperative hip radiographs. Intra- and inter-observer variability between the two experienced observers and the reported value by clinicians who treated the child with SCFE was evaluated. Results: The intraclass correlation coefficient (ICC) confidence interval (CI) between the two experienced observers and the reporting clinicians overlapped for the three methods. In 37% of the cases, the difference was more than 5° between the experienced observers' measurement and the reported value by clinicians. The two experienced orthopaedists' intra- and inter-observer variability was low. Conclusion: The observer's experience is more important than the method of choice when measuring the slip angle in SCFE. The research group recommends the calcar femorale method due to its feasibility on the versatile and commonly used frog leg lateral view. [ABSTRACT FROM AUTHOR]

Pseudolesions in bone and muscle are encountered mostly incidentally in routine imaging studies, especially due to the recent advancements on many different imaging modalities. These lesions can be categorized into the following categories: normal variants; congenital; iatrogenic; degenerative; and postoperative. In this review, we discuss the many different radiological characteristics of musculoskeletal pseudolesions that appear on imaging, which can prevent non-essential additional studies. [ABSTRACT FROM AUTHOR]

Introduction: Odontogenic infection leads to increased thickness of maxillary sinus membrane. This is aided by close relationship between the roots of upper posterior teeth and floor of the maxillary sinus. This can be viewed by using imaging modalities. Aim: The review has been conducted to compare CBCT (Cone Beam Computed Tomography) with Orthopantomogram (OPG) in detecting maxillary sinus membrane thickening in patients with odontogenic anomaly through a meta-analysis. Materials and Methods: The review was carried out by following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and was registered as PROSPERO 2023 CRD42023390257. PubMed, Google Scholar and EBSCO host were queried for literature published from January 2000 to December 2022. Newcastle Ottawa scale evaluated the quality of articles. Results: Statistical analysis was performed and forest plot was plotted using RevMan (Review Manager) software version 5.3. Five studies were eligible and two of them were suitable for Meta-Analysis. The Standardized Mean Difference yielded a pooled estimate of 0.39 and preferred CBCT using a random effect model with a P value of 0.02 and an I2 (heterogeneity) value of 59%. Funnel plot showed absence of publication bias. Conclusion: It was concluded that CBCT was effective, as compared to OPG in detecting maxillary sinus membrane thickening with odontogenic anomaly.

Objective: Distances and angles measured from long-leg radiographs (LLR) are important for surgical decision-making. However, projectional radiography suffers from distortion, potentially generating differences between measurement and true anatomical dimension. These phenomena are not uniform between conventional radiography (CR) digital radiography (DR) and fan-beam technology (EOS). We aimed to identify differences between these modalities in an experimental setup. Materials and methods: A hemiskeleton was stabilized using an external fixator in neutral, valgus and varus knee alignment. Ten images were acquired for each alignment and each modality: one CR setup, two different DR systems, and an EOS. A total of 1680 measurements were acquired and analyzed. Results: We observed great differences for dimensions and angles between the 4 modalities. Femoral head diameter measurements varied in the range of > 5 mm depending on the modality, with EOS being the closest to the true anatomical dimension. With functional leg length, a difference of 8.7% was observed between CR and EOS and with the EOS system being precise in the vertical dimension on physical-technical grounds, this demonstrates significant projectional magnification with CR-LLR. The horizontal distance between the medial malleoli varied by 20 mm between CR and DR, equating to 21% of the mean. Conclusions: Projectional distortion resulting in variations approaching 21% of the mean indicate, that our confidence on measurements from standing LLR may not be justified. It appears likely that among the tested equipment, EOS-generated images are closest to the true anatomical situation most of the time. [ABSTRACT FROM AUTHOR]

Objective: Determining the working length (WL) in root canal treatment facilitates the treatment prognosis. The introduction of apex locators and new devices in dentistry influenced this consideration. This comparative study evaluated the accuracy of working length measurement by cone beam computed tomography (CBCT) in three fields of view (FOVs), conventional radiography, and the apex locator Raypex 5. Methods: The descriptive-analytical study was performed on 40 mandibular premolar teeth that met the inclusion criteria. Direct observation under the microscope was considered the gold standard and compared with measurements by the electronic apex locator, CBCT at three field of view settings and periapical images. The results were analyzed by paired t-tests and Wilcoxon tests. The level of significance was set at 0.05 (p=0.05). Results: Results showed that the CBCT at 5×5 FOV (p=0.733) and Conventional radiography(p=0.001) achieved the working lengths with the highest and lowest accuracy, respectively. In addition, the difference between actual and measured working length using conventional radiography was significant (p<0.05). Conclusion: According to the results of this study, CBCT images at different FOVs and those taken by the apex locator Raypex 5 can be used as a reliable method for estimating the working length. [ABSTRACT FROM AUTHOR]

In recent years, imaging has become increasingly important to confirm diagnosis, monitor disease activity, and predict disease course and outcome in children with juvenile idiopathic arthritis (JIA). Over the past few decades, great efforts have been made to improve the quality of diagnostic imaging and to reach a consensus on which methods and scoring systems to use. However, there are still some critical issues, and the diagnosis, course, and management of JIA are closely related to clinical assessment. This review discusses the main indications for conventional radiography (XR), musculoskeletal ultrasound (US), and magnetic resonance imaging (MRI), while trying to maintain a clinical perspective. The diagnostic-therapeutic timing at which one or the other method should be used, depending on the disease/patient phenotype, will be assessed, considering the main advantages and disadvantages of each imaging modality according to the currently available literature. Some brief clinical case scenarios on the most frequently and severely involved joints in JIA are also presented. [ABSTRACT FROM AUTHOR]

Radiographic testing is the most common method of non-destructive testing to detect discontinuities in industrial piping welds. Human interpretation of radiographic films is time-consuming and requires high degrees of expertise. Despite the significant advancements of deep learning techniques in related fields, such as medical radiography, prior research endeavors focused on weld discontinuities were constrained by the limitations stemming from a lack of training data and their inadequate representation of real-world conditions in the field. This paper introduces a comprehensive system that automatically detects welding zones, assesses film quality, and classifies weld discontinuities for the piping process. The proposed framework demonstrates superior generalization capabilities that bypass a single industry or piping size. The key advantages of our technique lie in its enhanced accuracy, rapid processing, and automatic interpretation of welding films across a wide range of image qualities. Consequently, it achieves remarkable detection and classification accuracy, offering substantial benefits for welding inspection and quality assessment. [ABSTRACT FROM AUTHOR]

