CT-like images based on T1-weighted gradient echo MRI sequences for the assessment of fractures of the hand and wrist compared to CT.

OBJECTIVE: To evaluate the performance of a 3D T1-weighted gradient-echo (3D T1GRE) computed tomography (CT)-like magnetic resonance imaging (MRI) sequence for detecting and assessing wrist and hand fractures compared to conventional CT. METHODS: Subjects with acute wrist or hand fracture in CT underwent additional 3 T MRI including a CT-like 3D T1GRE sequence and were compared to patients without fractures. Two radiologists assessed fracture morphology on both modalities according to the Arbeitsgemeinschaft Osteosynthese (AO) and graded image quality and diagnostic confidence on a 5-point Likert scale. Besides diagnostic test evaluation, differences in image quality and diagnostic confidence between CT-like MRI and CT were calculated using the Wilcoxon test. Agreement of AO classification between modalities and readers was assessed using Cohen's Kappa. RESULTS: Twenty-eight patients with 43 fractures and 43 controls were included. Image quality (3D T1GRE 1.19 ± 0.37 vs. CT 1.22 ± 0.42; p = 0.65) and diagnostic confidence (3D T1GRE 1.28 ± 0.53 vs. CT 1.28 ± 0.55; p = 1.00) were rated excellent for both modalities. Regarding the AO classification, intra- (rater 1 and rater 2, κ = 0.89; 95% CI 0.80-0.97) and interrater agreement were excellent (3D T1GRE, κ = 0.82; 95% CI, 0.70-0.93; CT, κ = 0.85; 95% CI, 0.75-0.94). CT-like MRI showed excellent sensitivity, specificity and accuracy for fracture detection (reader 1: 1.00, 0.92, 0.96; reader 2: 0.98, 0.94, 0.96). CONCLUSION: CT-like MRI is a comparable alternative to CT for assessing hand and wrist fractures, offering the advantage of avoiding radiation exposure.

[Sports-related injuries of the thumb and fingers]. / Sportverletzungen des Daumens und der Finger.

Finger and thumb injuries are common in established and trend sports. Imaging plays an important role in acute trauma care, further therapy planning, and ultimately for a rapid return to play. Sound knowledge of the complex anatomy of the fingers and thumb is indispensable for accurate diagnosis. This article presents the ligament anatomy of the metacarpophalangeal and interphalangeal joints of the finger and the thumb, the extensor and flexor tendon apparatus, and the diagnosis of typical sports injuries using x­rays and magnetic resonance imaging. Furthermore, imaging findings of typical sports-associated injuries are illustrated.

Effects of a single transdermal administration of flunixin meglumine in early postpartum Holstein Friesian dairy cows: Part 2. Milk yield, culling risk, and reproductive performance.

This study was conducted to assess the effects of a single transdermal administration of flunixin meglumine (FM) in early postpartum Holstein Friesian dairy cows on milk yield, culling risk, and reproductive performance. We hypothesized that FM treatment would reduce systemic inflammation, leading to higher milk yield, reduced culling risk, and better reproductive performance in the subsequent lactation. Holstein Friesian dairy cows [n = 500, 153 primiparous (PRIM), 347 multiparous (MULT)] from 3 farms in northeast Germany were enrolled in a prospective, randomized controlled clinical trial. Farms at risk for cows with excessive postpartum inflammation were identified in a preliminary trial by measuring serum haptoglobin concentrations in their fresh lactating cows. Only cows that had a eutocic birth and delivered a singleton calf alive, with no signs of milk fever or retained fetal membranes and rectal temperature ≤40°C at first clinical examination, were included within 24 to 36 h postpartum. Treatment included a single transdermal administration of either FM (3.33 mg/kg) or a placebo as control (CON). Milk production, milk solids, urea, and somatic cell count were recorded monthly for 8 mo after calving. Culling risk, first-service conception risk, and days open were retrieved from the farms' herd management software. Separate models for PRIM and MULT cows were built for most parameters because of significant effects of parity and parity × treatment interaction. Energy-corrected milk yield from 8 monthly Dairy Herd Improvement-equivalent tests was slightly greater in PRIM cows treated with FM (29.51 and 30.73 ± 1.35 kg, CON vs. FM), whereas it was reduced in treated MULT cows (38.23 and 37.47 ± 1.17 kg, CON vs. FM) compared with CON. Milk fat and protein yields were greater in FM-treated PRIM cows and lower in treated MULT cows compared with CON. Milk urea and somatic cell count were not affected by treatment. No differences in culling risk, first-service conception risk, or days open were observed. We conclude that a single transdermal administration of FM in early postpartum dairy cows on farms at risk for excessive postpartum inflammation slightly increased milk, milk fat, and milk protein yields in PRIM cows and decreased these variables in MULT cows. Neither culling risk nor fertility was affected by treatment in this study.

