1,100 research outputs found
Femoral anteversion change is associated with ischiofemoral impingement after total hip arthroplasty: a retrospective CT evaluation
OBJECTIVES
We evaluated the relationship between femoral anteversion (FA), FA change, and ischiofemoral impingement (IFI) and the relationship between FA, femoral offset (FO), and greater trochanteric pain syndrome (GTPS) after total hip arthroplasty (THA).
MATERIALS AND METHODS
In this retrospective study, two readers assessed FA and FO on CT images of 197 patients following primary THA with an anterior surgical approach between 2014 and 2021. FA change was calculated relative to preoperative CT, while FO change was calculated relative to preoperative radiographs and classified as decreased (≥-5 mm), increased (≥ + 5 mm), or restored (± 5 mm). Clinical and imaging data were analyzed for IFI and GTPS after surgery. Group differences were evaluated using Student's t-test, chi-square analysis, and receiver operating characteristic (ROC) analysis.
RESULTS
The change in FA was 3.6 ± 3.3° to a postoperative FA of 22.5 ± 6.8°, while FO increased by 1.7 ± 3.5 mm to a postoperative FO of 42.9 ± 7.1 mm. FA and FA change were higher in patients with IFI (p ≤ 0.006), while no significant difference was observed for patients with and without GTPS (p ≥ 0.122). IFI was more common in females (p = 0.023). In the ROC analysis, an AUC of 0.859 was observed for FA change to predict IFI, whereas the AUC value was 0.726 for FA alone. No significant difference was found for FO change in patients with and without IFI or GTPS (p ≥ 0.187).
CONCLUSION
Postoperative FA, FA change, and female sex were associated with IFI after anterior-approached THA. The change in FA was a better predictor of IFI than absolute postoperative FA alone.
CLINICAL RELEVANCE STATEMENT
The findings of this study suggest that preservation of the preoperative femoral anteversion may reduce postoperative ischiofemoral impingement in patients undergoing total hip arthroplasty.
KEY POINTS
• Higher postoperative femoral anteversion and anteversion change were associated with ischiofemoral impingement. • Femoral anteversion change was a better predictor of impingement than absolute postoperative anteversion. • No significant association was found between femoral offset and postoperative hip pain
Quantifying cup overhang after total hip arthroplasty: standardized measurement using reformatted computed tomography and association of overhang distance with iliopsoas impingement
OBJECTIVES
Currently, there is no standardized measurement method for evaluating cup overhang (CO) in patients undergoing total hip arthroplasty (THA). We propose a novel, standardized method of measuring overhang distance in patients following primary total hip arthroplasty (THA) on computed tomography (CT) images after multiplanar reformation and compare it to a previously proposed measurement method on sagittal CT images.
MATERIALS AND METHODS
This retrospective study included patients who underwent primary THA with an anterior approach. Patients with cup overhang (CO) and iliopsoas impingement (IPI) were identified by clinical and imaging data. Uncorrected overhang distance (OD) was evaluated on orthogonal sagittal CT images while corrected overhang distance (OD) was evaluated on reformatted sagittal CT images corrected for pelvic rotation and aligned with the plane of the cup face.
RESULTS
Out of 220 patients with THA, 23 patients (10.4%) with CO and 16 patients (7.3%) with IPI were identified. CO was significantly associated to IPI (p < 0.001). The inter- and intrareader agreement was almost perfect for OD (κ = 0.822, κ = 0.850), whereas it was fair and moderate for OD (κ = 0.391, κ = 0.455), respectively. The discriminative ability of OD was excellent (area under the curve (AUC) = 0.909 (95% confidence interval (CI) 0.784-1.000)) in the receiver operating characteristic analysis. Conversely, AUC for OD was poor, measuring 0.677 (95% CI 0.433-0.921).
CONCLUSION
We implemented a novel measurement method for CT images reformatted at the plane of the cup face to assess overhang distance in patients with CO following THA.