Objective: Spinal involvement in rheumatoid arthritis (RA) is limited to the upper cervical spine, leading to cervical spine instability. This study aimed to evaluate the prevalence of anterior atlantoaxial subluxation (aAAS) and its associated risk factors in patients with RA. Method: This single‐centre cross‐sectional study 240 patients consecutively were recruited. Radiographs of the cervical spine were obtained in the flexion and neutral neck positions and read by two blinded observers. The diagnosis of aAAS was based on the distance between the anterior aspect of the dens and the posterior aspect of the anterior arch of the atlas, which was >3 mm during flexion. Statistical analysis was performed to determine the predictive factors of aAAS. Results: Two hundred and forty patients with a mean ± SD age of 56.4 ± 11.4 years were recruited, and 191 (78%) were female. The mean ± SD duration of the disease was 10.2 ± 8.5 years. Of all 25 cases (10.4%) diagnosed with aAAS, the mean anterior atlantodental interval in patients with AAS was 4.19 ± 1.20 mm. One in three patients with aAAS had no neck pain. Patients with aAAS had longer disease duration, lower age at diagnosis, lower body mass index, higher anti‐cyclic citrullinated peptide autoantibodies (anti‐CCP), more frequent erosion, joint restriction, and joint prostheses. In the multivariate regression model, joint limitation, history of joint prostheses, low BMI, and higher anti‐CCP levels were independent predictors of the aAAS. Conclusion: Thirty‐three percent of patients with cervical involvement do not experience neck pain. Cervical involvement should be considered even without neck pain, particularly in established diseases. [ABSTRACT FROM AUTHOR]

Background: Fracture detection plays a crucial role in clinical settings, influencing patient management and treatment decisions. Traditional methods, such as conventional radiography, have been the standard for fracture imaging. However, with advancements in technology, ultrasonography has emerged as a potential alternative, offering benefits such as portability and the absence of ionizing radiation. This study aims to compare the accuracy of ultrasonography and conventional radiography in identifying fractures in individuals presenting with clinical suspicion. The primary objective of this study is to assess and compare the diagnostic accuracy of ultrasonography and conventional radiography in detecting fractures. By evaluating both imaging modalities, we aim to provide insights into the potential utility of ultrasonography as a viable option for fracture diagnosis, particularly in cases where conventional radiography may present limitations. Methods: This prospective comparative study involves individuals with a clinical suspicion of fractures, who will undergo both ultrasonography and conventional radiography. The imaging results will be independently assessed by experienced radiologists blinded to the clinical information. Sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy will be calculated for both modalities. Statistical analyses, including paired t-tests, will be employed to determine significant differences between the two methods. Results: Preliminary results indicate that ultrasonography demonstrates comparable accuracy to conventional radiography in detecting fractures. Sensitivity, specificity, and overall accuracy will be presented, highlighting the strengths and limitations of each imaging modality. Any statistically significant differences between the two methods will be discussed in detail. Conclusion: This study contributes valuable insights into the comparative accuracy of ultrasonography and conventional radiography in fracture detection among individuals with clinical suspicion. The findings aim to guide healthcare professionals in making informed decisions regarding the choice of imaging modality based on the clinical context and available resources. [ABSTRACT FROM AUTHOR]

Conventional radiography is the most commonly used imaging modality for the evaluation of osteoarthritis (OA) in clinical trials of disease-modifying OA drugs (DMOADs). Unfortunately, radiography has many shortcomings as an imaging technique to meaningfully assess the pathological features of OA. In this perspective paper, we will describe the reasons why radiography is not an ideal tool for structural OA assessment and why magnetic resonance imaging (MRI) should be preferred for such purposes. These shortcomings include a lack of reproducibility of radiographic joint space measurements (if conducted without using a standardized positioning frame), a lack of sensitivity and specificity, an insufficient definition of disease severity, a weak association of radiographic structural damage and pain, a lack of ability to depict many faces of OA, and incapability to depict diagnoses of exclusion. MRI offers solutions to these limitations of radiography. Several different phenotypes of OA have been recognized and it is important to recruit appropriate patients for specific therapeutic approaches in DMOAD trials. Radiography does not allow such phenotypical stratification. We will explain known hurdles for widespread deployment of MRI at eligibility screening and how they can be overcome by technological advances and the use of simplified image assessment. [ABSTRACT FROM AUTHOR]

Diagnosis of hip osteoarthritis (OA) is based on clinical arguments, and medical imaging is obtained to confirm the diagnosis and rule out other possible sources of pain. Conventional radiographs are recommended as the first line imaging modality to investigate chronic hip pain. They should be obtained in a rigorous technique that includes an antero-posterior (AP) radiograph of the pelvis. The choice of the appropriate lateral view depends on the clinical indication, Lequesne's false profile being valuable in the assessment of OA. Magnetic resonance imaging (MRI) is more sensitive to detect joint effusion/synovitis, cartilage, labral, and bone marrow lesions. However, structural joint changes are frequent in asymptomatic population and neither radiographs nor MRI have shown a good correlation with pain and functional impairment. MRI seems to be more suitable than radiographs as a biomarker for clinical trials addressing early OA. The absence of a validated MR biomarker of early OA, together with issues related to machine availability and MRI protocol repeatability, prevent the widespread use of MRI in clinical trials. [ABSTRACT FROM AUTHOR]

The craniocervical junction (CCJ) is a complex anatomical structure comprising the occiput, the atlas, and the axis. The CCJ plays an important role in maintaining stability, providing protection, and supporting neurovascular structures. The CCJ can be affected by a wide range of congenital variants and traumatic, degenerative, inflammatory, and tumoral pathologies. This pictorial review the normal anatomy of the CCJ and presents the most common anatomical variants and pathologic conditions affecting the CCJ. [ABSTRACT FROM AUTHOR]

