OBJECTIVE: To determine the prevalence of radiographic evidence of sacroiliitis in a large population of patients with psoriatic arthritis. PATIENTS AND DESIGN: Patients were recruited from 15 clinical centers. This was part of a large, multicenter study of patients with an established diagnosis of ankylosing spondylitis, psoriatic arthritis, or reactive arthritis. For this cohort, an established diagnosis of psoriatic arthritis was required, with cutaneous manifestations and involvement of at least three appendicular joints. At entry, patients were not selected for the presence of axial involvement. Radiographs - one anteroposterior view of the pelvis and one oblique view of each sacroiliac joint - were graded using the New York classification scale by a musculoskeletal radiologist masked to the specific diagnosis and clinical symptoms. Re-evaluation of 10% of the films 3 years later quantified intraobserver variability. RESULTS: Two hundred and two patients with psoriatic arthritis were studied. Duration of the disease averaged 12 years; all patients had psoriasis and peripheral arthritis. The prevalence of radiographic evidence of sacroiliitis (grade 2 or higher) was 78%; 71% of these had grade 3 disease. CONCLUSIONS: Previously reported prevalence of sacroiliitis in patients with psoriatic arthritis ranges from 30% to 50%. The prevalence of radiographic evidence of sacroiliitis in this large multicenter cohort of patients with appendicular psoriatic arthritis was substantially higher.

Arthritis, Psoriatic↗

PubMed1999

The road to success: factors affecting the speed of promotion of academic radiologists.

RATIONALE AND OBJECTIVES: The authors' purpose was to determine the factors influencing the speed of promotion of academic radiologists. MATERIALS AND METHODS: Three hundred forty-three surveys from faculty members of academic radiology departments with continuous academic careers were analyzed for time in rank at assistant and associate professor levels in relation to publication rate, grant funding rate, and distribution of professional time. Individuals promoted faster than the median time (6 years for assistant professors, 5 years for associate professors) were considered "fast track" and were compared with the remainder of the group. RESULTS: At the assistant professor level, fast track individuals had significantly higher rates of total publications and original articles than did others. At the level of associate professor, fast track individuals had significantly faster rates of publication of original articles, but no significant difference existed in total publication rate. No significant difference was found in the rate of founding of fast track individuals and others. Those with funding were not more likely to be on a fast track than those without funding. Fast track individuals spent significantly more time in administration at the assistant professor level than did other faculty, but no other significant differences were discovered in time distribution at the assistant or associate professor level. CONCLUSIONS: The rate of publishing original articles at the assistant and associate professor levels and the rate of overall publication at the assistant professor level were the most important parameters in predicting speed of promotion.

Adult↗

PubMed1999

Nutritional rickets without vitamin D deficiency in Bangladesh.

To understand nutritional rickets in Bangladesh better, 14 rachitic and 13 'unaffected' children were evaluated. Seventy per cent of children with active rickets had no evidence of either vitamin D deficiency or familial rickets. Rickets in Bangladesh is probably related to calcium deficiency. Abnormalities in 'unaffected' children suggest that subclinical calcium insufficiency is common.

Bangladesh↗

PubMed1998

Total hip arthroplasty: imaging evaluation.

Total hip arthroplasty is a common procedure with rare complications but is necessarily followed up by plain radiographs. In this article, I describe a logical approach to evaluation of the arthroplasty, both at its initial implantation and in follow-up. Criteria regarding loosening and other complications are outlined.

Arthroplasty, Replacement, Hip↗

PubMed1998

Radiographic diagnosis of sacroiliitis--are sacroiliac views really better?

OBJECTIVE: To determine whether detailed oblique radiographs of the sacroiliac (SI) joints provide significant diagnostic advantage to a single AP projection of the pelvis in establishing the presence and severity of sacroiliitis. METHODS: Radiographs (both AP pelvis and detailed oblique projections) of 445 right SI joints and 442 left SI joints were obtained from patients with an established diagnosis of a seronegative spondyloarthropathy, and interpreted for severity. Data for the right and left SI joints were analyzed, comparing interpretations of severity based on AP pelvis projections with oblique views. RESULTS: Analysis of these data showed an agreement rate between AP views and SI views of 89.7% for the right SI joint radiographs and 86.4% for the left SI joint. There was no instance in which a patient with "unequivocal abnormalities"of the SI joints on the AP pelvis was read as having "normal" SI views. Similarly, there were no cases in which "normal" SI joints on AP pelvis films were read as having unequivocal abnormalities on SI views. CONCLUSION: In this group of patients with seronegative spondyloarthropathies, there was very close agreement between severity score of sacroiliitis from AP pelvis radiographs and SI joint views. We conclude that in most circumstances, the AP pelvis film will yield the diagnosis of sacroiliitis without the additional radiation exposure and expense related to specific SI joint radiographs.

Adult↗