Effects of a single transdermal administration of flunixin meglumine in early postpartum Holstein Friesian dairy cows: Part 1. Inflammatory and metabolic markers, uterine health, and indicators of pain.

The objectives of this study were to assess the effects of a single transdermal administration of flunixin meglumine (FM) in early postpartum Holstein Friesian dairy cows on serum concentrations of inflammatory and metabolic markers, uterine health, and indicators of pain. The hypothesis was that the anti-inflammatory, antipyretic, and analgetic effects of the pharmaceutic agent would reduce systemic inflammation, resulting in improved metabolic and inflammatory profile, diminished incidence of metritis, and reduced expression of pain. A total of 500 cows (153 primiparous, 347 multiparous) from 3 different commercial dairy farms in the northeast of Germany were included in a randomized controlled clinical trial. Farms were preselected based on high haptoglobin concentrations in their fresh lactating cows. Cows were excluded if they had experienced dystocia, stillbirth, or twin birth, or if they showed any signs of milk fever, retained fetal membranes, or fever (>40°C). The cows were treated once with either FM (3.33 mg/kg) or a placebo as control (CON) through transdermal administration between 24 to 36 h postpartum (d 2). General health examinations were performed (daily from d 2-8 and additionally on d 15 postpartum), vaginal discharge was assessed using the Metricheck device (d 8 and 15 postpartum) and serum samples were analyzed for inflammatory and metabolic markers (d 2, 4, and 6 postpartum). Effects of treatment, parity, sampling day, and their interactions were evaluated using mixed effects models. Primiparous cows treated with FM showed lower serum haptoglobin concentrations (0.90 ± 0.08 vs. 1.17 ± 0.07 g/L; ± standard error of the mean) and higher serum albumin concentrations (35.5 ± 0.31 vs. 34.8 ± 0.31 g/L) on d 6 postpartum. They also had a lower risk for purulent vaginal discharge with or without a fever compared with CON cows on d 15 postpartum (odds ratio for CON vs. FM: 1.63, 95% CI: 1.26-2.00), and body temperature was lower throughout the first 15 d in milk (39.1 ± 0.11 vs. 39.2 ± 0.11°C). Multiparous cows treated with FM had lower serum ß-hydroxybutyrate concentrations on d 4 postpartum (0.71 ± 0.05 vs. 0.78 ± 0.05 mmol/L) and d 6 postpartum (0.74 ± 0.05 vs. 0.80 ± 0.05 mmol/L). Regardless of parity, FM-treated cows were significantly less likely to abduct their tail from their body (14.3 vs. 23.6%) and show an arched back (27.9 vs. 39.7%) on the day after treatment compared with CON cows. It can be concluded that FM treatment slightly reduced inflammation and diminished the risk for metritis in primiparous cows, improved metabolic profile in multiparous cows, and reduced expressions of pain in all cows.

[Analyses of the relationship between the concentrations of essential trace elements in total mixed ration and faeces samples from Holstein Friesian dairy cows and the estimation of faeces reference values]. / Untersuchungen zum Zusammenhang der Konzentrationen an essenziellen Spurenelementen in totalen Misch­rationen- und Kotproben bei Holstein Friesian Milchkühen und Ableitung von Kotreferenzwerten.

