Accuracy of Anatomical Depictions in Cone Beam Computed Tomography (CBCT)-Reconstructed Panoramic Projections Compared to Conventional Panoramic Radiographs: A Clinical Risk-Benefit Analysis.

INTRODUCTION: Two-dimensional (2D) radiographs are the standard of care for diagnosis and treatment planning in the day-to-day practice of dentistry. With the growing popularity of cone beam computed tomography (CBCT), it is now becoming the standard of care in many areas of general dentistry due to its ability to create non-linear projections from volumetric data. The CBCT-generated non-orthogonal radiographs can serve as easy-to-use 2D and three-dimensional (3D) diagnostic tools and offer a similar experience for diagnosis as conventional 2D images. The aim of this study is to compare the accuracy of conventional radiographs and CBCT-generated projections to identify relevant anatomic landmarks and their associated variants. METHODS: Thirty-two patients referred to the University of Connecticut School of Dental Medicine's Advanced Imaging Center were selected for this retrospective analysis. Nineteen anatomical landmarks were retrospectively assessed on conventional panoramic and CBCT scans generated panoramic radiographs using two different digital imaging and communications in medicine viewers. A total of 1,216 anatomical landmarks were evaluated by two oral and maxillofacial radiologists to assess the accuracy and consistency of the depiction of radiographic anatomy. RESULTS: There was a very good agreement between the two evaluators with a Cohen's kappa value of 0.934. McNemar change test concluded that the anatomical assessment values compared between conventional panoramic and CBCT-generated panoramic radiographs are similar. CONCLUSION: This study showed that CBCT-generated panoramic images are comparable to conventional panoramic radiographs in identifying anatomical landmarks typically evaluated using a conventional panoramic projection. In addition, they have the added advantage of having 3D information in the acquired volume to better evaluate the area of interest. In clinical situations where a mid- to large-volume CBCT scan is available, a simulated panoramic image can be generated using the CBCT volume, leaving exposure of the patient to the additional radiation of a panoramic image unnecessary.

Laboratory methods: A concise review and update for COVID-19 diagnosis.

Since late December 2019, coronavirus disease 2019 (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been rapidly spread across the globe. The early, safe, sensitive, and accurate diagnosis of viral infection is required to decrease and control contagious infection and improve public health surveillance. The diagnosis generally is made by detecting SARS-CoV-2-related agents, including a range of nucleic acid detection-based, immunoassay-based, radiographic-based, and biosensor-based methods. This review presents the progress of various detection tools for diagnosing COVID-19 and addresses the advantages and restrictions of each detection method. Given that diagnosis of a contagious various like SARS-COV-2 can improve patient survival rates and break the transmission chain, there is no surprise that significant efforts should be made to reduce the limitations of tests that lead to false-negative results and to develop a substantial test for COVID-19 diagnosis.

Comparison of Diagnostic Accuracy of Panoramic Radiography to CBCT in Maxillary Sinus Diseases.

We aimed to compare the effectiveness of panoramic radiography (PR) and cone beam computed tomography (CBCT) in radiographic diagnosis of maxillary sinus (MS) diseases. MS diseases (mucosal thickening, mucus retention cyst, polyp sinusitis, mucocele and tumoral formations) was carried out on both PR and CBCT images belonging to 625 patients. Analyzes were performed separately for right and left maxillary sinus, and total of 1250 PR and CBCT images. While a diagnosis of disease was made in 42.96% of a total of 1250 MS according to CBCT. According to PR, diagnosis was made in 58.72%. The 537 diagnoses where lesion presence was determined on CBCT in our study were compared over PR, and it was observed that, there was the right diagnosis (true positive) in 106 (19.73%) of these including respectively mucus retention cyst (n = 88), polyp (n = 16), 1 sinusitis and 1 tumor, and there was an incorrect diagnosis (false positive) in 221 (41.15%). In 42.92% of the MS that were identified as healthy based on CBCT, the correct diagnosis was also made on PR (true negative). The use of CBCT instead of PR in the diagnosis of pathological or inflammatory diseases contributes to a more accurate radiographic differential diagnosis.

Radiographic Diagnosis of Hip Laxity in Rottweilers: Interobserver Agreement at Eight- and Twelve-Months of Age.

