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At least 1,621 records · Page 90Linked to original sources
PubMed1998

Observer variation in plain radiography of the lumbosacral spine.

In this study, interobserver and intraobserver variations in the interpretation of plain radiographs of the lumbosacral spine were evaluated. Three radiologists independently interpreted the radiographs from 200 consecutive outpatients, aged 13-93 years, mostly referred from general practitioners. Interobserver agreement was best for vertebral fractures, osteopenia, spondylolisthesis at L5-S1, lumbosacral junctional vertebra, reduced disc height at L4-S1 and osteophytes at L2-S1 (kappa 0.61-0.95), and poorest for spina bifida of S1, degenerative spondylolisthesis and facet joint arthrosis at T12-L4, sacroiliac joint arthrosis, narrow central spinal canal, film quality, and for decisions concerning evaluation of facet joints and spinal canal (kappa < 0.34). For several diagnoses, the number of abnormal findings differed significantly between observers (p < 0.05, McNemar's test), indicating different diagnostic thresholds. Intraobserver agreement in 36 reevaluated patients was fair to excellent for almost all variables (kappa > 0.46). Although some diagnoses related to low back pain were quite consistently evaluated, the substantial disagreement on many findings should alert clinicians and radiologists against overestimating the validity and usefulness of the examinations. To improve diagnostic consistency, it is important to reduce variation caused by different thresholds for abnormality.

Adolescent↗
PubMed1995

Does radiographic feature recognition contribute to dentists' diagnosis of pathology?

OBJECTIVES: To measure the degree to which dentists can accurately identify radiographic features and use their findings in the diagnosis of three lesions. METHODS: Fourteen radiographic examples were used in this study and five features derived from the literature: border sharpness, border radiopacity, lesion shape, lesion radiopacity and root contact. A 'silver standard' for the presence of the features in the radiographic images of the lesions was established by expert observers; and a diagnostic 'gold standard' based on the histopathology of the lesions was available. Dentists scored each image according to these features and gave their diagnosis. RESULTS: When dentists made different subjective diagnoses for a case, significant differences were found in the extent to which features were reported to be present. The degrees of presence of border sharpness (21%) and border radiopacity (46%) measured using the 'silver standard' were significantly related to the diagnosis of osteosarcoma. CONCLUSIONS: Radiographic information is not used to its full extent and improvement in the recognition of features and the cognitive use of this radiographic information in the diagnostic process could improve diagnostic accuracy.

Analysis of Variance↗
PubMed1996

A radiological analysis of chronic sclerosing osteomyelitis of the mandible.

OBJECTIVE: To determine the frequency of specific characteristics of chronic sclerosing osteomyelitis (CSO) of the mandible in plain films compared with CT scans. METHODS: After calibration, three observers studied 13 cases of plain films and 11 sets of separated and masked CT scans from the same cases. Controls consisted of cases of fibro-osseous disease with a similar appearance. Comparison with the results of nuclear scans of eight of the cases was made. RESULTS: Periosteal new bone formation, sclerosis and bone enlargement were the most common characteristics. When the CT scans were analysed, detection of sequestra improved from 45 to 91%. There was greater agreement between observers when analysing CT scans compared with plain films. The results of the gallium scans supported the diagnosis in only two of the eight cases. CONCLUSION: In this study, the CT scans were the most reliable imaging method for revealing characteristics such as sequestra which are useful for the diagnosis of CSO.

Chronic Disease↗
PubMed2004

Relationship between temporomandibular joint (TMJ)-related pain and morphological changes of the TMJ condyle in patients with temporomandibular disorders.

OBJECTIVES: The purpose of this study was to analyse the relationship between temporomandibular joint (TMJ)-related pain and morphological change of the TMJ condyle in patients with temporomandibular disorders. METHODS: Data were obtained from 178 joints in 89 patients. The joints were clinically assessed for pain on mandibular function and on lateral palpation of the TMJ. They were also assessed for radiographic evidence of bone change at the articular surface (OAAS) and resorption of the lateral part of the condyle (RLC). RESULTS: A higher prevalence of joint pain on function was observed in joints with OAAS than in those without OAAS (Chi-square test of independence, P < 0.05). Significant relationships were found between palpation pain and OAAS and between palpation pain and RLC (Chi-square test of independence, P < 0.05). In addition, patients with RLC showed a significantly lower pain threshold for external mechanical stimuli than those without RLC (Welch's t-test, P < 0.05). CONCLUSIONS: These results suggest a possible relationship between pain on function and OAAS as well as a relationship between palpation pain and RLC. Pain on lateral palpation may be related to the pathological conditions that induce RLC.