INTRODUCTION: Undersupply and oversupply of dairy cows with essential trace elements should be avoided from the point of view of animal health and environmental pollution. The aim of the study was to proof the results faecal analyzes on the nutritional supply situation with essential trace elements in comparison to measurements from total mixed ration (TMR) analyses. Concentrations of iron (Fe), copper (Cu), zinc (Zn), Mangan (Mn), selenium (Se), cobalt (Co), molybdenum (Mo) were measured as representative multicentric random sample in 574 TMR, 600 pooled faecal and blood samples from dairy cows. Trace elements, Fe in 0 %, Se 18 %, Zn 43 %, Cu 52 %, Co 53 % and Mn 59 %, were within the target range. Undersupply was found in 0 to 8 % and an oversupply in 39 to 100 % of the TMR samples. The tolerance limit for Fe was exceeded in 11 % and for Mo in 13 %. The results indicate the need for optimized ration design. The trace element concentrations in the faecal samples varied over a wide range. Results of pooled faecal samples (n=10 per pool) corresponded closely with the mean values calculated from the individual samples (r2 > 0,9). Correlation between element concentrations in the TMR and faecal samples for Fe (r=0,687), Cu (r=0,675), Zn (r=0,635), Mn (r=0,656), Se (r=0,573), Co (r=0,795), and Mo (r=0,708) were highly significant. No correlations were detected between the element concentrations in the TMR and in the blood samples. The regression analyzes showed a highly significant linear adjustment of the measured value distribution around the regression lines over the entire value range including the zero point. Reference values were calculated for the faecal concentrations of Cu, Zn, Mn, Se and Co. Tolerance reference limits in the TMR were calculated for the faecal concentrations of Fe and Mo. The trace element concentrations in the TMR samples reflect the nutritional supply situation. Knowledge of the nutritional supply situation of the herd is of great importance for the stock management of dairy cow. Fecal sample analyzes can be used as an alternative to TMR examinations to assess the nutritional supply situation.

INTRODUCTION: Les sous-approvisionnements et les surapprovisionnements des vaches laitières en oligo-éléments essentiels doivent être évités du point de vue de la santé animale et de la pollution de l'environnement. L'objectif de cette étude était de vérifier la pertinence des analyses de fèces pour évaluer l'apport nutritionnel en oligo-éléments essentiels en les comparant aux valeurs mesurées dans les analyses de RTM (ration totale mélangée). Dans un échantillon aléatoire multicentrique représentatif, les concentrations de fer (Fe), de cuivre (Cu), de zinc (Zn), de manganèse (Mn), de sélénium (Se), de cobalt (Co) et de molybdène (Mo) ont été mesurées dans 574 échantillons de RTM et 600 échantillons de fèces regroupés de vaches laitières et des échantillons de sang ont été analysés. La plage cible pour la teneur en oligo-éléments dans la RTM a été respectée pour Fe à 0 %, Se à 18 %, Zn à 43 %, Cu à 52 %, Co à 53 % et Mn à 59 %. La plage de sous-alimentation a été constatée dans 0 à 8 % des échantillons de RTM, la plage de suralimentation dans 39 à 100 %. La limite de tolérance pour le Fe a été dépassée dans 11 %, pour le Mo dans 13 %. Ces résultats indiquent la nécessité d'optimiser les rations. Dans les échantillons de fèces, les concentrations en oligo-éléments variaient sur une large plage. Les résultats d'analyse des échantillons de fèces regroupés (n=10 par pool) correspondaient étroitement, avec une valeur r2 supérieure à 0,9, aux valeurs moyennes calculées à partir des échantillons individuels. Il y avait des corrélations très significatives entre les concentrations d'éléments dans les échantillons de RTM et de fèces pour Fe (r=0,687), Cu (r=0,675), Zn (r=0,635), Mn (r=0,656), Se (r=0,573), Co (r=0,795), et Mo (r=0,708). Aucune corrélation n'a pu être établie entre les concentrations d'éléments dans le RTM et dans les échantillons de sang. Les analyses de régression ont montré un ajustement linéaire hautement significatif de la distribution des valeurs mesurées autour de la droite de régression sur l'ensemble de la plage de valeurs, y compris le point zéro. Des valeurs de référence ont été calculées pour les concentrations de Cu, Zn, Mn, Se et Co dans les fèces. Pour les concentrations de Fe et Mo dans les fèces, des limites de référence ont été calculées pour les limites de tolérance dans la RTM. Les concentrations en oligo-éléments dans les échantillons de RTM reflètent la situation nutritionnelle. Pour le suivi des troupeaux de vaches laitières, il est très important de connaître l'état nutritionnel du troupeau. Les analyses d'échantillons de fèces peuvent être utilisées comme alternative aux analyses de RTM pour évaluer la situation nutritionnelle.

Save the Mekong Delta from drowning.

Policy must address drivers, not just symptoms, of subsidence.

Strategic basin and delta planning increases the resilience of the Mekong Delta under future uncertainty.