The proportion of diagnostic images not applied for diagnostic purposes is an indicator of image quality, safety, and efficiency in radiography. Despite increased awareness, image reject is still a substantial problem and needs continued observation and targeted measures. Accordingly, the objective of this study is to estimate the extent, variation, and characteristics of image rejects, in order to improve the quality, safety, and efficiency in radiography. All skeletal images at two digital X-ray rooms at two public hospitals in Norway were reviewed for four weeks in 2020. The number of exposed images, type of examination, and number of deleted images were registered. For each deleted image the deduced reasons for deleting the image were recorded. 2183 and 1467 X-ray images were taken at Hospital 1 and 2 respectively. The corresponding reject rates were 14.2% and 9.1%. The reject rate varied greatly from day to day (from 0% to 22%), and the examinations with the highest reject rate were X-ray of extremities (knee, elbow, ankle, wrist) (12–25%) and of the spine (14–19%). The two clearly dominating reasons for image rejects were positioning and centering errors. The reject rate is high and reduces quality, safety, and efficiency of imaging services. The reasons for image rejects are typical professionally reducible errors indicating great potential for improvement. Monitoring and assessing image rejects are of great importance to management, training, education, patient safety, and for quality improvement of imaging services. [ABSTRACT FROM AUTHOR]

Objectives: To compare if the 4th and 5th metatarsophalangeal (MTP) joints evaluated by high‐resolution peripheral quantitative computed tomography (HR‐pQCT) could classify more patients with erosive rheumatoid arthritis (RA) compared with conventional radiography (CR) of the hands, wrists, and feet. Furthermore, we characterize and quantify bone erosions in the two MTP joints by HR‐pQCT. Methods: This single‐center cross‐sectional study included patients with established RA (disease duration ≥5 years). Blinded to patient data, the number and volume of erosions in the 4th and 5th MTP joints were measured by HR‐pQCT, whereas the erosive scores by CR of 44 joints in the hands, wrists, and feet were assessed according to the Sharp/van der Heijde method. Results: Among 42 participants, 30 patients were classified with erosive RA and 12 with non‐erosive RA by CR. HR‐pQCT of two MTP joints could classify more patients with erosive RA compared with CR of 44 joints (p =.03). The optimal cut‐off value for the number and volume of erosions per patient in the 4th and 5th MTP joints by HR‐pQCT was 7.5 erosions and 11.7 mm3, respectively, for detecting erosive disease by CR. Erosions in the two MTP joints by HR‐pQCT were found most frequently and were largest at the lateral quadrant of the 5th metatarsal head. Conclusion: The superiority of HR‐pQCT of the 4th and 5th MTP joints compared with CR of 44 joints for classifying erosive RA provides a basis for larger studies evaluating if HR‐pQCT could be used for diagnosing erosive RA in the future. [ABSTRACT FROM AUTHOR]

Objectives: To clarify the performance of transfer learning with a small number of Waters' images at institution B in diagnosing maxillary sinusitis, based on a source model trained with a large number of panoramic radiographs at institution A. Methods: The source model was created by a 200-epoch training process with 800 training and 60 validation datasets of panoramic radiographs at institution A using VGG-16. One hundred and eighty Waters' and 180 panoramic image patches with or without maxillary sinusitis at institution B were enrolled in this study, and were arbitrarily assigned to 120 training, 20 validation, and 40 test datasets, respectively. Transfer learning of 200 epochs was performed using the training and validation datasets of Waters' images based on the source model, and the target model was obtained. The test Waters' images were applied to the source and target models, and the performance of each model was evaluated. Transfer learning with panoramic radiographs and evaluation by two radiologists were undertaken and compared. The evaluation was based on the area of receiver-operating characteristic curves (AUC). Results: When using Waters' images as the test dataset, the AUCs of the source model, target model, and radiologists were 0.780, 0.830, and 0.806, respectively. There were no significant differences between these models and the radiologists, whereas the target model performed better than the source model. For panoramic radiographs, AUCs were 0.863, 0.863, and 0.808, respectively, with no significant differences. Conclusions: This study performed transfer learning using a small number of Waters' images, based on a source model created solely from panoramic radiographs, resulting in a performance improvement to 0.830 in diagnosing maxillary sinusitis, which was equivalent to that of radiologists. Transfer learning is considered a useful method to improve diagnostic performance. [ABSTRACT FROM AUTHOR]

ObjectivesTo identify the prevalence of calcium pyrophosphate crystal deposition (CPPD) using ultrasound and conventional radiology at peripheral joints in patients with suspected or definite CPPD.MethodsA systematic literature search was performed in PubMed and Embase using pre-defined search strategies from inception to April 2021 to identify studies that evaluated conventional radiology and ultrasound in detecting CPPD at peripheral joints, including definite or suspected CPPD [Research question 1 (RQ1) and Research Question 2 (RQ2), respectively]. For the meta-analysis, the first, second, and third sub-analysis included studies with the knee, and knee or wrist as the index joint for CPPD (without restrictions on the reference standard) and synovial fluid analysis or histology as a reference standard (without restrictions on the index joint), respectively.ResultsOne-thousand eight hundred and twenty-seven manuscripts were identified, of which 94 articles were finally included. Twenty-two and seventy-two papers were included in RQ1 and RQ2, respectively. The knee had the highest prevalence for RQ1 and RQ2 by both conventional radiology and ultrasound, followed by the wrist with the highest prevalence for RQ1. The hand had the lowest CPPD prevalence. The third sub-analysis showed a higher CPPD prevalence on ultrasound than conventional radiology at the knee (only data available).ConclusionAmong all peripheral joints, the knees and wrists could be regarded as the target joints for CPPD detection by imaging. Furthermore, ultrasound seems to detect a higher number of calcium pyrophosphate deposits than conventional radiology, even when using a more restrictive reference standard.

Medical imaging remains the cornerstone of diagnostics and follow-up of axial spondyloarthritis (axSpA) patients. With the lack of specific biomarkers allowing monitoring of disease activity and progression, clinicians refer to imaging modalities for accurate evaluation of the axSpA burden. Technological advances and increasing availability of modern imaging techniques such as MRI have enabled faster diagnosis of the disease, hence dramatically changed the diagnostic delay and improved the prognosis and functional outcomes for axSpA patients. Active sacroiliitis as visualized by MRI has been widely accepted as a diagnostic tool, and definitions of inflammatory and structural lesions within the axial skeleton have been developed. Recently, it has been acknowledged that bone marrow edema, suggestive of sacroiliitis, is a common finding among non-SpA patients, and could be attributed to mechanical loading or accumulate with age in healthy individuals. Therefore, it is crucial to distinguish between true pathological and concealing imaging findings, not only for diagnostic but also for disease remission purposes. New imaging modalities, aimed for in vivo visualization of specific molecular processes, could be employed to cross-validate findings from techniques used in daily clinical practice. This review critically evaluates the use of different imaging modalities for diagnosis and assessment of disease remission in axSpA in the year 2022. [ABSTRACT FROM AUTHOR]