Adolescent↗
PubMed2006

Osseous abnormalities of the mandibular condyle: diagnostic reliability of cone beam computed tomography compared with helical computed tomography based on an autopsy material.

OBJECTIVES: We compared the diagnostic reliability of cone beam computed tomography (3DX) and helical computed tomography (helical CT) for the detection of osseous abnormalities of the mandibular condyle, using macroscopic observations as the gold standard. METHODS: Twenty-one temporomandibular joint autopsy specimens underwent imaging with 3DX and helical CT. The specimens were macroscopically evaluated for cortical erosion or osteophytosis and sclerosis. The images were independently assessed for the same osseous abnormalities. Observations with the two imaging modalities were compared with the macroscopic observations using the McNemar test. RESULTS: According to the macroscopic observations, 10 of the 21 mandibular condyles and one fossa showed osseous abnormalities. 3DX detected abnormalities in eight of these condyles and helical CT identified abnormalities in seven, giving a sensitivity of 0.80 for 3DX and 0.70 for helical CT. The specificity of the condyle assessment was 1.0 for both 3DX and helical CT and hence, the accuracy was 0.90 and 0.86, respectively. No significant differences were detected between the 3DX and helical CT for assessment of osseous abnormalities of the mandibular condyle (P=0.286). CONCLUSIONS: The cone beam CT equipment 3DX is a dose-effective and a cost-effective alternative to helical CT for the diagnostic evaluation of osseous abnormalities of the mandibular condyle.

Adult↗
PubMed2004

Craniometaphyseal dysplasia associated with obstructive sleep apnoea syndrome.

Craniometaphyseal dysplasia (CMD) is a genetic craniotubular bone disorder characterized by early progressive hyperostosis and sclerosis of the craniofacial bones, and abnormal modelling of the metaphyses of the tubular bones. We present the case of a patient with a confirmed history of the autosomal dominant form of CMD, associated with symptoms of obstructive sleep apnoea syndrome. Examination and imaging studies revealed several unusual features in addition to the common findings of CMD such as: bimaxillary retrusion with hyperostosis of the mental area, severe notching of the external occipital protuberance, huge occipital horn, decreased angle of the mandible with notching of the body and thickening of the areas of muscle attachment, and macrodontia. The literature and differential diagnoses are reviewed.

Bone Diseases, Developmental↗
PubMed2003

Temporomandibular internal derangement: correlation of MRI findings with clinical symptoms of pain and joint sounds in patients with bruxing behaviour.

OBJECTIVES: The aim of this study was to correlate magnetic resonance imaging (MRI) findings of effusion, disc displacement, condylar bony changes and disc form with clinical findings of pain and sounds in patients with bruxing and non-bruxing behaviour. METHODS: Disc displacement was confirmed by MRI in 102 joints from 64 patients (total of 128 joints) with bruxing behaviour who were referred for clinically diagnosed internal derangements of the temporomandibular joint (TMJ). Sixty joints with internal derangement from 30 patients without bruxing behaviour served as a control group. The clinical inclusion criteria were pain in the pre-auricular area and muscles of mastication, limitation or deviation in mandibular range of motion, and TMJ sounds. Signs of bruxism were diagnosed clinically and were obtained from the patient's history given on their first visit. Pain was evaluated using a visual analogue scale. RESULTS: Of the 102 joints in the study group with disc displacement, 53 (52%) showed disc displacement with reduction and 49 (48%) showed disc displacement without reduction. In the control group, 16 joints were classified as normal. Of the remaining 44 joints, 27 (61%) had disc displacement with reduction and 17 (39%) had unilateral disc displacement without reduction. Condylar bony changes were seen in 55% of the reducing joints in the study group and in 38% of the reducing joints in the control group, compared with 86% of the non-reducing joints in the study group and 24% of the non-reducing joints in the control group. There was a strong correlation between age and degenerative change in the study group. In the reducing joints, there was a significant difference in the prevalence of condylar bony changes between the study and control groups (P<0.01). In non-reducing joints, 30% of painful joints in the study group and 59% of those in the control group showed a strong signal in the joint space on T(2) weighted imaging. Statistically significant differences between the study and control groups were also found for disc form and the prevalence of effusion and disc displacement. Joint sounds were important in unilaterally affected joints in the study group. A statistically significant correlation was found between joint sounds and reducing joints (P<0.05). CONCLUSION: It was demonstrated that a higher prevalence of condylar bony changes occurred in reducing joints in patients with bruxing behaviour.

