32 research outputs found
Hybrid SPECT/CT for the assessment of a painful hip after uncemented total hip arthroplasty
Background The diagnosis of hip pain after total hip replacement (THR)
represents a highly challenging question that is of increasing concern to
orthopedic surgeons. This retrospective study assesses bone scintigraphy with
Hybrid SPECT/CT for the diagnosis of painful THR in a selected cohort of
patients. Methods Bone SPECT/CT datasets of 23 patients (mean age 68.9 years)
with a painful hip after THR were evaluated. Selection of the patients
required an inconclusive radiograph, normal serum levels of inflammatory
parameters (CRP and ESR) or a negative aspiration of the hip joint prior to
the examination. The standard of reference was established by an
interdisciplinary adjudication-panel using all imaging data and clinical
follow-up data (>12 month). Pathological and physiological uptake patterns
were defined and applied. Results The cause of pain in this study group could
be determined in 18 out of 23 cases. Reasons were aseptic loosening (n = 5),
spine-related (n = 5), heterotopic ossification (n = 5), neuronal (n = 1),
septic loosening (n = 1) and periprosthetic stress fracture (n = 1). In (n =
5) cases the cause of hip pain could not be identified. SPECT/CT imaging
correctly identified the cause of pain in (n = 13) cases, in which the
integrated CT-information led to the correct diagnosis in (n = 4) cases,
mainly through superior anatomic correlation. Loosening was correctly assessed
in all cases with a definite diagnosis. Conclusions SPECT/CT of THA reliably
detects or rules out loosening and provides valuable information about
heterotopic ossifications. Furthermore differential diagnoses may be detected
with a whole-body scan and mechanical or osseous failure is covered by CT-
imaging. SPECT/CT holds great potential for imaging-based assessment of
painful prostheses
A systematic review of the relationship between subchondral bone features, pain and structural pathology in peripheral joint osteoarthritis
Introduction: Bone is an integral part of the osteoarthritis (OA) process. We conducted a systematic literature review in order to understand the relationship between non-conventional radiographic imaging of subchondral bone, pain, structural pathology and joint replacement in peripheral joint OA. Methods: A search of the Medline, EMBASE and Cochrane library databases was performed for original articles reporting association between non-conventional radiographic imaging-assessed subchondral bone pathologies and joint replacement, pain or structural progression in knee, hip, hand, ankle and foot OA. Each association was qualitatively characterised by a synthesis of the data from each analysis based upon study design, adequacy of covariate adjustment and quality scoring. Results: In total 2456 abstracts were screened and 139 papers were included (70 cross-sectional, 71 longitudinal analyses; 116 knee, 15 hip, six hand, two ankle and involved 113 MRI, eight DXA, four CT, eight scintigraphic and eight 2D shape analyses). BMLs, osteophytes and bone shape were independently associated with structural progression or joint replacement. BMLs and bone shape were independently associated with longitudinal change in pain and incident frequent knee pain respectively. Conclusion: Subchondral bone features have independent associations with structural progression, pain and joint replacement in peripheral OA in the hip and hand but especially in the knee. For peripheral OA sites other than the knee, there are fewer associations and independent associations of bone pathologies with these important OA outcomes which may reflect fewer studies; for example the foot and ankle were poorly studied. Subchondral OA bone appears to be a relevant therapeutic target. Systematic review: PROSPERO registration number: CRD 4201300500
A comparison of two stomatal conductance models for ozone flux modelling using data from two **Brassica** species
Radionuclide arthrogram with SPECT/CT for the evaluation of mechanical loosening of hip and knee prostheses
ObjectiveTo evaluate the value of SPECT/CT in radionuclide arthrogram (RNA) for the assessment of mechanical loosening of hip and knee prostheses.MethodA retrospective audit of 117 RNA SPECT/CTs evaluated by a single reader--40 hips, (1 hemiarthroplasty) and 77 knees (12 unicompartmental). The detection of any radiotracer within the bone/prosthetic interface was deemed positive for loosening. The operative assessment of 29 hip and 44 knee prosthetic joints was known and used as the gold standard. A subsequent blinded reassessment of the planar images was performed and compared with the SPECT/CT results for 26 of the 29 hip and 42 of the 44 knee prostheses.ResultsThe respective SPECT/CT versus planar results were as follows: hips--acetabular cup: sensitivity: 73 versus 0%; specificity: 71 versus 100%; positive predictive value: 62% versus indeterminate; negative predictive value: 80% versus 72% (p = 0.0044). Hips--femoral component: sensitivity: 78 versus 63%; specificity: 90 versus 94%; positive predictive value: 78 versus 83%; negative predictive value: 90 versus 85% (p = 0.2482). Knees--femoral component: sensitivity: 75 versus 17%; specificity 63 versus 97%; positive predictive value: 43 versus 67%; negative predictive value: 87 versus 74% (p = 0.0001). Knees--tibial component: sensitivity: 86 versus 63%; specificity: 86 versus 76%; positive predictive value: 55 versus 38%; negative predictive value: 97 versus 90% (p = 0.6831).ConclusionFor evaluation of mechanical loosening of the hip prosthesis SPECT/CT was significantly better than planar scanning for the acetabular cup, but not for the femoral stem. For evaluation of the knee prosthesis, a significant improvement was noted using SPECT/CT for the femoral component, and although superior results were also noted for the tibial component, statistical significance was not reached. Taking into account the limitations of this retrospective audit, the value of using RNA SPECT/CT appeared to lie in the exclusion of mechanical loosening.Chong Ghee Chew, Peter Lewis, Fiona Middleton, Rene van den Wijngaard, Annie Deshaie
Systematic Review on Reproducibility of Nuclear Imaging in the Assessment of Painful Hip and Knee Replacements
Methoden zur Konstruktion und Bewertung von Fragebögen zur Erfassung einer Basisanamnese
Surveillance of effects of HPV vaccination in Belgium
Early effects of HPV (human papillomavirus) vaccination are reflected by changes observable in young women attending cervical cancer screening.publisher: Elsevier
articletitle: Surveillance of effects of HPV vaccination in Belgium
journaltitle: Cancer Epidemiology
articlelink: http://dx.doi.org/10.1016/j.canep.2015.12.011
content_type: article
copyright: Copyright © 2016 Elsevier Ltd. All rights reserved.status: publishe