Hip laxity is one of the predisposing factors of canine hip dysplasia. The early diagnosis of hip laxity allows veterinarians to prevent the participation of dysplastic dogs in breeding programs, which could lower the disease's prevalence due to its genetic background. Furthermore, it allows them to plan preventive/therapeutic procedures for mild/near-normal hips to reduce the symptoms of the disease at older ages. A reliable screening program must be repeatable and reproducible, and intra- and inter-observer studies can help us to determine the best methods. In this study, we aimed to evaluate the radiographic parameters used for the early diagnosis of hip dysplasia in Rottweilers at 8 and 12 months of age with five observers to assess the interobserver agreements. According to our findings, there were high interobserver agreements at both ages for the quantitative values, such as the center edge angle (CEA), dorsal acetabular rim slope (DARS), distraction index (DI), and Norberg angle (NA), whereas we recorded from poor to moderate agreements for the qualitative values, such as the grading of the dorsal acetabular rim (GDAR), grading of the degenerative joint disease (GDJD), location of the center of the femoral head (LCFH), and sclerosis of the cranial acetabular rim (SCAR).

Spinal Metastases without Pedicle Signs on Radiograph and their Associated Clinical and Radiological Features.

BACKGROUND: The pedicle sign is a radiographic indicator of spinal metastases. However, it is not only the pedicle sign that is important in radiographic diagnosis of bone metastases. In the present study, the radiological features of symptomatic spinal metastases in patients without the pedicle sign were retrospectively examined. MATERIALS AND METHODS: Among 186 patients with symptomatic spinal metastases who visited our department between January 1, 2011, and December 31, 2017, 64 without the pedicle sign and with available computed tomography (CT) and magnetic resonance imaging (MRI) data in the first visit were enrolled and their data were analyzed. One author evaluated radiographs for findings suggestive of spinal metastases, CT to assess bone destruction, and MRI to evaluate the extent of lesions. Clinical variables were also examined and compared between patients with and without bone changes on radiography. RESULTS: Bone changes strongly suggesting bone metastasis, other than the pedicle sign, were observed in 31 out of 64 patients: bone cortical disappearance in 20, increased radiolucency of the central area in the vertebral body in 8, an irregular osteoblastic change in 5, and asymmetrical vertebral collapse in 10. An analysis of CT data revealed that intertrabecular, mildly osteolytic, and mildly osteoblastic types were more frequent in patients without any changes suggestive of bone metastases on radiographs. CONCLUSION: Radiographic findings other than the pedicle sign are useful for diagnosing bone metastases. The key to a radiographic diagnosis of spinal metastases is to pay attention to changes in the bone cortex of all vertebral components on radiographs in addition to the pedicle.

Imaging diagnosis of canine hip dysplasia with and without human exposure to ionizing radiation.

Hip dysplasia (HD) is one of the most common hereditary orthopaedic diseases in dogs, with serious implications for the quality of life of the affected animals. Radiographic screening is essential for the selection of breeding stock in some at-risk breeds, and radiography is also used in the diagnosis of clinical HD cases. A definitive diagnosis of HD is based on radiographic examination, and the most commonly used view is the ventrodorsal hip extended projection, sometimes in combination with various hip stress-based techniques. Radiographic images require high quality positioning and dogs are usually anesthetized and often manually restrained to facilitate optimal positioning. The 'as low as reasonably achievable' (ALARA) principle used in human radioprotection is not always fulfilled in veterinary practice, except in the UK, where human exposure to ionizing radiation in veterinary medicine is strictly regulated. While each dose of ionizing radiation is small, doses accumulate over a lifetime, which can eventually result in substantial radiation exposure. Therefore, manual restraint should be avoided and mechanical immobilization, sedation or general anaesthesia should be used. This review examines the biological effects of human exposure to ionizing radiation and common sources of veterinary exposure. The diagnostic quality of imaging methods for the diagnosis of canine HD is compared between manually restrained and hands-free dog positioning. Hands-free radiographic techniques are available to assess hip laxity, degenerative joint changes and hip osseous structure while preserving image quality, and can be used to select animals for breeding or for the diagnosis of HD.

