CT evaluation of medial clavicular epiphysis as a method of bone age determination in adolescents and young adults

PURPOSE We aimed to investigate the use of computed tomography (CT) staging of the medial clavicular epiphysis ossification in forensic bone age determination, and find a CT criterion to determine whether an individual is adult or not. METHODS Chest CT and pulmonary CT angiography exams of 354 patients between 10 and 30 years of age (mean, 21.4 years) were retrospectively evaluated for epiphyseal ossification phase of the bilateral medial clavicles (708 clavicles) and compared with the sex and chronologic age of the individuals. The ossification phase of the medial clavicular epiphyses was classified from stage I to stage V using a modified staging system. RESULTS Epiphyseal ossification center appeared from 11 to 21 years of age. Partial fusion occurred between 16 and 23 years of age. Complete fusion was first achieved at the ages of 18 and 19 years for male and female individuals, respectively. The probability of an individual being ≥18 years old was 70.8% in stage III A and 100% in stages III B, IV, and V in females and males. CONCLUSION CT evaluation of the medial clavicular epiphysis is helpful in forensic age determination and stage III B can be used as a criterion to make the prediction that an individual is older than 18 years. © Turkish Society of Radiology 2016

COVID-19 pneumonia: lessons learned, challenges, and preparing for the future

Coronavirus disease 2019 (COVID-19) is a viral disease that causes life-threatening health problems during acute illness, causing a pandemic and millions of deaths. Although computed tomography (CT) was used as a diagnostic tool for COVID-19 in the early period of the pandemic due to the inaccessibility or long duration of the polymerase chain reaction tests, current studies have revealed that CT scan should not be used to diagnose COVID-19. However, radiologic findings are vital in assessing pneumonia severity and investigating complications in patients with COVID-19. Long-term symptoms, also known as long COVID, in people recovering from COVID-19 affect patients’ quality of life and cause global health problems. Herein, we aimed to summarize the lessons learned in COVID-19 pneumonia, the challenges in diagnosing the disease and complications, and the prospects for future studies

Cross-sectional imaging findings of cardiac outpouchings

A cardiac outpouching (CO) is a protrusion in a heart chamber’s internal anatomical lining. Most COs are clinically insignificant, but some are of vital importance, requiring immediate surgery. Cross-sectional imaging findings of COs, such as location, morphology, size, and accompanying wall motion abnormalities, play an essential role in determining the correct diagnosis and appropriate clinical management. Therefore, radiologists should be familiar with them. This article reviews the key cross-sectional imaging findings and differential diagnoses of COs

Tracheobronchial Angle Measurements in Children: An Anthropometric Retrospective Study With Multislice Computed Tomography

Objectives The purpose of this study is to investigate if any change exists in the values of tracheal bifurcation angles (subcarinal angle [SCA] and interbronchial angle [IBA]), right and left bronchial angles (RBA and LBA) in different pediatric age groups. Methods Chest computed tomography (CT) images of children aged 18 years and younger were reviewed retrospectively by two radiologists who were blinded to each other’s measurements. One hundred and eighteen children were involved. RBA, LBA, SCA, and IBA were measured on coronal reformatted images. Subjects were classified into three groups according to their age. Measurement of IBA was done by measuring the angle between the lines drawn along the central axis of right and left main bronchi over their length. RBA and LBA were measured at the intersection points of the lines drawn along the inferior borders of the right and left main bronchi and the line passing through the longitudinal axis of trachea. Sums of RBA and LBA gave SCA. Interobserver agreement was also analyzed. Results SCA, IBA, and RBA values were statistically significant between children of ages less than 10 years and over 10 years P<0.01). Interobserver agreement was excellent with an intraclass correlation coefficient score of 0.87 (95% confidence interval) for RBA, SCA, and IBA measurements. Conclusion We concluded that tracheal bifurcation angles are wider in children of age 10 years and younger. As age increases values of SCA, IBA, and RBA decrease

Management of patients with connective tissue disease-associated interstitial lung diseases during the COVID-19 pandemic

The novel coronavirus disease (COVID-19) is similar to connective tissue disease-associated interstitial lung diseases (CTD-ILD) in many aspects. However, patients with CTD-ILD have required particular attention during the pandemic since they are at high risk due to -immunosuppressive treatments. Thus, prompt decisions for diagnosis and treatment initiation have become more important than earlier for these patients during the pandemic. Radiological perspectives have become inevitable for the differential diagnosis of this group -during the pandemic, particularly to obtain rapid and accurate results that allow the physicians to start treatment immediately. However, in addition to radiological images, a definitive diagnosis also requires access to extensive information regarding patient history, including characteristics of comorbidities, and clinical and serological findings. Consequently, the differential diagnosis of COVID-19 and CTD-ILD can yield accurate treatment regimens that differ greatly between the 2 diseases, and also prevent the spread of the outbreak with COVID-19 patients treated under isolation

Drug-induced lung disease: a brief update for radiologists

Pulmonary adverse events and drug-induced lung disease (DILD) can occur when treating many conditions. The incidence of DILDs in clinical practice and the variety of radiological findings have increased, mainly due to the increased use of novel therapeutic agents. It is crucial to determine whether the newly emerging clinical and imaging findings in these patients are due to the progression of the underlying disease, infection, pulmonary edema, or drug use, as this will change the patient management. Although the diagnosis of DILD is usually obtained by excluding other possible causes, radiologists should be aware of the imaging findings of DILD. This article reviews the essential radiological results of DILD and summarizes the critical clinical and imaging findings with an emphasis on novel therapeutic agents