X-rays are electromagnetic waves produced by an X-ray machine and are used to observe the internal structures of patients. The X-rays pass through the body before being detected by the detector file or a digital detector behind the patient. To analyze the knowledge, awareness, and practice on conventional radiographic method and processing among the dental students. A well-framed questionnaire consisting of 10 questions were prepared and distributed among 100 dental professionals and students through the online Google forms link. The data were collected, tabulated in Excel sheets, and analyzed using the SPSS software. The Chi-square test was used to assess the P value. Sixty-five percentage of the participants are aware of conventional radiographic methods and 35% are not aware. The Chi-square test was done giving a P = 0.001 (

Context: High-frequency ultrasound (US) of painful rheumatoid joints allows an increasingly refined analysis of the extent of joint involvement and disease activity. Aims: The aim of this study was to establish the role of the US in the evaluation of painful hand joints in patients with rheumatoid arthritis (RA) and its comparison with Conventional Radiography (CR) changes. Settings and Design: Cross-sectional study. Subjects and Methods: Patients diagnosed with RA were assessed by a thorough clinical examination and relevant laboratory investigations. After X-ray imaging, grayscale, and power Doppler US examination of the wrist, metacarpophalangeal, and proximal interphalangeal joints of both hands were performed using a high-frequency linear transducer. Statistical Analysis Used: SPSS version 20.0 (a statistical package for the social sciences) was used to collect, tabulate, and analyze all data. The results were presented as mean standard deviation or percentage. Differences in categorical data were compared using the Chi-square test and Fisher's exact test. A P < 0.05 was considered statistically significant. Results: Thirty-two of the 51 individuals studied had radiographic abnormalities, whereas 44 had abnormal findings in the US. The US can detect erosions in 37 patients, including all 15 of those who had radiographically visible erosions. A statistically significant difference was noted between the findings of radiography compared with US findings (P < 0.001). Conclusions: US is more sensitive than CR for the detection of erosion and can complement the CR in the evaluation of these patients.

Lunotriquetral (LT) coalition is the most common carpal coalition. Four morphological types of LT coalition have been described. LT coalition is usually asymptomatic, but rarely a fibrocartilaginous type may cause ulnar wrist pain. We report a case of bilateral asymptomatic LT coalition that was seen incidentally on conventional radiography taken after a wrist injury. Conventional radiography is the first imaging technique to detect and classify this type of LT coalition. Magnetic resonance imaging is a useful tool to investigate possible associated pathology of the carpal joints, particularly if surgical treatment of a symptomatic patient is anticipated. [ABSTRACT FROM AUTHOR]

X-rays are electromagnetic waves produced by an X-ray machine and are used to observe the internal structures of patients. The X-rays pass through the body before being detected by the detector file or a digital detector behind the patient. To analyze the knowledge, awareness, and practice on conventional radiographic method and processing among the dental students. A well-framed questionnaire consisting of 10 questions were prepared and distributed among 100 dental professionals and students through the online Google forms link. The data were collected, tabulated in Excel sheets, and analyzed using the SPSS software. The Chi-square test was used to assess the P value. Sixty-five percentage of the participants are aware of conventional radiographic methods and 35% are not aware. The Chi-square test was done giving a P = 0.001 (<0.05), which is statistically significant. The dental students as compared to the other specialties have adequate and efficient knowledge and are aware of the conventional radiographic methods and its processing. [ABSTRACT FROM AUTHOR]

Background: Artifacts in radiography images are distracting and may sometimes influence interpretation. In appearance and cause, computed radiography (CR) systems can produce artifacts that differ from those observed in conventional film radiography. Various components utilized in digital photography have been associated with these artifacts. Computed radiography offers numerous advantages over conventional radiography. In recent years, its use has expanded due to new technologies and the development of other time-saving alternatives. However, like with any imaging technique, it is essential to be aware of the numerous artifacts that might lead to misdiagnosis. It appears hardware and software artifacts are comparable in their application to this topic. Radiographic artifacts are distracting and may precise diagnosis. Although most conventional radiography artifacts are well-known, computed radiography (CR) systems generate unique anomalies from those observed in traditional radiography. We have seen several artifacts in C.R. photographs taken by four specific plate readers. These distortions and operator errors have been associated with the imaging plate, plate reader, image processing software, or laser printer. In this article, many computed radiography artifacts are shown, some of which can be used to mimic pathologic injuries. Their root causes and potential remedies are briefly covered. Over the past five years, there has been an increase in the number of computed radiography systems with photostimulable storage phosphors installed in radiology departments across the globe. The image quality and dependability of the equipment have both been outstanding. However, there have been various perplexing artifacts, some of which mimic actual illness. Computed radiographic systems can modify the severity or appearance of non-computed radiographic artifacts (fogging, double exposure, foreign substances, etc.). [ABSTRACT FROM AUTHOR]

Background: Forensic dentistry relies heavily on conventional radiography's identification technique for age and sex determination. Forensic dentistry uses various radiographic images, including intraoral periapical radiographs, lateral and oblique radiographs, cephalometric radiographs, panoramic radiographs, and advanced imaging techniques. Recent years have also seen a rise in digital radiographs for distinguishing between antemortem images captured in dental offices and centres and postmortem radiographic images used for independent recognition. De tomatillo-facial radiographs are becoming a valuable resource for investigators thanks to the accessibility of the internet. In this essay, we will examine the development of forensic radiology and assess its Role in forensic dentistry thus far. The mandible, located midway between the pelvis and the head, is the experimental part utilised to establish sexual identity. Scientists have looked at the location of their brain foramen to tell males and women apart. This sort of skeletal metric analysis is performed on verified high-quality radiographs. Forensic investigators must determine a person's sex when only a skull fragment is present. The mandible is a fixed bone that shows considerable differences between sexes. The mandibular angle, bicondylar breadth, begonia breadth, and mental foramen position were all shown to be significantly different between the sexes. As the most significant and first form of the paranasal sinuses, the maxillary sinus is an essential component of the face. In the past, sinus radiography helped identify gender among human and skeletal remains. Accordingly, the current investigations' motivation and objectives were to initiate the reliability of maxillary sinuses for gender determination and to initiate novel methods for determining gender utilising maxillary sinus index from lateral cephalometric radiographs. [ABSTRACT FROM AUTHOR]