Medial Sigmoid Depression of the Mandibular Ramus as a Lesion-Mimicking Anatomical Variation: A Systematic Review.

(1) Background: Medial sigmoid depression (MSD) of the mandibular ramus is an anatomical variation that resembles non-odontogenic cystic lesion. (2) Aim: The aim of this systematic review was to survey the literature to identify the relevant journal publications, reveal their scientific impact in terms of citations and compare the reported prevalence of MSD. (3) Materials and methods: PubMed, Google Scholar, Scopus and Web of Science were queried to identify relevant publications. The search string was: "medial depression of mandibular ramus" OR "medial depression of the mandibular ramus" OR "medial depression of the mandibular rami" OR "medial depression of mandibular rami" OR "medial sigmoid depression". (4) Results: Eight studies were identified. Dry mandibles and patient dental panoramic radiographs were evaluated in four and seven of the eight studies, respectively. The prevalence of MSD varied from 20.2% to 82.0%. In male and female patients, the prevalence was 18.3-76.0% and 22.0-64.0%, respectively. MSD tended to occur bilaterally and most prevalent in patients with Angle's Class II occlusion. The semilunar and triangular shapes were more common than teardrop and circular shapes. The most cited study had 12 citations. (5) Conclusions: MSD was a seldom investigated and cited anatomical variation that was not uncommon. Its recognition should be further promoted.

Radiographic diagnosis and surgical management for successful outcomes for osteochondrosis in Japanese Black calves.

Osteochondrosis (OC) is not well recognized in cattle. Japanese Black (JB) cattle are valued for their beef and studies regarding OC are scarce. Hence, the aim of this study was to retrospectively discuss clinical and radiographical findings, diagnosis and treatment options for OC in JB cattle for successful outcomes. Medical records of 11 calves affected with OC were reviewed, retrospectively. Clinical and radiographic findings, treatment and outcomes and postmortem examination findings were analyzed. All calves had lameness. Stifle (4/14) and tarsal (4/14) were the most affected joints. Subchondral bone lucencies were observed in all joints (14/14) and accompanied with sclerosis (10/14). Radiographic grading was performed in calves. Calves were treated surgically (8/11) or conservatively (1/11). Surgically treated calves were auctioned (5/8). Postmortem examination was performed (2/11). Gross findings revealed ulcerative lesion at articular surface. Histopathologically, cartilage layer was defected at lesion. Inflammation (2/2) and granulation tissue (1/2) was also observed. In conclusion, OC in JB cattle can be diagnosed on the basis of radiography with history and clinical signs in clinical setting. Surgery should be performed in mild cases for successful outcomes. A modified radiographic grading criteria for clinical cases may hold potential in evaluating prognosis and outcomes.

Underreporting characteristics of osteoporotic vertebral fracture in back pain clinic patients of a tertiary hospital in China.

AIM: Osteoporotic vertebral compressive fractures (VCFs) â€‹are known to be commonly missed in X-rays indicated for pulmonary or heart diseases. In this study, we investigated the underreporting status of VCF in back pain clinic patients when the spine was the focus of interest. MATERIALS AND METHODS: This is a retrospective analysis of 105 female cases (mean: 72 years, range: 55-93 years) from a tertiary hospital in China (facility A, FA). The patients with back and/or leg pain were referred for a spine X-ray. The images were retrieved and transferred to a central reading facility (facility B, FB), where images were double-read by two readers experienced in evaluating osteoporotic vertebral compressive deformity (VCD)/VCF. A qualitative VCD with <20%, 20-25%, 25-40%, and >40% vertebral body height loss was recorded as minimal, mild, moderate, and severe grades, respectively. A â€‹VCD coexisted with endplate/cortex fracture (ECF) was VCF. FB readings were considered as the reference. RESULTS: There were 34 true negative cases where FA and FB had a consensus. In 7 cases with minimal VCD, 3 cases with ECF, and 7 cases with minimal or mild VCFs, the FA readings were false negative. No standalone singular moderate or severe VCD/VCF in a patient was missed in FA's reports. In 25 FA reading positive cases with multiple VCFs, one VCF was missed in 8 cases, more than one VCF was missed in 15 cases, and one additional ECF was missed in 2 cases. In 14 cases, FA and FB had VCF number agreement, with the term 'vertebral fracture' was used appropriately in FA reports. In 15 cases, FA and FB had agreement in VCF number; however, the appropriate term 'vertebral fracture' was not used in FA reports; instead the terms of 'compressive change' or 'wedging change' were used. In most VCFs, severity grading was not given in FA. In 13 VCFs where grading was reported, all were marked as 'mild', including seven mild VCFs, five moderate VCFs, and even one severe VCF. CONCLUSION: Among the patients with VCD/VCF, the false negative rate among was 23.9% (17/71), but the missed cases were all minimal or mild grades. One or more VCFs were missed in 32.4% (23/71) of the cases with multiple VCFs. Appropriate severity grading was not reported for most cases. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE: The underreporting rate of osteoporotic vertebral compressive fracture in back pain clinic patients in a typical tertiary hospital setting in China compared favorably with literature reports. However, there is a general lack of awareness of vertebral endplate/cortex fracture sign and vertebral fracture severity grading, while minimal and mild VCD with endplate/cortex fracture may have clinical significance. Moreover, after one VCF is spotted in a patient, it is highly advisable to carefully check the whole spine so that multiple VCFs will not be missed.