The climate resilience of river deltas is threatened by rising sea levels, accelerated land subsidence, and reduced sediment supply from contributing river basins. Yet, these uncertain and rapidly changing threats are rarely considered in conjunction. Here we provide an integrated assessment, on basin and delta scales, to identify key planning levers for increasing the climate resilience of the Mekong Delta. We find, first, that 23 to 90% of this unusually productive delta might fall below sea level by 2100, with the large uncertainty driven mainly by future management of groundwater pumping and associated land subsidence. Second, maintaining sediment supply from the basin is crucial under all scenarios for maintaining delta land and enhancing the climate resilience of the system. We then use a bottom-up approach to identify basin development scenarios that are compatible with maintaining sediment supply at current levels. This analysis highlights, third, that strategic placement of hydropower dams will be more important for maintaining sediment supply than either projected increases in sediment yields or improved sediment management at individual dams. Our results demonstrate 1) the need for integrated planning across basin and delta scales, 2) the role of river sediment management as a nature-based solution to increase delta resilience, and 3) global benefits from strategic basin management to maintain resilient deltas, especially under uncertain and changing conditions.

[The ulnocarpal complex : New clinical and radiological considerations]. / Der ulnokarpale Komplex : Neue klinische und radiologische Überlegungen.

CLINICAL ISSUE: The triangular fibrocartilage complex (TFCC) is an anatomically complex structure with high demands on spatial and contrast resolution in imaging. RADIOLOGICAL METHODS: The central, predominantly avascular articular disc can be distinguished from the ligamentous, vascularized periphery. Imaging methods include magnetic resonance imaging (MRI, preferably contrast-enhanced) as well as MR and computed tomography (CT) arthrography. DIAGNOSTIC INNOVATIONS: While high-resolution MRI represents the standard diagnostic tool for the TFCC in general, arthrographic imaging is particularly useful for assessment of the foveal (proximal) lamina of the TFCC. In radiological reporting, the convergence of the TFCC periphery towards the ulnar styloid process and the ulnar fovea must be considered. ACHIEVEMENTS: The Palmer classification is suitable for evaluating lesions of the articular disc, whereas the Atzei classification is superior for lesions of the ulnar TFCC insertions. PRACTICAL RECOMMENDATION: Use of a high-resolution examination technique and anatomy-based image interpretation are important for reliable MRI of the TFCC.

Eco-environmental impacts of dams in the Yangtze River Basin, China.

Nearly half large dams of China have been built in the Yangtze River Basin (YRB) and the eco-environmental impacts of existing dams remain elusive. Here we present a spatio-temporal approach to measuring the eco-environmental impacts of dams and its long-term changes. We also develop a new metric, the dam eco-environmental effect index (DEEI), that quickly identifies the eco-environmental impacts on dams over 36 years. Underlying the analysis are the revised universal soil loss equation (RUSLE), the generalized boosted regression modeling (GBM), the generalized linear model (GLM), stepwise multiple regression, trend analysis, soil erosion and sediment yield balance equation, and sample entropy used to identify the eco-environmental impacts of dams on yearly timescales. We find that the accumulated negative environmental effects of constructed dams have increased significantly and has led to large-scale hydrophysical and human health risk affecting the Yangtze River Basins downstream (i.e. Jianghan-Lushui-Northeastern Hubei, Dongting Lake District, Yichang-Jianli, and Qingjiang) and reservoir areas (i.e. Wanxian-Miaohe, Miaohe-Huanglingmiao, and Huanglingmiao-Yichang). We also provide observational evidence that dam construction has reduced the complexity of short-term (1-12 months) in runoff and sediment loads. This spatial pattern seems to reflect a filtering effect of the dams on the temporal and spatial patterns of runoff and sediment. Three Gorges Dam (TGD) has a significant impact on the complexity of the runoff and sediment loads in the mainstream of the Yangtze River. This enhanced impact is attributed to the high trapping efficiency of the dam and its associated large reservoir. This assessment may underestimate the cumulative effect of the dam because it does not consider the future effects of the planned dam. Our study provides a quantitative methodology for finding the relative change rate of eco-environmental impact on dams, which is the first step towards addressing the extent, process, and magnitude of the dam-induced effects.

[Special aspects of fractures of the distal forearm]. / Spezielle Aspekte der Frakturen am distalen Unterarm.