This retrospective study compared the diagnostic accuracy of conventional radiography (CR) and computed tomography (CT) in classifying Kienböck's disease (KD) according to Lichtman staging. Besides age, cartilage condition and vascularity, bone morphology is important in choosing the most appropriate treatment in KD. In 278 patients, two musculoskeletal radiologists performed a consensus reading of 281 lunate necroses according to the Lichtman classification, based on CR and CT. Stage IIIc was most common in CR (43%) and CT (61%), followed by stage IIIa for CR (25%) and stage IV for CT (15%). In 67%, KD was classified as the same in both modalities. The KD stage had to be upgraded in CT in 34% of cases, notably with stage IIIa progressing to IIIc in 24 out of 69 patients and stage IIIb to IIIc in 23 out of 38 cases. Overall, the Lichtman score was significantly higher on CT. The findings suggest that CT is better than CR in accurately determining the stage of KD stage, indicating a potential shift towards more surgical salvage procedures. Level of evidence: III., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose To develop and evaluate a publicly available deep learning model for segmenting and classifying cardiac implantable electronic devices (CIEDs) on Digital Imaging and Communications in Medicine (DICOM) and smartphone-based chest radiographs. Materials and Methods This institutional review board-approved retrospective study included patients with implantable pacemakers, cardioverter defibrillators, cardiac resynchronization therapy devices, and cardiac monitors who underwent chest radiography between January 2012 and January 2022. A U-Net model with a ResNet-50 backbone was created to classify CIEDs on DICOM and smartphone images. Using 2321 chest radiographs in 897 patients (median age, 76 years [range, 18-96 years]; 625 male, 272 female), CIEDs were categorized into four manufacturers, 27 models, and one "other" category. Five smartphones were used to acquire 11 072 images. Performance was reported using the Dice coefficient on the validation set for segmentation or balanced accuracy on the test set for manufacturer and model classification, respectively. Results The segmentation tool achieved a mean Dice coefficient of 0.936 (IQR: 0.890-0.958). The model had an accuracy of 94.36% (95% CI: 90.93%, 96.84%; 251 of 266) for CIED manufacturer classification and 84.21% (95% CI: 79.31%, 88.30%; 224 of 266) for CIED model classification. Conclusion The proposed deep learning model, trained on both traditional DICOM and smartphone images, showed high accuracy for segmentation and classification of CIEDs on chest radiographs. Keywords: Conventional Radiography, Segmentation Supplemental material is available for this article . © RSNA, 2024 See also the commentary by Júdice de Mattos Farina and Celi in this issue.

MRI, ultrasound, and conventional radiography each play distinct roles in the evaluation of juvenile idiopathic arthritis (JIA), with MRI being the preferred imaging modality of choice for assessing both inflammatory and destructive changes. These various imaging modalities provide valuable insights into JIA in pediatric patients. However, challenges persist in terms of achieving precision, ensuring validity, and distinguishing between pathologic findings and normal anatomic variations. Establishing normal reference values and implementing scoring systems can aid in the precise evaluation of disease activity and provide information to assist treatment decisions for children with JIA. Ongoing advancements in imaging techniques and standardization initiatives aim to bolster the accuracy of JIA diagnosis and assessment, ultimately leading to enhanced patient care and treatment outcomes., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose To assess the prognostic value of a deep learning-based chest radiographic age (hereafter, CXR-Age) model in a large external test cohort of Asian individuals. Materials and Methods This single-center, retrospective study included chest radiographs from consecutive, asymptomatic Asian individuals aged 50-80 years who underwent health checkups between January 2004 and June 2018. This study performed a dedicated external test of a previously developed CXR-Age model, which predicts an age adjusted based on the risk of all-cause mortality. Adjusted hazard ratios (HRs) of CXR-Age for all-cause, cardiovascular, lung cancer, and respiratory disease mortality were assessed using multivariable Cox or Fine-Gray models, and their added values were evaluated by likelihood ratio tests. Results A total of 36 924 individuals (mean chronological age, 58 years ± 7 [SD]; CXR-Age, 60 years ± 5; 22 352 male) were included. During a median follow-up of 11.0 years, 1250 individuals (3.4%) died, including 153 cardiovascular (0.4%), 166 lung cancer (0.4%), and 98 respiratory (0.3%) deaths. CXR-Age was a significant risk factor for all-cause (adjusted HR at chronological age of 50 years, 1.03; at 60 years, 1.05; at 70 years, 1.07), cardiovascular (adjusted HR, 1.11), lung cancer (adjusted HR for individuals who formerly smoked, 1.12; for those who currently smoke, 1.05), and respiratory disease (adjusted HR, 1.12) mortality ( P < .05 for all). The likelihood ratio test demonstrated added prognostic value of CXR-Age to clinical factors, including chronological age for all outcomes ( P < .001 for all). Conclusion Deep learning-based chest radiographic age was associated with various survival outcomes and had added value to clinical factors in asymptomatic Asian individuals, suggesting its generalizability. Keywords: Conventional Radiography, Thorax, Heart, Lung, Mediastinum, Outcomes Analysis, Quantification, Prognosis, Convolutional Neural Network (CNN) Supplemental material is available for this article. © RSNA, 2024 See also the commentary by Adams and Bressem in this issue.

Teaching point: A linear flake of bone at the posterolateral aspect of the distal fibula indicates avulsion of the superior peroneal retinaculum and warrants further investigation by dynamic ultrasound.

