Imaging Non-Specific Wrist Pain: Interobserver Agreement and Diagnostic Accuracy of SPECT/CT, MRI, CT, Bone Scan and Plain Radiographs

PURPOSE: Chronic hand and wrist pain is a common clinical issue for orthopaedic surgeons and rheumatologists. The purpose of this study was 1. To analyze the interobserver agreement of SPECT/CT, MRI, CT, bone scan and plain radiographs in patients with non-specific pain of the hand and wrist, and 2. to assess the diagnostic accuracy of these imaging methods in this selected patient population. MATERIALS AND METHODS: Thirty-two consecutive patients with non-specific pain of the hand or wrist were evaluated retrospectively. All patients had been imaged by plain radiographs, planar early-phase imaging (bone scan), late-phase imaging (SPECT/CT including bone scan and CT), and MRI. Two experienced and two inexperienced readers analyzed the images with a standardized read-out protocol. Reading criteria were lesion detection and localisation, type and etiology of the underlying pathology. Diagnostic accuracy and interobserver agreement were determined for all readers and imaging modalities. RESULTS: The most accurate modality for experienced readers was SPECT/CT (accuracy 77%), followed by MRI (56%). The best performing, though little accurate modality for inexperienced readers was also SPECT/CT (44%), followed by MRI and bone scan (38% each). The interobserver agreement of experienced readers was generally high in SPECT/CT concerning lesion detection (kappa 0.93, MRI 0.72), localisation (kappa 0.91, MRI 0.75) and etiology (kappa 0.85, MRI 0.74), while MRI yielded better results on typification of lesions (kappa 0.75, SPECT/CT 0.69). There was poor agreement between experienced and inexperienced readers in SPECT/CT and MRI. CONCLUSIONS: SPECT/CT proved to be the most helpful imaging modality in patients with non-specific wrist pain. The method was found reliable, providing high interobserver agreement, being outperformed by MRI only concerning the typification of lesions. We believe it is beneficial to integrate SPECT/CT into the diagnostic imaging algorithm of chronic wrist pain

Explicitly searching for useful inventions: dynamic relatedness and the costs of connecting versus synthesizing

Inventions combine technological features. When features are barely related, burdensomely broad knowledge is required to identify the situations that they share. When features are overly related, burdensomely broad knowledge is required to identify the situations that distinguish them. Thus, according to my first hypothesis, when features are moderately related, the costs of connecting and costs of synthesizing are cumulatively minimized, and the most useful inventions emerge. I also hypothesize that continued experimentation with a specific set of features is likely to lead to the discovery of decreasingly useful inventions; the earlier-identified connections reflect the more common consumer situations. Covering data from all industries, the empirical analysis provides broad support for the first hypothesis. Regressions to test the second hypothesis are inconclusive when examining industry types individually. Yet, this study represents an exploratory investigation, and future research should test refined hypotheses with more sophisticated data, such as that found in literature-based discovery research

Le Lai du Conseil. Ein altfranzösisches Minnegedicht. Kritischer Text, mit Einleitung und Anmerkungen herausg. von Albert Barth. 1911

Von Wartburg W. Le Lai du Conseil. Ein altfranzösisches Minnegedicht. Kritischer Text, mit Einleitung und Anmerkungen herausg. von Albert Barth. 1911. In: Romania, tome 41 n°162, 1912. pp. 288-291

Albus und seine Familie in Frankreich.

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Le Lai du Conseil. Ein altfranzösisches Minnegedicht. Kritischer Text, mit Einleitung und Anmerkungen herausg. von Albert Barth. 1911

Von Wartburg W. Le Lai du Conseil. Ein altfranzösisches Minnegedicht. Kritischer Text, mit Einleitung und Anmerkungen herausg. von Albert Barth. 1911. In: Romania, tome 41 n°162, 1912. pp. 288-291

Franco-provençal bo(t) « étable »

Von Wartburg W. Franco-provençal bo(t) « étable ». In: Romania, tome 53 n°209-210, 1927. pp. 213-218

Un doute lexicologique : franç. chevrin

Von Wartburg W. Un doute lexicologique : franç. chevrin. In: Romania, tome 63 n°251, 1937. pp. 381-383