Adolescent↗
PubMed2004

Radiographic examination of the temporomandibular joint using cone beam computed tomography.

Cone beam CT (CBCT) is a new technique for maxillofacial imaging. We describe a reconstruction technique for radiographic examination of the temporomandibular joint (TMJ) using CBCT, and we further present four cases where the technique was employed. The technique provides a complete radiographic investigation of the bony components of the TMJ. The reconstructed images are of high diagnostic quality. The examination time is shorter and the patient dose is lower than that with conventional CT. It may therefore be considered as the imaging technique of choice when investigation of bony changes of the TMJ is the task at hand.

Adult↗
PubMed2003

Accuracy of panoramic radiography in assessing the dimensions of radiolucent jaw lesions with distinct or indistinct borders.

OBJECTIVES: To evaluate the accuracy of panoramic radiography (PR) in assessing the dimensions of mandibular lesions. METHODS: One hundred and fifteen cases exhibiting radiolucent lesions in the mandibular premolar, molar or ramus area were selected retrospectively. They were divided into four types: cyst with sclerotic margin (Type I); cyst without sclerotic margin (Type II); ameloblastoma (Type III); or squamous cell carcinoma (Type IV). Maximum mesiodistal length and superoinferior height were measured on PR (Lpmax and Hpmax, respectively) and on CT (Lcmax and Hcmax, respectively) and the results were compared. RESULTS: Correlation coefficients between Lpmax and Lcmax and between Hpmax and Hcmax were high for Type I, II and III lesions but were significantly lower for Type IV lesions. Regression coefficients between Lpmax and Lcmax and between Hpmax and Hcmax were indistinguishable from 1.0 for all types of lesions. The mean relative difference between Lpmax and Lcmax varied from 1.2% to 8.2%. The difference was only -0.3% for larger lesions of combined Types I and II. The mean relative difference between Hpmax and Hcmax varied from--3.5% to 1.1% depending on the type of lesions. CONCLUSION: PR is accurate for assessing the dimensions of radiolucent lesions in the posterior mandible when the margins are well defined.

Adolescent↗
PubMed2006

Diagnostic criteria for the detection of mandibular osteomyelitis using cone-beam computed tomography.

OBJECTIVES: To investigate the usefulness of cone-beam computed tomography (CBCT) in cases of suspected osteomyelitis (OM) of the mandible. METHODS: 13 patients with clinical suspected OM of the mandible underwent cone-beam computed tomography with the NewTom QR-DVT 9000. After CBCT revealed signs confirming the diagnosis of OM, biopsies were performed. Only cases in which histology confirmed the OM were included in this study. RESULTS: CBCT sufficiently depicts OM-typical lesions like osteolytic and osteosclerotic areas as well as periosteal reaction, ill-defined cortical borders and sequestra. CONCLUSIONS: Because the local extension of the disease and its relationship to anatomic structures can be sufficiently detected by CBCT, we see an important additional indication for the usage of CBCT. With regard to distinct cases CBCT combined with scintigraphy seems to be a sufficient diagnostic strategy concerning suspected OM.

Adolescent↗
PubMed1984

Chronic sclerosing osteomyelitis. An unusual case.

An unusual case of bilateral chronic sclerosing osteomyelitis of the clavicles is reported. A culture of resistant Staphylococcus aureus was obtained. Curettage of the lesions resulted in healing and symptomatic relief. There has been no recurrence on follow-up at one year.

Adolescent↗