Hallazgo incidental en tomografía computada de haz cónico / Incidenal finding in cone beam computed tomography

El creciente número de técnicas radiográficas realizadas por paciente para diagnóstico y planificación provoca un aumento en el número de hallazgos incidentales. La descripción de un hallazgo incidental puede desencadenar atención médica adicional, que incluye otros procedimientos y tratamientos de diagnóstico, con lo cual, en muchas ocasiones es necesario derivar al paciente para tratar la patología descubierta en forma incidental. La CBCT puede ayudar a detectar la presencia de lesión periapical no diagnosticada previamente, donde la evaluación clínica previa y las radiografías convencionales no han revelado la patología. La patología asintomática u oculta puede conducir a un diagnóstico tardío, lo que puede afectar negativamente las posibles estrategias de tratamiento y los resultados. La detección temprana y la precisión diagnóstica son esenciales. La CBCT es una técnica que proporciona vistas de zonas anatómicas con las cuales la mayoría de los odontólogos no están familiarizados y que pueden revelar patología oculta, permitiendo diagnósticos más precisos y confiables, y reduciendo así la posibilidad de perder la patología clínicamente relevante. Este articulo trata de sintetizar las ventajas del uso de la tomografía para diagnosticar el hallazgo incidental (AU)

The increasing number of radiographic techniques performed by the patient for diagnosis and planning causes an increase the number of incidental findings. The description of an unexpected finding can trigger additional medical care including, other diagnostic procedures and treatments, therefore, in many occasions it is necessary to refer the patient to treat the pathology discovered incidentally. CBCT may aid in detecting the presence of previously undiagnosed periapical disease, where prior clinical evaluation and conventional radiographs have failed to reveal pathology. Asymptomatic or occult pathology may lead to delayed diagnosis, which may adversely affect eventual treatment strategies and outcomes. Early detection and improved diagnostic accuracy are essential, also, provide views of anatomy that most dentists have never before seen; in addition, they may reveal occult pathology, enabling more accurate and reliable diagnoses thereby reducing the possibility of missing clinically relevant disease (AU)

Comparison of Radiography and Histopathologic Analysis in the Evaluation of Hip Arthritis.