BACKGROUND: Fractures of the distal forearm, especially fractures of the distal radius which are the most common fracture in humans, are of increasing socioeconomic relevance due to the increasing incidence and the increasing costs that are associated with the popularity of palmar plating. OBJECTIVES: Radiological imaging for diagnosis and follow-up are presented with special focus on new biomechanical fracture concepts such as the four-corner concept. MATERIALS AND METHODS: The basic literature and expert opinions are evaluated and discussed. RESULTS: In intra-articular fractures of the distal radius, plain radiographs must be supplemented by computed tomography (CT). Direct CT arthrography allows not only analysis of the fracture pattern, but also detection of accompanying injuries of the carpus, especially the scapholunate ligament, and the ulnocarpal complex. The plain radiographs should also be analyzed for accompanying injuries. Therefore, both acquisition of the imaging data and their morphometrical analysis have to be standardized. CONCLUSIONS: In addition to diagnosis and follow-up, radiological imaging plays a decisive role in the treatment of distal forearm fractures. CT and direct CT arthrography have become important tools in intra-articular distal radius fractures.

Kidney injury enhances renal G-CSF expression and modulates granulopoiesis and human neutrophil CD177 in vivo.

Kidney injury significantly increases overall mortality. Neutrophilic granulocytes (neutrophils) are the most abundant human blood leukocytes. They are characterized by a high turnover rate, chiefly controlled by granulocyte colony stimulating factor (G-CSF). The role of kidney injury and uremia in regulation of granulopoiesis has not been reported. Kidney transplantation, which inherently causes ischemia-reperfusion injury of the graft, elevated human neutrophil expression of the surface glycoprotein CD177. CD177 is among the most G-CSF-responsive neutrophil genes and reversibly increased on neutrophils of healthy donors who received recombinant G-CSF. In kidney graft recipients, a transient rise in neutrophil CD177 correlated with renal tubular epithelial G-CSF expression. In contrast, CD177 was unaltered in patients with chronic renal impairment and independent of renal replacement therapy. Under controlled conditions of experimental ischemia-reperfusion and unilateral ureteral obstruction injuries in mice, renal G-CSF mRNA and protein expression significantly increased and systemic neutrophilia developed. Human renal tubular epithelial cell G-CSF expression was promoted by hypoxia and proinflammatory cytokine interleukin 17A in vitro. Clinically, recipients of ABO blood group-incompatible kidney grafts developed a larger rise in neutrophil CD177. Their grafts are characterized by complement C4d deposition on the renal endothelium, even in the absence of rejection. Indeed, complement activation, but not hypoxia, induced primary human endothelial cell G-CSF expression. Our data demonstrate that kidney injury induces renal G-CSF expression and modulates granulopoiesis. They delineate differential G-CSF regulation in renal epithelium and endothelium. Altered granulopoiesis may contribute to the systemic impact of kidney injury.

Automation in cell and gene therapy manufacturing: from past to future.

As more and more cell and gene therapies are being developed and with the increasing number of regulatory approvals being obtained, there is an emerging and pressing need for industrial translation. Process efficiency, associated cost drivers and regulatory requirements are issues that need to be addressed before industrialisation of cell and gene therapies can be established. Automation has the potential to address these issues and pave the way towards commercialisation and mass production as it has been the case for 'classical' production industries. This review provides an insight into how automation can help address the manufacturing issues arising from the development of large-scale manufacturing processes for modern cell and gene therapy. The existing automated technologies with applicability in cell and gene therapy manufacturing are summarized and evaluated here.

Author Correction: Mapping the world's free-flowing rivers.

An Amendment to this paper has been published and can be accessed via a link at the top of the paper.

Mapping the world's free-flowing rivers.

Free-flowing rivers (FFRs) support diverse, complex and dynamic ecosystems globally, providing important societal and economic services. Infrastructure development threatens the ecosystem processes, biodiversity and services that these rivers support. Here we assess the connectivity status of 12 million kilometres of rivers globally and identify those that remain free-flowing in their entire length. Only 37 per cent of rivers longer than 1,000 kilometres remain free-flowing over their entire length and 23 per cent flow uninterrupted to the ocean. Very long FFRs are largely restricted to remote regions of the Arctic and of the Amazon and Congo basins. In densely populated areas only few very long rivers remain free-flowing, such as the Irrawaddy and Salween. Dams and reservoirs and their up- and downstream propagation of fragmentation and flow regulation are the leading contributors to the loss of river connectivity. By applying a new method to quantify riverine connectivity and map FFRs, we provide a foundation for concerted global and national strategies to maintain or restore them.