The purpose of this experimental study on recently deceased human cadavers was to investigate whether (I) the radiation exposure of the cervical spine CT can be reduced comparable to a dose level of conventional radiography (CR); and (II) whether and which human body parameters can be predictive for higher dose reduction potential (in this context). Materials and Methods: Seventy serial CT scans of the cervical spine of 10 human cadavers undergoing postmortem virtual autopsy were taken using stepwise decreasing upper limits of the tube current (300 mAs, 150 mAs, 110 mAs, 80 mAs, 60 mAs, 40 mAs, and 20 mAs) at 120 kVp. An additional scan acquired at a fixed tube current of 300 mAs served as a reference. Images were reconstructed with filtered back projection and the upper (C1-4) and lower (C4-7) cervical spine were evaluated by three blinded readers for image quality, regarding diagnostic value and resolution of anatomical structures according to a semiquantitative three-point-scale. Dose values and individual physical parameters were recorded. The relationship of diagnostic IQ, dose reduction level, and patients' physical parameters were investigated. The high-contrast resolution of the applied CT protocols was tested in an additional phantom study. Results: The IQ of the upper cervical spine was diagnostic at 1.69 ± 0.58 mGy (CTDI) corresponding to 0.20 ± 0.07 mSv (effective dose) in all cadavers. IQ of the lower cervical spine was diagnostic at 4.77 ± 1.86 mGy corresponding to 0.560 ± 0.21 mSv (effective dose) in seven cadavers and at 2.60 ± 0.93 mGy corresponding to 0.31 ± 0.11 mSv in four cadavers. Significant correlation was detected for BMI (0.8366; p = 0.002548) and the anteroposterior (a.p.) chest diameter (0.8363; p = 0.002566), shoulder positioning (0.79799; p = 0.00995), and radiation exposure. Conclusions: Conventional radiography can be replaced with a nearly dose-neutral CT scan of the cervical spine. [ABSTRACT FROM AUTHOR]

Calcific tendinopathy (CT) is a very common condition caused by the deposition of calcium hydroxyapatite crystals in tendons and it can be an incidental finding or associated with severe pain. CT can be easily detected by first level exams such as traditional radiography and ultrasound (US), which provide information on the site, extent and composition of the calcific formation. Classically, the most affected site is represented by the rotator cuff tendons, in particular the supraspinatus tendon. In this pictorial essay we illustrate various unusual localizations of CT detected by US and plain radiography, in order to provide an overview with the aim of preventing diagnostic delays and consequently CT complications. [ABSTRACT FROM AUTHOR]

Abstract Background Trabecular bone texture analysis (TBTA) has been identified as an imaging biomarker that provides information on trabecular bone changes due to knee osteoarthritis (KOA). Consequently, it is important to conduct a comprehensive review that would permit a better understanding of this unfamiliar image analysis technique in the area of KOA research. We examined how TBTA, conducted on knee radiographs, is associated to (i) KOA incidence and progression, (ii) total knee arthroplasty, and (iii) KOA treatment responses. The primary aims of this study are twofold: to provide (i) a narrative review of the studies conducted on radiographic KOA using TBTA, and (ii) a viewpoint on future research priorities. Method Literature searches were performed in the PubMed electronic database. Studies published between June 1991 and March 2020 and related to traditional and fractal image analysis of trabecular bone texture (TBT) on knee radiographs were identified. Results The search resulted in 219 papers. After title and abstract scanning, 39 studies were found eligible and then classified in accordance to six criteria: cross-sectional evaluation of osteoarthritis and non-osteoarthritis knees, understanding of bone microarchitecture, prediction of KOA progression, KOA incidence, and total knee arthroplasty and association with treatment response. Numerous studies have reported the relevance of TBTA as a potential bioimaging marker in the prediction of KOA incidence and progression. However, only a few studies have focused on the association of TBTA with both OA treatment responses and the prediction of knee joint replacement. Conclusion Clear evidence of biological plausibility for TBTA in KOA is already established. The review confirms the consistent association between TBT and important KOA endpoints such as KOA radiographic incidence and progression. TBTA could provide markers for enrichment of clinical trials enhancing the screening of KOA progressors. Major advances were made towards a fully automated assessment of KOA.

Abstract Background The aim of the study is to assess the diagnostic value of preoperative conventional radiographs for diagnosing infection associated with internal fixation devices. Methods We prospectively collected data of patients undergoing removal of internal fixation devices for any reason. Infection was diagnosed in case of purulence, sinus tract, positive histopathology and/or positive peri-implant tissue or sonication fluid culture. In radiographs radiolucent lines, implant breakage or displacement, or periosteal reaction were assessed. White blood cell count (WBC) and serum C-reactive protein (CRP) were determined at admission. Results We included 421 surgeries in 380 patients (median age 53.6 years, range 11–98 years), mainly indicated for infection (24.9%), nonunion (20.0%) and symptomatic implants (13.5%). Radiologic signs of infection included radiolucent lines (11.4%); implant breakage (12.4%) or displacement (10.7%); and periosteal reaction (7.1%). Infection was confirmed in 116 cases (27.6%). Only radiolucent lines (OR = 1.86 [95%CI: 1.00–3.38]) and periosteal reaction (OR = 2.48 [95%CI: 1.17–5.26]) were associated with infection, with a low sensitivity (16.4 and 12.1%, respectively), and high specificity (90.5 and 94.8%, respectively). Preoperative WBC and CRP had a sensitivity of 23.0 and 35.3%, and specificity of 91.7 and 89.5%, respectively. Conclusions Radiological signs suggestive of infection were uncommon. Radiolucency and periosteal reaction were associated with infection, though with low sensitivity.

Background: Most trauma systems and traumatic spinal injury guidelines mandate spinal stabilization from the site of injury to a radiological confirmation or refutal of spinal injury. Vacuum mattresses have been advocated for patients in need of prehospital spinal stabilization. Purpose: To investigate the effect of different vacuum mattresses on standard resuscitation bay conventional radiography of chest and pelvis, especially regarding artefacts. Material and Methods: We used a mobile X-ray machine to perform chest and pelvic conventional radiography on an anthropomorphic whole-body phantom with a trauma transfer board, three different vacuum mattresses, and without any stabilization device. The vacuum mattresses were investigated in activated, deactivated, and stretched after deactivated states. Two radiologists assessed the artefacts independently. Agreement was measured using kappa coefficient. Results: All radiographs were of good technical quality and fully diagnostic. With the exception of one disagreed occurrence, artefacts were seen to hamper clinical judgment exclusively with activated vacuum mattresses. There was substantial agreement on artefact assessment. The observed agreement was 0.82 with a kappa coefficient of 0.71. The first vacuum mattress caused no artefacts hampering with clinical judgment. Conclusion: Our study concludes that it is feasible to maintain some vacuum mattresses through resuscitation bay conventional radiography of chest and pelvis. They do not result in artefacts hampering with clinical judgment. Our vacuum mattress No. 1 is recommendable for this purpose. Together with our previous findings our present results indicate that some vacuum mattresses may be used throughout the initial resuscitation bay assessment and CT examination. [ABSTRACT FROM AUTHOR]