OBJECTIVE. The purpose of this study was to establish the correlation of radiography findings with findings of gross and microscopic histopathologic analysis to assess the usefulness of radiography in preoperative assessment for hip arthroplasty. MATERIALS AND METHODS. Radiology and pathology reports from 953 consecutive femoral head resections were reviewed to establish the correlation of radiography and pathology findings as used in routine clinical practice. In 83 cases MR images were also available for review. Both radiologists and pathologists prospectively used a four-grade scale of absent, mild, moderate, or severe osteoarthritis. The grades established by radiologists and pathologists were compared by means of both the four-grade system and a simplified two-grade system of none-to-mild versus moderate-to-severe osteoarthritis. RESULTS. The mean patient age was 60 years (range, 18-94 years). Resection was performed for osteoarthritis in 941 cases and for infection, inflammatory arthritis, avascular necrosis, fracture, or tumor in the others. Radiographs showed severe osteoarthritis in 62.3% of patients and no or mild osteoarthritis in 17.7%. Observed agreement between radiology and pathology findings was 90% for both the four-grade and two-grade osteoarthritis scales. Findings on standing radiographs were more concordant with pathology results than findings on supine radiographs (odds ratio, 1.4). Observed agreement between radiography and MRI was 78%. There were significant discrepancies between radiography grade and pathology grade in 2.2% of cases. Observed agreement of MRI and pathologic analysis was 76% (κ = 0.64). CONCLUSION. Radiography findings are a reliable indicator of severity of osteoarthritis. This is important because previous studies have shown that patients with no or mild osteoarthritis are less likely to benefit from arthroplasty. If evidence of moderate or severe osteoarthritis is not present on radiographs, further investigation is warranted before proceeding to arthroplasty.

Radiographic Diagnosis of Scapholunate Diastasis in Distal Radius Fractures: Implications for Surgical Practice.

Background Radiographic diagnosis of scapholunate ligament injury (SLI) in the setting of distal radius fractures (DRFs) is challenging. It remains unclear to what extent radiographic diagnosis of SLI by a radiologist influences surgical decision-making regarding treatment of SLI. Purpose We aimed to (1) identify the number of times that concerns for the possibility of concurrent SLI in the setting of a DRF had been raised by the radiologists, (2) identify how often the radiologist's diagnosis was confirmed by the treating surgeon, and (3) how many of the patients with a radiographic concern for SLI by the radiologist received operative treatment for the SLI. Patients and Methods Based on Current Procedural Terminology codes, we identified 2,923 patients that were operatively treated for their DRF in 1 of 3 participating institutions in an urban city in the United States. We reviewed the medical charts of 654 patients who had a mention of scapholunate ligament (SL) distance in their radiography, surgery, or clinical notes. We then measured the SL distance and recorded patient, diagnosis, and treatment characteristics of all these patients. Results A total of 200 out of 2,923 patients (6.8%) received a radiological diagnosis of SLI. In seven of these patients (3.5%), the surgeon confirmed the diagnosis of the radiologist. Four patients (2%) had operative repair of their SLI. Conclusion Radiologists demonstrate a low threshold to identify SLI in the setting of DRFs, while the number of SLIs identified by the treating surgeon is a remarkably smaller number. Level of Evidence Level II, prognostic study.

Diagnosing slipped capital femoral epiphysis amongst various medical specialists.

PURPOSE: To evaluate sensitivity, specificity and accuracy of a radiographic slipped capital femoral epiphysis (SCFE)-diagnosis among medical specialists. METHODS: Three paediatricians, three paediatric radiologists and three paediatric orthopaedic surgeons completed two rounds of a survey of anteroposterior and frog-leg lateral radiographs of patients with a diagnosis of SCFE (25), femoroacetabular impingement (four), Legg-Calvé-Perthes (11) or no hip pathology (ten). Intra- and interobserver agreement among specialties regarding the diagnosis of a SCFE were assessed using Cohen's kappa coefficient (κ). Diagnostic accuracy of SCFE relative to the benchmark, a combination of the radiographic diagnosis based on Klein's line, clinical symptoms and surgical treatment, was assessed computing sensitivity, specificity and accuracy. RESULTS: Intraobserver agreement between the surveys was moderate among paediatricians (κ-range, 0.44 to 0.52), moderate to almost perfect among orthopaedic surgeons (κ-range, 0.79 to 0.88) and almost perfect among paediatric radiologists (κ-range, 0.83 to 1.00). Interobserver agreement for survey 1 and 2 was slight among paediatricians (mean κ, 0.19), substantial among orthopaedic surgeons (mean κ, 0.77) and almost perfect among paediatric radiologists (mean κ, 0.86). Sensitivity of SCFE-diagnosis was high among radiologists and orthopaedic surgeons (88% to 100% for both specialties), but lower for paediatricians (24% to 76%). Specificity was high among radiologists and orthopaedic surgeons (72% to 84%), however, variable among paediatricians (56% to 80%). Accuracy of a SCFE-diagnosis was highest in radiologists (84% to 92%), followed by orthopaedic surgeons (80% to 88%) and paediatricians (48% to 78%). CONCLUSION: SCFE can be detected on radiographs by different medical specialties. Intra- and interobserver agreement, specificity, sensitivity and accuracy for radiographic SCFE-diagnosis amongst paediatric radiologists and orthopaedic surgeons are better than that of general paediatricians. LEVEL OF EVIDENCE: II.

