ABSTRACT
Resnick-Niwayama criteria for diagnosing DISH depict an advanced stage, and a new reduced cut-off point with three contiguous vertebrae affected (two bone bridges) has been proposed. The aim has been to know the interobserver agreement by using a graded scale of DISH in which grade II matches with the new proposed cut-off point and grade III matches with the first criterion of Resnick-Niwayama. Males ≥ 50 years and postmenopausal women included in a population-based prospective study (the Camargo Cohort) were analyzed. Sample size was obtained according to an expected kappa of 0.95 and an accuracy of ± 8%. Three physicians applied independently Schlapbach graded scale (ranged from grade 0, no ossification, to grade III, ≥ 3 consecutive bone bridges) on the lateral radiographs of thoracic and lumbar spine of participants. We calculated inter- and intra-observer agreement and correlation. One hundred and fifty eight radiographs (79 patients, 68 ± 9 years) were assessed. Kappa values (95% confidence interval) for grades 0, I, II, and III were 0.63 (0.50-0.77), 0.49 (0.37-0.62), 0.32 (0.17-0.47), and 0.69 (0.60-0.77), respectively. Weighted kappa for the three pairs of raters were 0.87 (0.82-0.93), 0.84 (0.77-0.91), and 0.81 (0.72-0.90). Grade III was the image that generated greater agreement, while a significant decrease was noted in grade II, the new proposed criterion. The simultaneous presence of an incomplete DISH and osteoarthritis, in a thoracic spinal segment with peculiar anatomical characteristics (reduced disk spaces, kyphotic curve), is thought to be a major cause of variability in the results.
Subject(s)
Hyperostosis, Diffuse Idiopathic Skeletal/diagnostic imaging , Lumbar Vertebrae/diagnostic imaging , Thoracic Vertebrae/diagnostic imaging , Aged , Female , Humans , Male , Middle Aged , Observer Variation , Tomography, X-Ray ComputedABSTRACT
Los paragangliomas son tumores neuroendocrinos que surgen de los paraganglios autonómicos extraadrenales, los cuales son pequeños órganos formados por células derivadas de la cresta neural embrionaria con capacidad de secretar catecolaminas. Los paragangliomas están estrechamente relacionados con los feocromocitomas porque son indistinguibles a nivel celular, y a menudo comparten las mismas manifestaciones clínicas, como hipertensión, cefalea episódica, sudoración y taquicardia. El diagnóstico de estos tumores es importante por su riesgo de malignización, por las implicaciones de otras neoplasias asociadas, y para la posibilidad de realizar estudios genéticos para detección de otros casos dentro de una misma familia. El objetivo de este artículo es desarrollar un resumen sobre la epidemiología, manifestaciones clínicas, pruebas diagnósticas y tratamiento de estos tumores. Se presenta el caso de un joven de raza negra diagnosticado de un paraganglioma(AU)
Paragangliomas are neuroendocrine tumors emerging from the extra-adrenal autonomic paraganglia, which are small organs formed by embryonic neural crest-derived cells with catecholamine-secreting capacity. Paragangliomas are closely linked to pheochromocytomas because they cannot be differentiated at cell level and often share the same clinical manifestations such as hypertension, episodic headache, sweating and tachycardia. The diagnosis of these tumors is important because of risk of becoming malignant, the implications of other related neoplasias and the possibility of making genetic studies to detect other cases in the same family. The objective of this article was to make an abstract about epidemiology, clinical manifestations, diagnostic tests and treatment of these tumors. This is the case of a young Black female who was diagnosed with paraganglioma(AU)