CLINICAL RELEVANCE STATEMENT
While further validation is necessary, the proposed method is characterized by its high reproducibility and might be used to predict the occurrence of iliopsoas impingement in patients with cup overhang following total hip arthroplasty.
KEY POINTS
• A novel, standardized method of measuring cup overhang distance in patients following primary total hip arthroplasty on CT images is proposed. • Cup overhang was associated to iliopsoas impingement. The proposed method was reproducible and showed excellent prediction of iliopsoas impingement in patients with cup overhang. • This method can be implemented in clinical practice when assessing CT images of patients with cup overhang for iliopsoas impingement
Pointwise reconstruction of wave functions from their moments through weighted polynomial expansions: an alternative global-local quantization procedure
Many quantum systems admit an explicit analytic Fourier space expansion,
besides the usual analytic Schrodinger configuration space representation. We
argue that the use of weighted orthonormal polynomial expansions for the
physical states (generated through the power moments) can define both an
convergent, non-orthogonal, basis expansion with sufficient point-wise
convergent behaviors enabling the direct coupling of the global (power moments)
and local (Taylor series) expansions in configuration space. Our formulation is
elaborated within the orthogonal polynomial projection quantization (OPPQ)
configuration space representation previously developed by Handy and Vrinceanu.
The quantization approach pursued here defines an alternative strategy
emphasizing the relevance OPPQ to the reconstruction of the local structure of
the physical states
How accurate is MRI for diagnosing tarsal coalitions? A retrospective diagnostic accuracy study
OBJECTIVES
This study aimed to evaluate the diagnostic accuracy, inter-reader agreement, and associated pathologies on MR images of patients with confirmed TC.
METHODS AND MATERIALS
In this retrospective study, 168 ankle MRI exams were included, consisting of 56 patients with clinically or surgically confirmed TC and 112 controls without TC, matched for age and sex. Images were analyzed independently by three radiologists blinded to clinical information. The evaluation criteria included the presence, type, and location of TC, as well as associated pathologies. After calculating diagnostic accuracy and the odds ratio of demographic data and anatomic coalition type for associated pathologies, inter-reader agreement was assessed using kappa statistics.
RESULTS
The majority of TCs were non-osseous (91.1%) and located at the calcaneonavicular (33.9%) or talocalcaneal joint (66.1%). Associated pathologies included adjacent and distant bone marrow edema (57.1% and 25.0%), osteochondral defect of the talar dome (OCD, 19.6%), and joint effusion (10.7%) and accessory anterolateral talar facet (17.9%). Talar OCD was associated with increased patient age (p = 0.03). MRI exhibited a cumulative sensitivity and specificity of 95.8% and 94.3% with almost perfect inter-reader agreement (κ = 0.895).
CONCLUSION
MRI is a reliable method for detecting tarsal coalition and identifying commonly associated pathologies. Therefore, we recommend the routine use of MRI in the diagnostic workup of patients with foot pain and suspected tarsal coalition.
CLINICAL RELEVANCE STATEMENT
MRI is an accurate and reliable modality for diagnosing tarsal coalitions and detecting associated pathologies, while improving patient safety compared to computed tomography by avoiding radiation exposure.