Management Strategies and Outcomes for VHL-related Craniospinal Hemangioblastomas.

Hemangioblastomas are rare and benign tumors accounting for less than 2% of all central nervous system (CNS) tumors. The vast majority of hemangioblastomas occur sporadically, whereas a small number of cases, especially in younger patients, are associated with Von Hippel-Lindau (VHL) syndrome. It is thought that loss of tumor suppressor function of the VHL gene results in stabilization of hypoxia-inducible factor alpha with downstream activation of cellular proliferative and angiogenic genes that promote tumorigenesis. VHL-related hemangioblastomas predominantly occur in the cerebellum and spine. Lesions are often diagnosed on contrast-enhanced craniospinal MRIs, and the diagnosis of VHL occurs through assessment for germline VHL mutations. Surgical resection remains the primary treatment modality for symptomatic or worrisome lesions, with excellent local control rates and neurological outcomes. Stereotactic radiotherapy can be employed in patients who are deemed high risk for surgery, have multiple lesions, or have non-resectable lesions. Given the tendency for development of either new or multiple lesions, close radiographic surveillance is often recommended for asymptomatic lesions.

Predictive Power of Distal Radial Metaphyseal Tenderness for Diagnosing Occult Fracture.

PURPOSE: To correlate the physical examination finding of distal radial metaphyseal tenderness with plain radiographic and magnetic resonance imaging after acute wrist injury to diagnose occult distal radius fractures. We hypothesized that persistent distal radial metaphyseal tenderness 2 weeks after acute injuries is predictive of an occult fracture. METHODS: Twenty-nine adult patients presented, after acute trauma, with distal radial metaphyseal tenderness and initial plain radiographs and/or fluoroscopic images that did not show a distal radius fracture. Patients were reevaluated clinically and radiographically at approximately 2 weeks after initial presentation. Patients with persistent distal radial tenderness and negative radiographs underwent magnetic resonance imaging to definitively diagnose an occult distal radius fracture. We calculated the sensitivity and positive predictive value for persistent distal radial metaphyseal tenderness using a 95% confidence interval and standard formulas. Both radiographs and magnetic resonance imaging were used as our endpoint diagnosis for a distal radius fracture. RESULTS: We diagnosed 28 occult distal radius fractures, 8 by follow-up radiograph and 20 by magnetic resonance imaging. The positive predictive value for patients who completed the protocol was 96%. One patient who did not have an occult distal radius fracture had a fracture of the ulnar styloid. CONCLUSIONS: Tenderness of the distal radial metaphysis after wrist injury is strongly suggestive of a distal radius fracture despite both normal plain radiographs and fluoroscopic images. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic III.

Radiographic Diagnosis of Pincer-Type Femoroacetabular Impingement: A Systematic Review.

