The physiological range of the Böhler's angle in the adult Croatian population.

BACKGROUND: To examine the relationship of the Böhler's angle with age, sex, and laterality, and to analyze the interrater agreement. METHODS: After 248 digital lateral radiographs of the foot were submitted to exclusion criteria, three raters independently measured the Böhler's angle on the remaining 130 X-rays in PACS. The variables were analyzed with correlation coefficients, and one-way ANOVA. The repeated measures of ANOVA were computed across age groups (30-39, 40-49, 50-59, and 60-69 years). The interrater agreement was calculated using intraclass correlation coefficient (ICC). RESULTS: The mean value of the Böhler's angle was 34±5° (21-46°). It was not related to age (in general [p=0.057], and across groups [p from 0.107 to 0.122]), sex (p=0.344; p=0.342), and laterality (p=0.618; p=0.617). The interrater reliability was almost perfect (ICC=0.94). CONCLUSIONS: The Böhler's angle was not related to age, sex, and laterality, whereas the interrater agreement was almost perfect.

A new reference line in diagnosing a high-riding patella on routine digital lateral radiographs of the knee.

OBJECTIVE: To propose a new reference line in diagnosing a high-riding patella (patella alta) on routine digital lateral radiographs of the knee. MATERIALS AND METHODS: On 64 routine digital lateral radiographs of adult knees with no bone pathology or surgery and over the range of knee flexion between 1.6° and 79.1° (34.4°± 16.6°), the long axis of the superimposed egg-shaped femoral condyles was drawn and moved upward to pass through the point where the posterior contours of the femoral diaphysis and the femoral condyles meet-the posterior reference point-to become a new reference line. Any part of the patella crossing the new reference line indicated a high-riding patella. The new reference line was compared with the four most common patellar height ratios (Insall-Salvati, Grelsamer-Meadows or the modified Insall-Salvati, Caton Deschamps, and Blackburne-Peel) for the drawing time, accuracy, and reproducibility (intra- and interobserver agreement). RESULTS: The new reference line required approximately one-third to one-half of the drawing time compared to the most common patellar height ratios, with equal accuracy and complete reproducibility. On the contrary, the reproducibility of the most common patellar height ratios ranged from poor to moderate, with the best results for the Insall-Salvati ratio. CONCLUSIONS: The new reference line proved to be a very simple, accurate, and reproducible tool in diagnosing a high-riding patella. We believe that our preliminary results are an encouraging impetus to more complex research.

[Flexion and version of the uterus on pelvic ultrasound examination]. / Fleksija I verzija maternice na ultrazvucnon pregledu zdjelice kroz trbusnu stijenku.

In the longitudinal (sagittal) plane, the angle between the axis of the uterine body and the cervix defines the flexion, whereas the angle between the axis of the cervix and the axis of the vagina defines the version of the uterus. In that regard, there are four uterine positions in the pelvis: anteflexion, retroflexion, anteversion and retroversion. The anteflexion with anteversion of the uterus is considered the natural position of the uterus in the pelvis. The transabdominal ultrasound examination of the female pelvis is most frequently performed if, for any reason, it is not possible to make a more appropriate transvaginal ultrasound examination. Suprapubic region is scanned with a high-frequency convex transducer in the longitudinal and transverse plane. The prerequisites for appropriate ultrasound examination are the filled urinary bladder, optimal quality of the ultrasound image, consistency in the sonographic technique and excellent knowledge of echomorphology of the pelvic organs. The commonest of the less common variants of the uterine position is retroflexion with retroversion. Although sometimes related with serious problems during childbirth as well as miscarriage, it usually does not cause any major problems. Yet, data on the uterine position may help the clinician in planning of various procedures.

[Ultrasonography in locomotor system diseases]. / Ultrazvucna dijagnostika u bolestima sustava za kretanje.

Ultrasonography and Doppler sonography have a significant role in detecting structural changes of joints and soft tissues, in clinical follow-up and evaluation of therapy. Ultrasonography is sensitive, available, inexpensive method, as well as the method without ionization effects. It is method that has a high sensitivity when compared with conventional radiography. It clearly demonstrates joint and soft tissue abnormalities and may be recommended in early evaluation, monitoring of response to therapy and disease activity monitoring. In some patients ultrasonographic findings suggest application of the other imaging modalities and diagnostic procedures. Ultrasound should be the part of a teamwork of experienced radiologist, physiatrics, and rheumatologist. It implies adequate equipment, defined site of examination based on clinical exam.

[Diagnostic ultrasound of the small joints of the hands and feet: current status and role of ultrasound in early arthritis]. / Dijagnosticki ultrazvuk u podrucju malih zglobova saka i stopala s naglaskom na primjenu u ranom artritisu.

The small joints of the hands and feet play a central role in the diagnosis and classification of arthropathy. Ultrasound can be used to assess involvement in areas that are clinically occult. The aim of this article was to review the current status of ultrasound imaging of patients with rheumatological disorders of the hands and feet. There is increasing evidence that ultrasound detects synovitis that is silent to clinical examination. Detection and classification of synovitis and the early detection of bone erosions are important in clinical decision making. Ultrasound has many advantages over other imaging techniques with which it is compared, particularly magnetic resonance. The ability to carry out a rapid assessment of many widely spacedjoints, coupled with clinical correlation, the ability to move and stress musculoskeletal structures and the use of ultrasound to guide therapy accurately are principal amongst these. The use of colour flow Doppler studies provides a measure of neovascularisation within the synovial lining of joints and tendons, and within tendons themselves, that is not available with other imaging techniques. Disadvantages compared to MRI include small field of view, poor image presentation, and difficulty in demonstrating cartilage and deep joints in their entirety.