KEY POINTS
• Despite the technological progress in magnetic resonance imaging (MRI), computed tomography (CT) is still regarded as the gold standard for diagnosing tarsal coalition (TC). • MRI had a cumulative sensitivity of 95.8% and specificity of 94.3% for detecting tarsal coalition with an almost perfect inter-reader agreement. • MRI demonstrates high accuracy and reliability in diagnosing tarsal coalitions and is useful for identifying associated pathologies, while also improving patient safety by avoiding radiation exposure
Analysis of concordance of different haplotype block partitioning algorithms
BACKGROUND: Different classes of haplotype block algorithms exist and the ideal dataset to assess their performance would be to comprehensively re-sequence a large genomic region in a large population. Such data sets are expensive to collect. Alternatively, we performed coalescent simulations to generate haplotypes with a high marker density and compared block partitioning results from diversity based, LD based, and information theoretic algorithms under different values of SNP density and allele frequency. RESULTS: We simulated 1000 haplotypes using the standard coalescent for three world populations – European, African American, and East Asian – and applied three classes of block partitioning algorithms – diversity based, LD based, and information theoretic. We assessed algorithm differences in number, size, and coverage of blocks inferred under different conditions of SNP density, allele frequency, and sample size. Each algorithm inferred blocks differing in number, size, and coverage under different density and allele frequency conditions. Different partitions had few if any matching block boundaries. However they still overlapped and a high percentage of total chromosomal region was common to all methods. This percentage was generally higher with a higher density of SNPs and when rarer markers were included. CONCLUSION: A gold standard definition of a haplotype block is difficult to achieve, but collecting haplotypes covered with a high density of SNPs, partitioning them with a variety of block algorithms, and identifying regions common to all methods may be the best way to identify genomic regions that harbor SNP variants that cause disease
Developmentally regulated glycosylation of the CD8alphabeta coreceptor stalk modulates ligand binding.
The functional consequences of glycan structural changes associated with cellular differentiation are ill defined. Herein, we investigate the role of glycan adducts to the O-glycosylated polypeptide stalk tethering the CD8alphabeta coreceptor to the thymocyte surface. We show that immature CD4(+)CD8(+) double-positive thymocytes bind MHCI tetramers more avidly than mature CD8 single-positive thymocytes, and that this differential binding is governed by developmentally programmed O-glycan modification controlled by the ST3Gal-I sialyltransferase. ST3Gal-I induction and attendant core 1 sialic acid addition to CD8beta on mature thymocytes decreases CD8alphabeta-MHCI avidity by altering CD8alphabeta domain-domain association and/or orientation. Hence, glycans on the CD8beta stalk appear to modulate the ability of the distal binding surface of the dimeric CD8 globular head domains to clamp MHCI
7 T MRI of the Cervical Neuroforamen: Assessment of Nerve Root Compression and Dorsal Root Ganglia in Patients With Radiculopathy
OBJECTIVES: The aim of this study was to assess the diagnostic value of 3-dimensional dual-echo steady-state (DESS) magnetic resonance imaging (MRI) of the cervical spine at 7 T compared with 3 T in patients with cervical radiculopathy.
MATERIALS AND METHODS: Patients diagnosed with cervical radiculopathy were prospectively recruited between March 2020 and January 2023 before undergoing surgical decompression and received 3-dimensional DESS imaging at 3 T and 7 T MRI. Cervical nerve root compression and the dimensions of the dorsal root ganglia were assessed by 2 radiologists independently. Signal intensity, visibility of nerve anatomy, diagnostic confidence, and image artifacts were evaluated with Likert scales. The degree of neuroforaminal stenosis was assessed on standard clinical 3 T scans. Statistics included the analysis of the diagnostic accuracy and interreader reliability. The Wilcoxon signed rank test was used to assess differences between the groups.
RESULTS: Forty-eight patients (mean age, 57 ± 12 years; 22 women) were included in the study with the highest prevalence of severe neuroforaminal stenosis observed at C6 (n = 68) followed by C7 (n = 43). Direct evaluation of nerve root compression showed significantly higher diagnostic confidence and visibility of cervical nerve rootlets, roots, and dorsal root ganglia on 7 T DESS than on 3 T DESS (diagnostic confidence: P = 0.01, visibility: P < 0.01). Assessment of nerve root compression using 7 T DESS allowed more sensitive grading than standard clinical MRI (P < 0.01) and improved the performance in predicting sensory or motor dysfunction (area under the curve combined: 0.87).
CONCLUSIONS: 7 T DESS imaging allows direct assessment of cervical nerve root compression in patients with radiculopathy, with a better prediction of sensory or motor dysfunction than standard clinical MRI. Diagnostic confidence and image quality of 7 T DESS were superior to 3 T DESS
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