BACKGROUND: Femoroacetabular impingement (FAI) is a well-recognized condition that causes hip pain and can lead to early osteoarthritis if not managed properly. With the increasing awareness and efficacy of operative treatments for pincer-type FAI, there is a need for consensus on the standardized radiographic diagnosis. PURPOSE: To perform a systematic review of the evidence regarding imaging modalities and radiographic signs for diagnosing pincer-type FAI. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A literature review was performed in 2016 using the Cochrane, PubMed, and Embase search engines. All articles focusing on a radiographic diagnosis of pincer-type FAI were reviewed. Each of the included 44 articles was assigned the appropriate level of evidence, and the particular radiographic marker and/or type of imaging were also summarized. RESULTS: There were 44 studies included in the final review. Most of the articles were level 4 evidence (26 articles), and there were 12 level 3 and 6 level 2 articles. The crossover sign was the most commonly used radiographic sign (27/44) followed by the lateral center-edge angle (22/44). Anteroposterior (AP) pelvis plain radiographs were the most commonly used imaging modality (33 studies). Poor-quality evidence exists in support of most currently used radiographic markers, including the crossover sign, lateral center-edge angle, posterior wall sign, ischial spine sign, coxa profunda, acetabular protrusion, and acetabular index. There is poor-quality conflicting evidence regarding the use of the herniation pit to diagnose pincer-type FAI. Some novel measurements, such as ß-angle, acetabular roof ratio, and acetabular retroversion index, have been proposed, but they also lack support from the literature. CONCLUSION: No strong evidence exists to support a single best set of current radiographic markers for the diagnosis of pincer-type FAI, largely due to the lack of better quality trials (levels 1 and 2) that compare conventional radiographic findings with the gold standard, which is the intraoperative findings. More sophisticated imaging modalities such as computed tomography and magnetic resonance arthrography are often needed to diagnose pincer-type FAI, and these investigations are relatively accurate in assessing labral pathology or cartilage damage.

Prevalencia de lesiones cariosas proximales en molares temporales según ICDAS II y su correlación con el diagnóstico radiográfico, en niños de 4 a 9 años de edad

La caries dental se refiere a una patología que se caracteriza por la desmineralización progresiva, pasando por las primeras manifestaciones clínicas, hasta la pérdida del tejido dental propiamente dicho. El diagnóstico de la caries dental se limitaba únicamente a un punto final, la cavidad y la pérdida dental y no como en la actualidad, que se considera como todo un proceso de enfermedad. Sin embargo actualmente continúa siendo un problema de salud pública. El correcto diagnóstico de la caries dental es fundamental para disminuir este asunto, incluyendo áreas de difícil acceso como son las lesiones cariosas proximales. Realizar el diagnóstico clínico visual en la superficie interproximal es casi imposible, y en muchos casos se dan falsos negativos a la hora de realizar los diagnósticos; por lo tanto, es necesario utilizar métodos complementarios como la radiografía de aleta. En el presente estudio se utilizaron tanto el método clínico visual ICDAS II "(Sistema Internacional para la Detección y Evaluación de Caries), como el método diagnóstico radiográfico. Al realizar el examen clínico visual de las superficies proximales de las molares temporales, se utilizaron separadores de ortodoncia que lograron la separación temporal de las piezas, de manera que permitió un espacio físico para facilitar la valoración clínica y a su vez se implementó el ICDAS II " como instrumento para la evaluación de los niveles de severidad del proceso carioso en las diferentes superficies; de igual manera se tomaron radiografías de aleta en las mismas superficies dentales, valoradas con el examen clínico visual. El objetivo principal fue determinar la prevalencia de lesiones proximales en molares temporales, de acuerdo con los criterios de valoración y detección de caries ICDAS II y su correlación con el diagnóstico de la misma lesión observada con el método radiográfico. De las superficies observadas con el método diagnóstico clínico visual con separadores un 18,7% presentó superficies lesionadas con caries dental, mientras que con el método diagnóstico radiográfico mostró un 22,5% de superficies lesionadas con caries dental; se encontró una asociación fuerte entre el diagnóstico clínico visual y el radiográfico, con una probabilidad de 91,1% de hallar los mismos resultados con significancia estadística.

Tooth decay refers to a condition characterized by progressive demineralization, through the first clinical manifestations, to loss of tooth structure itself. The diagnosis of dental caries was limited only to an endpoint, cavity and at last, tooth loss. Now days it is considered tooth decay as a whole disease process. The disease remains a public health problem. The correct diagnosis of dental caries is essential to diminish this problem, including difficult access areas like the interproximal carious lesions. Performing visual clinical diagnosis in the proximal surface is almost impossible, and in many cases false negatives are given in the diagnosis, so it is necessary to use complementary methods such as x-rays. In this study both the visual clinical method ICDAS II (International Caries Detection and Assessment System) and the radiographic diagnostic method where used. When performing visual clinical examination of the proximal surfaces of molars, orthodontic separators achieved temporary separation of the tooth, so it allowed a physical space to facilitate clinical evaluation andimplemented ICDAS II as an instrument used for evaluating the severity levels of caries process in different areas; x rays were taken on the same tooth surfaces, valued with the visual clinical examination. The main objective was to determine the prevalence of interproximal lesions in molars according to the criteria of assessment and detection of ICDAS II caries and its correlation with the diagnosis of the same injury observed with radiographic method. 18.7% Surfaces observed with clinical diagnostic method with orthodontics separators showed surfaces with carious lesions, while the radiographic diagnosis method presented 22.5% of surfaces with carious lesions; a strong association between visual clinical diagnosis and radiographic diagnosis, with a 91.1% probability of finding the same results with statistical significance, allowing a generalization of the results.

