The Role of Plain Radiography in Diagnosing Brodie's Abscess: Clinical Image
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ABSTRACT Plain radiographs can still be of considerable diagnostic value for recognizing Brodie's abscess, especially in resource constrained settings.Keywords:
Plain radiography
Projectional radiography
The elderly have some indications for plain film radiography that are specifically determined by their age group. Imaging of the pelvis is most commonly prompted by pain and/or trauma. In addition to identification of fractures, emergency physicians should look for neoplastic lesions and degenerative changes of the hip joints or sacroiliac joints. Rheumatologic conditions are increasingly common with age. Plain radiology in the evaluation of non bony abdominal pathology has the same limitations in the elderly as it does for other adults, with the consequence that CT is often the imaging modality of choice. Most of the limitations of plain radiography in the elderly are the same as those for adults. Radiographs are limited by the patient's ability to cooperate with the exam. This chapter presents clinical images depicting radiographic findings and pathology that clinicians should be familiar with in the elderly patient.
Plain radiography
Projectional radiography
Sacroiliac joint
Conventional radiography
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Radiographic evaluation of acutely injured patients with a displaced acetabular fracture usually includes plain radiographs and computed tomography (CT) scans. Because of patient and technologist factors, plain radiographs can be compromised and therefore can be insufficient for assessment of the fractured acetabulum. We conducted a study to determine whether computer-reconstructed radiographs (CRRs), plain radiograph-like images created from CT data, are equivalent to traditional radiographs for assessment of acetabular fractures. Five orthopedic surgeons with various trauma experience compared 77 radiographic images from 11 retrospectively identified patients with a displaced acetabular fracture. CRRs were found to be equal to plain radiographs for fracture pattern recognition, image clarity, level of information provided, and overall reviewer satisfaction. Reviewers were confident in their ability to assess fractures using CRRs and found them more aesthetically pleasing than plain radiographs. CRRs provide information equal to that of plain radiographs for assessment of displaced acetabular fractures and have the potential to overcome the problems associated with patient factors (discomfort, body habitus, fracture pattern, presence of overlying osseous structures, bowel gas and intestinal contrast materials) and technologist factors.
Acetabular fracture
Plain radiography
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Plain radiography
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Plain radiography
Projectional radiography
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Background The Instability Severity Index Score (ISIS) was developed to help determine the prognosis for recurrent shoulder instability and to assist surgical decision-making. The radiographic portion of the ISIS represents a substantial portion of the total score. The present study examined the intra- and inter-rater agreement, reliability and accuracy of the radiographic components of the ISIS. Methods Four assessors evaluated 49 blinded shoulder radiographs. Assessors documented their observation of the presence of a Hill–Sachs lesion and/or a loss of glenoid contour. Radiographs were reviewed twice in random order over two sessions. Intra- and inter-rater reliability and accuracy were calculated. Results Intra-rater agreement ranged from 71% to 94% for the presence of a Hill–Sachs lesion and 85% to 94% for a loss of glenoid contour. Intra-rater kappa values ranged from 0.41 to 0.86 and 0.56 to 0.74, respectively. Inter-rater agreement was found to be 63% to 78% and 78% to 90% for Hill–Sachs and glenoid lesions, respectively. Corresponding kappa values were 0.31 and 0.48. Accuracy ranged from 29% to 57% for Hill–Sachs and 65% to 73% for glenoid lesions. Conclusions In the present study, intra- and inter-rater reliability of the radiographic portion of the ISIS demonstrated limited kappa and accuracy. We suggest that the ISIS should be used with caution as a guide for surgical management.
Plain radiography
Inter-Rater Reliability
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This study was performed for the purpose of comparing vertebral heart score (VHS), radiographic left atrial dimension (RLAD) and vertebral left atrial size (VLAS) values derived from plain and contrast right lateral thoracic radiographs from 70 healthy, young adult Wistar albino rats and to identify reference values for these radiographic cardiac indices. Measurements were taken by two observers blinded to the study data. VHS, RLAD and VLAS median values and reference ranges were 8v and 7-9.3v for plain radiography, 8.2v and 7.4-9.5v for contrast radiography (P< 0.000), 1.3v and 1-1.8v for plain radiography, 1.3v and 1.1-1.6v for contrast radiography (P <0.000) and 1.9v and 1.4-2.4v for plain radiography and 1.95v 1.5-2.4v for contrast radiography (P<0.001), respectively. The only statistically significant difference was observed in terms of gender between VHS values from plain and contrast radiographs (P<0.02). Intraobserver and interobserver measurements revealed excellent agreement for radiographic cardiac indices obtained from contrast radiography. The study measurements indicate that contrast radiography provides a more effective quantitative assessment of cardiac and left atrial sizes than plain radiography. The radiographic cardiac index measurements presented in this study can serve as a reference baseline for both veterinarians and experimental cardiovascular studies.
Plain radiography
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Pelvic ring injury classification traditionally is made using plain radiographs. Recent studies suggest that computed tomography (CT)-generated images have higher diagnostic accuracy than plain films for the classification of acetabular fractures. However, similar studies have not been performed for pelvic ring injuries. The purpose of this study was to compare CT-generated and plain radiographs in terms of the ability of surgeons at different experience levels to identify pelvic injury type.CT-generated and plain radiograph image sets were created from 15 pelvic ring injury patients with known classification morphology. Three groups, each consisting of three orthopaedic surgeons representing different levels of expertise, viewed these image sets and recorded their diagnoses. These diagnoses were compared to the gold standard findings of the treating physician and to each other.Overall, there was a significantly improved ability to correctly classify pelvic ring injury type by CT-generated radiographs as compared to plain radiographs (p < 0.01). However, analysis of the groups revealed that this difference was limited to the less experienced groups (p < 0.05).CT-generated radiographs are diagnostically beneficial for less experienced surgeons and at least as good as conventional plain radiographs for experienced surgeons in classifying pelvic ring injuries. Therefore, CT-generated radiographs may be clinically valuable: sparing the patient additional radiation exposure and discomfort by avoiding the reordering of plain radiographs when the initial studies are of poor quality, as well as serving as a possible alternative for supplemental initial injury plain radiographic views.
Plain radiography
Gold standard (test)
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Plain radiography
Projectional radiography
Conventional radiography
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Objective To compare the clinical value of multislice spiral CT ( MSCT ) with that of plain film radiography in the diagnosis of intestinal obstruction.Methods The data of abdominal CT scans and plain film radiography for 83 patients with intestinal obstruction were analyzed.The diagnostic value and clinical value ( image quality,difficulty of operation,and comfort level to patients ) were compared.Results There were sigificant differences between MSCT and plain film radiography in the diagnosis of intestinal obstruction and the determination of obstruction sites and causes of obstruction ( P＜ 0.01 ).Of 37 patients with strangulation confirmed by surgery,only 5 were found by plain film radiography but all were found by MSCT.There was a significant statistical difference in the detection rate between the two approaches ( P＜ 0.01 ).MSCT was also superior to plain film radiography in image quality,difficulty of operation,and comfort level to patients ( P ＜ 0.01 ).Conclusions Multislice spiral CT has a higher clinical value than plain film radiography in the diagnosis of intestinal obstruction.
Key words:
Multi-slice spiral CT; Plain film radiography; Intestinal obstruction
Projectional radiography
Plain radiography
Multislice
Computed radiography
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