Purpose of Review: Among the imaging modalities for the investigation of articular damage of patients with peripheral inflammatory arthropathies, conventional radiography (CR) is the mostly used. Other imaging modalities such as the musculoskeletal ultrasonography, magnetic resonance imaging, and dual-energy computed tomography scans are often used depending on a patient's clinical needs. Recent Findings: With the publication of new classification criteria for rheumatoid arthritis (RA), spondyloarthropathies, polymyalgia rheumatica, and others, many physicians are not using any of the above imaging techniques because they believe that by relying only on the classification criteria of a disease the diagnosis can be an easy task. Summary: We present a patient with peripheral symmetrical polyarthritis involving the small joints of the hands, diagnosed and treated as RA and we discuss the role of imaging, especially the use of CR as an initial screening tool for the evaluation of the articular manifestations and joint damage, and its further usefulness in order to reach a definitive correct diagnosis. [ABSTRACT FROM AUTHOR]

Objective To investigate whether high-resolution peripheral quantitative CT (HR-pQCT) of two metacarpophalangeal (MCP) joints can more accurately classify patients as having erosive RA compared with conventional radiography (CR) of 44 joints in the hands, wrists and feet. Methods In this single-centre cross-sectional study, patients with established RA (disease duration ≥5 years) were investigated by HR-pQCT and CR. The second and third MCP joints of the dominant hand were assessed for erosions by HR-pQCT. CR of the hands, wrists and feet were scored according to the Sharp–van der Heijde (SHS) method. Results In total, 353 patients were included; 66 (18.7%) patients were classified as having non-erosive RA, and 287 (81.3%) had erosive RA by CR. The sensitivity and specificity (95% CI) of HR-pQCT for classifying patients as having erosive RA when standard CR of hands, wrists and feet was used as the reference was 89% (84, 92%) and 30% (20, 43%), respectively. Using HR-pQCT as the reference, the sensitivity and specificity of CR for classifying patients having erosive RA were 85% (80, 89%) and 38% (25, 52%), respectively. McNemar's χ2 test showed no significant difference between the sensitivities of patients classified as having erosive RA by HR-pQCT or by CR (2.14, P  = 0.177). Conclusion The diagnostic accuracy of HR-pQCT scanning of only two MCP joints and CR of 44 joints suggests the two modalities were comparable for classifying patients with established RA as having erosive disease. Clinical trial registration ClinicalTrials.gov (NCT03429426). [ABSTRACT FROM AUTHOR]

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Recently developed and commercialized dual-layer flat panel detectors (DL-FPDs) with two indirect scintillators are capable of acquiring dual-energy X-ray images. However, in clinical practice, they are utilized to perform conventional radiography using diagnostic X-rays with a wide energy spectrum. The two layers of the DL-FPD may affect the obtained image quality, even when only using one layer for conventional image acquisition, and these effects are yet to be substantiated. Therefore, in this study, we quantitatively evaluated the image quality of a conventional chest radiography using DL-FPD and visually verified the characteristics of the chest anthropomorphic phantom images. The physical characteristics of the system were evaluated using the pre-sampled modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE), for beam quality RQA 7 and RQA 9. In addition, the subjective visibility of the anthropomorphic chest phantom and simple objects images were compared with those of a conventional single-layer flat-panel detector (SL-FPD). No significant differences were found in the MTF between the SL-FPD and DL-FPD images. In addition, a higher DQE was observed at some exposure doses and in the high spatial frequency regions wherein NNPSs were lower for DL-FPD than for SL-FPD. Furthermore, no significant differences were found in the subjective visibility of the chest phantoms in each system. We concluded that the image quality of the conventional radiography acquired with DL-FPD is comparable to or better than that of the SL-FPD. [ABSTRACT FROM AUTHOR]

Teaching Point: A chondroid lipoma is a rare benign adipocytic neoplasm, containing a chondromyxoid matrix, that may mimic a myxoid liposarcoma and myxoid chondrosarcoma.

Context: High-frequency ultrasound (US) of painful rheumatoid joints allows an increasingly refined analysis of the extent of joint involvement and disease activity. Aims: The aim of this study was to establish the role of the US in the evaluation of painful hand joints in patients with rheumatoid arthritis (RA) and its comparison with Conventional Radiography (CR) changes. Settings and Design: Cross-sectional study. Subjects and Methods: Patients diagnosed with RA were assessed by a thorough clinical examination and relevant laboratory investigations. After X-ray imaging, grayscale, and power Doppler US examination of the wrist, metacarpophalangeal, and proximal interphalangeal joints of both hands were performed using a high-frequency linear transducer. Statistical Analysis Used: SPSS version 20.0 (a statistical package for the social sciences) was used to collect, tabulate, and analyze all data. The results were presented as mean standard deviation or percentage. Differences in categorical data were compared using the Chi-square test and Fisher's exact test. A P < 0.05 was considered statistically significant. Results: Thirty-two of the 51 individuals studied had radiographic abnormalities, whereas 44 had abnormal findings in the US. The US can detect erosions in 37 patients, including all 15 of those who had radiographically visible erosions. A statistically significant difference was noted between the findings of radiography compared with US findings (P < 0.001). Conclusions: US is more sensitive than CR for the detection of erosion and can complement the CR in the evaluation of these patients. [ABSTRACT FROM AUTHOR]

Teaching Point: A chondroid lipoma is a rare benign adipocytic neoplasm, containing a chondromyxoid matrix, that may mimic a myxoid liposarcoma and myxoid chondrosarcoma. [ABSTRACT FROM AUTHOR]

Introduction: Panoramic radiograph is an image used by the dentist to maintain diagnosis in dentistry, for example, to evaluate teeth condition in mixed dentition period. There are two panoramic radiography techniques, which are conventional and digital (direct and indirect) method. This study was aimed to analyse the differences of panoramic radiograph image quality between the conventional and digital indirect method on mixed dentition radiograph. Methods: Thirty samples of conventional and indirect digital panoramic radiograph were randomly taken from the database according to inclusion criteria. The image quality of conventional radiograph was manually assessed by using illuminator box, while indirect digital radiographs was assessed directly using DBS Win 5.7.0 software (Durr Dental, Germany). The radiographs were divided into six zones: teeth area, nasal and sinus, mandible, TMJ, ramus-spine, and hyoid bone. The image quality assessment was performed in each area based on three criteria: anatomical coverage, density and contrast, and anatomical structure. Results: The Cronbach's Alpha Intra-Class Correlation (ICC) inter and intraobserver agreement test of conventional and digital indirect methods on the aspect of anatomical, density and contrast coverage, and anatomic structure showed an excellent agreement. The independent sample t-test result showed significant difference (p < 0.05) between the conventional and indirect digital method in density and contrast as well as anatomical structure aspects, but not significantly different (p > 0.05) in the anatomical coverage aspect. Conclusion: Indirect digital panoramic radiograph shows better image quality as compared to conventional radiograph, especially in the anatomical structure aspect, density and contrast. There is no difference in the anatomical coverage aspect between conventional and indirect digital panoramic radiograph.

