Inflammatory sacroiliac joint pathology: evaluation of radiologic assessment techniques.

Recognition of sacroiliac disease has been integral to arthritis diagnostic approaches. However, intra- and inter-observer variation have been recognized as limiting factors in radiologic assessment of the sacroiliac joint. The assumption that such irregularly shaped joints can be radiologically assessed of the sacroiliac joint. The assumption that such irregularly shaped joints can be radiologically assessed has not actually been rigorously evaluated. Direct arthroscopic visualization of the joints was therefore used as a standard against which to assess the validity of routine radiologic views, stereo-radiology, tomography and computed tomography, in the analysis of a group of sacroiliac joints drawn from the Todd Collection (Cleveland Museum of Natural History). The most sensitive techniques for the recognition of erosions or fusion are 15 degree angulation and stereo, but the frequency of false positives makes the technique of questionable clinical utility. While sensitivity for joint space narrowing is high with several techniques (30 degree anterior-posterior or posterior-anterior projections and tomograms), specificity is still poor, with a high rate of false positives. Fulfillment of the New York Criteria for sacroiliac disease is especially insensitive and non-specific. Radiologic techniques therefore have major limitations for the assessment of sacroiliac disease and greater reliance on clinical acumen is required for patient categorization.

Sonography in acute pelvic inflammatory disease.

This study of 50 patients was designed to correlate laparoscopy findings with ultrasonography in women presenting with clinical evidence suggestive of acute pelvic inflammatory disease. The severity of the disease varied proportionately with the abnormalities discovered on ultrasound. The tuboovarian abscesses varied greatly in their sonographic appearance, as did the uterus, tubes and cul-de-sac. Ultrasonography, coupled with clinical findings, is a reliable aid in the diagnosis and follow-up of patients with acute pelvic inflammatory disease.

Comparative analysis of the optical characteristics of binocular indirect ophthalmoscopes.

Recommendations for the design of binocular indirect ophthalmoscopes are made based on a comparative analysis of the optics of various indirects currently available. Significant differences were found to exist in the areas of brightness, stereopsis, small pupil capability, and PD ranges among the brands under study.