Dilaceração radicular: relato de caso clínico / Tooth with root dilaceration: case report

A dilaceração radicular é uma anomalia de forma dentária, geralmente associada a fatores etiológicos traumáticos, na qual há uma mudança de direção da raiz, onde a parte calcificada é deslocada em relação à parte não calcificada, podendo ocorrer em qualquer ponto ao longo do comprimento radicular, dependendo do estágio da formação radicular quando ocorre o trauma, o local e a intensidade. Esta condição acomete cerca de 3% dos dentes permanentes. O tratamento da dilaceração radicular é controverso e o planejamento é essencial. O objetivo deste trabalho é demostrar a importância das imagens radiográficas e tomográficas para o diagnóstico e planejamento do tratamento da dilaceração radicular por meio de um caso clínico.

The root dilaceration is an anomaly of tooth form, usually associated with traumatic etiological factors, in which there is a change in the direction of the root, where the calcified portion is offset from the not calcified part, and may occur at any point along the length root, depending on the stage of root formation occurs when injured, it’s location and intensity. This condition affects about 3% of permanent teeth. Treatment of dilaceration root is controversial and planning is essential. The aim of this work is to demonstrate the importance of radiographic and tomographic images for diagnosis and treatment planning of root tearing through a case report.

Cone beam computed tomography updated technology for endodontic diagnosis.

Cone beam computed tomography has gained acceptance in the endodontic community for assistance with diagnosis, treatment, and evaluation of outcomes. This article reviews a multitude of applications, from basic principles to clinical applications, using specific cases and supporting literature to demonstrate the benefits for both the specialist and general practitioner.

Aspectos clínicos y radiográficos de la neumonía típica condensante en menores de 5 años / Clinical and radiographic aspects of condensing pneumonia in children under 5 years

Se realizó una investigación descriptiva de 150 menores de 5 años de edad con diagnóstico clínico y radiográfico de neumonía típica condensante -- seleccionados mediante un muestreo aleatorio simple --, ingresados en la sala de Neumología y en la Unidad de Cuidados Intensivos Polivalente del Hospital Docente Infantil Sur de Santiago de Cuba, de enero a diciembre del 2012. En la serie las variables edad, sexo, gravedad del cuadro clínico y complicaciones asociadas se relacionaron con los resultados de los rayos X de tórax, según localización topográfica, y se obtuvo que 66,6 % de los pacientes presentaba inflamación localizada en el pulmón derecho, predominante en todas las edades, el derrame pleural resultara la complicación más frecuente (8,0 %), que sobresalió en los niños con afectación en el pulmón izquierdo (16,6 %). Aunque primaron las neumonías condensantes en el pulmón derecho, la gravedad del cuadro clínico y las complicaciones resultaron más frecuentes en aquellos que presentaban inflamación del izquierdo.

A descriptive investigation of 150 children under 5 years with clinical and radiographic diagnosis of condensing pneumonia -- selected by means of a simple random sampling --, admitted in the Pneumology room and that of the Progressive Cares to the Severely ill Patient at the Children Southern Teaching Hospital in Santiago de Cuba was carried out from January to December, 2012. In the series the variable age, sex, severity of the clinical pattern and associated complications were related to the results of the thorax X rays, according to topographical localization, and it was obtained that 66.6% of the patients presented located swelling in the right lung, predominant in all ages, the pleural effusion was the most frequent complication (8.0%) which was relevant in the children with a damaged left lung (16.6%). Although the condensing pneumonias prevailed in the right lung, the severity of the clinical pattern and the complications were more frequent in those who presented a swollen left lung.