Influence of patient-specific anatomy on medical computed tomography and risk evaluation of minimally invasive surgery at the otobasis.

PURPOSE: With the increasing use of new minimally invasive approaches in temporal bone surgery, the need arises for evaluation of the risk of injury to sensitive anatomical structures. The factors that influence the measurement uncertainty (variation in representation of position and shape of anatomical structures) of imaging are of relevance. We investigate the effect of patients' anatomy on the measurement uncertainty of medical CT. METHODS: Six formalin-fixed temporal bones were used, fiducial markers were bone-implanted, and 20 CT scans of each temporal bone were generated. Surgically threatened anatomical structures of importance were defined. Manual segmentation was performed to create 3D surface models, and different Gaussian filters were applied. Analysis points were established along the border of the superior semicircular canal to determine the deviation between the 3D images of the labyrinth. The standard uncertainty was calculated, and one-way analysis of variance was performed (significance level = 5%) to evaluate the effect of certain factors (patient, side, Gaussian filter) on the measurement uncertainty. RESULTS: The influence of patient-specific anatomy on the measurement uncertainty of medical CT (p = 0.049) was demonstrated for the first time. The applied Gaussian filter (p = 0.622) and the patient's side (p = 0.341) showed no significant effect. CONCLUSION: The applied method and the results of the statistical analysis suggest that the patient's individual anatomical conditions affect the measurement uncertainty of medical CT. Thus, the patient's anatomy must be considered as an important influencing factor during risk evaluation concerning minimally invasive and image-guided surgery.

Planning dam portfolios for low sediment trapping shows limits for sustainable hydropower in the Mekong.

The transboundary Mekong Basin has been dubbed the "Battery of Southeast Asia" for its large hydropower potential. Development of hydropower dams in the six riparian countries proceeds without strategic analyses of dam impacts, e.g., reduced sediment delivery to the lower Mekong. This will impact some of the world's largest freshwater fisheries and endangers the resilience of the delta, which supports 17 million livelihoods, against rising sea levels. To highlight alternatives, we contribute an optimization-based framework for strategic sequencing of dam development. We quantify lost opportunities from past development and identify remaining opportunities for better tradeoffs between sediment and hydropower. We find that limited opportunities remain for less impactful hydropower in the lower basin, where most development is currently planned, while better trade-offs could be reached with dams in the upper Mekong in China. Our results offer a strategic vision for hydropower in the Mekong, introduce a globally applicable framework to optimize dam sequences in space and time, and highlight the importance of strategic planning on multiple scales to minimize hydropower impacts on rivers.

[Radiology of the distal radioulnar joint and the ulnocarpal complex]. / Radiologie des distalen Radioulnargelenks und des ulnokarpalen Komplexes.

X-ray images exposed in neutral position and radiocarpally centred are essential in imaging of the distal radioulnar joint (DRUJ). The anatomic orientation of the DRUJ is favourable for acquiring transaxial scans to display its anatomy, subtle derangements, osteoarthritis and intra-articular fractures free from superpositions. The triangular fibrocartilage complex (TFCC) is the most important stabilizer of the DRUJ. Provided that a focused clinical indication is given, high-resolution images are acquired, and an intra-venous or intra-articular contrast-agent is applied, all TFCC structures and destabilizing lesions can be displayed with the use of CT and MRI.

[Distal radius fractures : Update on imaging]. / Distale Radiusfrakturen : Update zur Bildgebung.

Distal radius fractures are associated with high individual and socioeconomic relevance. Optimized radiography and computed tomography (CT) imaging are essential for individualized therapy planning. Plain CT imaging with 3D reconstruction and digital removal of the carpus and ulna is helpful for choosing the surgical approach in the presence of intra-articular radius fractures. If the fracture line leads towards the scapholunate compartment, ligamentous injury requiring treatment can be detected or ruled out before surgery with the help of direct CT arthrography (CTA). Acquisition of imaging data and morphometrical analysis must be standardized and reproducible. In the diagnostics of distal radius fractures it is necessary for radiologists and surgeons to use a unified fracture classification.