Background: Many imaging modalities have been in use for the evaluation of temporal bone lesions. Plain X-rays are cost-effective however; they provide limited details and hence sometimes may result in an inaccurate diagnosis. With the advent of HRCT, the method of imaging of temporal bone has evolved with special algorithms and multiplanar formats. In the present study, we tried to evaluate the different pathologies of the temporal bone with X-ray and HRCT. Methods: The study was conducted in the Departments of Otorhinolaryngology and Radiology, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. A total of n=40 patients were identified and selected based on their symptoms and clinical findings suggestive of a lesion involving the temporal bone such as Otalgia, Otorrhoea, And Sensorineuronal deafness, pulsatile tinnitus, vertigo, and giddiness. These patients were subjected to high resolution computed tomography of the temporal bone on the 128 Slice CT Scanner (PHILIPS INGENUITY). The patients also underwent plain Radiography of temporal bone (CARESTREAM DRX-1 System). Results: Of the total n=40 patients studied the most common temporal bone disease was due to inflammation 85% and tumors were found in 15% of the patients. The common site of involvement of middle ear and mastoid air cells in chronic otitis media was epitympanum in n=30(90%) of cases, Mesotympanum in n=20(60%) of cases. In diseased ears, radiographs of the mastoids revealed pneumatised mastoid in 6(15%), diploic in 6(15%), and sclerosed mastoid in 28(70%) cases. HRCT temporal bone revealed pneumatised mastoid in 9(22.5%), diploic in 5(12.5%) and sclerosed mastoid in 26(65%) cases. Conclusion: The role of plain radiography is found to be limited to know the type of mastoid pneumatisation. It can also as Original Article detect bony erosion in few cases. Because of the ability to see temporal bone structures with great clarity, HRCT can be recommended not only in cases suspected with potential complications but also in all cases of temporal bone pathologies to know the extent of disease, inter-relationships of the tympanomastoid compartment with adjacent neurovascular structures, varied pneumatisation and the presence of anatomical variations, which should alert the clinician and guide in surgical approach and treatment plan.

Sialolithiasis is a common salivary gland disease. It may cause swelling of the gland, infection of the gland, or even death of glandular parenchymal cells. Various treatment modalities are available for management of sialolithiasis such as extracorporeal shock wave lithotripsy, sialoendoscopy, laser intracorporeal lithotripsy, interventional radiology, the video-assisted conservative surgical removal of the parotid, and submandibular calculi. These sophisticated procedures may not be available in all health-care centers. In this article, a new simple yet precise technique for management of ductal sialolith with minimum armamentarium is introduced.

Background: Accurate root canal length determination, simplicity of the procedure, and patient's cooperation are important determinants in the success of endodontic treatment in primary teeth. Aim: The aim of the study was to clinically compare the accuracy of Propex Pixi and Formatron D10 apex locators with conventional radiography in determining working length in mandibular primary second molars with and without varying degrees of physiological root resorption. Design: A nonrandomized clinical trial was conducted in 115 mandibular primary second molars indicated for pulpectomy in 90 pediatric dental patients. A single calibrated examiner determined the working length by conventional radiographic method and electronic apex locator (EAL) methods in a total of 376 canals. Behavior of the children during execution of each method in each tooth was recorded using the Frankl's behavior rating scale. The data obtained were tabulated and subjected to statistical analysis. Results: Significant correlation (intraclass correlation = 0.80 and 0.81, P < 0.001) could be detected between working length measurements obtained using Propex Pixi and Formatron D10 and measurements obtained using conventional radiography. Higher percentage of negative behaviors (negative and definitely negative) was observed during the conventional radiographic method (68.6%) as opposed to the Propex Pixi (16.5%) and Formatron D10 (20.8%) methods. Conclusions: Both the apex locators were as accurate as conventional radiography in determining working length in primary teeth; Formatron D10 being more accurate than Propex Pixi. The EALs were far better accepted by children than conventional radiography.

Purpose: To investigate the role of acromiohumeral distance (AHD) and critical shoulder angle (CSA) measurements from conventional radiographs (CR) in isolation and combined (prognostic index PIAHD-CSA) as predictors of full thickness rotator cuff tendon tears (RCT) and critical fatty degeneration (CFD; i.e. as much fat as muscle). Method: In this retrospective study AHD and CSA were measured in 127 CR. MR arthrograms served as reference standard and were screened for RCT and CFD. Statistical analysis for inter-reader agreement, Spearman’s rank correlation, linear stepwise regression and logistic regression for AHD and CSA with ROC analyses including PIAHD-CSA were performed. Results: In 90 subjects (17 females, mean age 36.1 ± 14.1) no RCT were found on MR imaging and served as control group. In 37 patients (13 females, mean age 58.7 ± 13.2) ≥ one RCT was found. Inter-reader agreements rated between к = 0.42–0.82 for categorical and 0.91–0.96 for continuous variables. No significant correlation of AHD and CSA with either age or sex was seen (p = 0.28 and p = 0.74, respectively). Case group had significantly smaller mean AHD (8.7 ± 3.2 vs. 10.8 ± 2.2 mm; p

Imaging methods capable of detecting inflammation, such as MR imaging and ultrasound, are of paramount importance in rheumatic disease management, not only for diagnostic purposes but also for monitoring disease activity and treatment response. However, more advanced stages of arthritis, characterized by findings of cumulative structural damage, have traditionally been accomplished by radiographs and computed tomography. The purpose of this review is to provide an overview of imaging of some of the most prevalent inflammatory rheumatic diseases affecting the lower limb (osteoarthritis, rheumatoid arthritis, and gout) and up-to-date recommendations regarding imaging diagnostic workup., (Published by Elsevier Inc.)