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Sønderby AH, Thomsen H, Skals RG, Storm S, Leutscher PDC, Simony A. Thoracic spine X-ray examination of patients with back pain using different breathing technique and exposure times - A diagnostic study. Radiography (Lond) 2024; 30:582-588. [PMID: 38310658 DOI: 10.1016/j.radi.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/04/2024] [Accepted: 01/14/2024] [Indexed: 02/06/2024]
Abstract
INTRODUCTION The breathing and suspended inspiration techniques are often used interchangeably for spine X-ray examinations. However, these techniques are not always adequately supported by clinical evidence. This study aimed to determine the two techniques' diagnostic value and adverse image outcomes. METHODS A total of 400 participants were examined on a Siemens Ysio Max system and randomized into four examination groups: suspended inspiration or breathing techniques with exposure times of 1, 2, and 3.2 s, respectively. Two consultant radiologists conducted the evaluation of the X-ray images. If disagreement was present, the radiologists collaboratively reviewed the X-ray images until a consensus was reached. RESULTS The final 394 study population comprised 275 women and 119 men with a mean age of 64 years (range:18-96 years). The proportions of visually sharp reproduction of the endplates and trabecular structures did not differ significantly with regards to differences in exposure times between groups. The breathing technique groups had significantly higher proportions of blurring and motion artifacts (p < 0.001). However, adverse image outcomes (motions artifacts) were significantly lower in the 1-s exposure group. CONCLUSIONS The suspended inspiration and breathing techniques performed equally well regarding visually sharp reproduction. However, the suspended inspiration technique was superior to the breathing technique. regarding adverse image outcomes, although the latter could be improved by using a shorter exposure time. IMPLICATIONS FOR PRACTICE The suspended inspiration and breathing technique appeared to perform at equal diagnostic levels. The suspended inspiration technique should be preferred due to its reduced risk of adverse image outcomes. However, the risk could also be reduced using a short exposure time with the breathing technique.
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Affiliation(s)
- A H Sønderby
- Department of X-ray Physics North Denmark, Aalborg University Hospital, Merkurvej 13, 9700 Brønderslev, Denmark.
| | - H Thomsen
- Department of Radiology, North Denmark Regional Hospital, Barfredsvej 83, 9900 Frederikshavn, Denmark.
| | - R G Skals
- Unit of Clinical Biostatistics, Sdr. Skovvej 15, 9000 Aalborg, Denmark.
| | - S Storm
- Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, 9100 Aalborg, Denmark.
| | - P D C Leutscher
- Centre for Clinical Research North Denmark Regional Hospital & Department of Clinical Medicine, Aalborg University Hospital, Bispensgade 37, 9800 Hjørrring, Denmark.
| | - A Simony
- Department of Orthopedic Surgery, The Region of Southern Denmark University Hospital, Sygehusvej 24, 6000 Kolding, Denmark.
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Shafiei M, Chalian M, Luna R, Ahlawat S, Fayad LM. Imaging in Musculoskeletal Oncology. Radiol Clin North Am 2022; 60:657-668. [DOI: 10.1016/j.rcl.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ho CS, Chen YP, Fan TY, Kuo CF, Yen TY, Liu YC, Pei YC. Application of deep learning neural network in predicting bone mineral density from plain X-ray radiography. Arch Osteoporos 2021; 16:153. [PMID: 34626252 DOI: 10.1007/s11657-021-00985-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 08/02/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED DeepDXA is a deep learning model designed to infer bone mineral density data from plain pelvis X-ray, and it can achieve good predicted value for clinical use. PURPOSE Osteoporosis is defined as a systemic disease of the bone characterized by a decrease in bone strength and deterioration of bone structure at the microscopic level, leading to bone fragility and increased risk of fracture. Bone mineral density (BMD) is the preferred method for the diagnosis of osteoporosis, and dual-energy x-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis. Conventional radiography is more suited for the screening of osteoporosis rather than diagnosis, and osteoporosis can be detected on radiographs by experienced physicians only. This study explored the possibility of predicting BMD relative to DXA using patient radiographs. METHODS A deep learning algorithm of convolutional neural network (CNN) was used for the purpose. The method includes image segmentation, CNN learning, and a convolution-based regression model (DeepDXA) that links the isolated images of the femur bone to predict BMD value. Data were obtained in a single medical center from 2006 to 2018, with a total amount of 3472 pairs of pelvis X-ray and DXA examination within 1 year. RESULTS The proposed workflow successfully predicted BMD values of the femur bone with the correlation coefficient (R) of 0.85 (P < 0.001) and the accuracy of 0.88 for prediction osteoporosis, a finding that could be reliably ready for further clinical use. CONCLUSION When suspicious osteoporosis is seen on plain films using the deep learning method we developed, further referral to DXA for the definite diagnosis of osteoporosis is indicated.
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Affiliation(s)
- Chan-Shien Ho
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan
| | - Yueh-Peng Chen
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan.
- Department of Industrial Design, College of Management, Chang Gung University, Taoyuan, Taiwan.
| | - Tzuo-Yau Fan
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan
| | - Chang-Fu Kuo
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Tzu-Yun Yen
- School of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan
- Department of Education, Chang Gung Memorial Hospital at Linkou, No.5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan
| | - Yuan-Chang Liu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan
- College of Medicine, Institute for Radiologic Research, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan
| | - Yu-Cheng Pei
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan.
- School of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan.
- Center of Vascularized Tissue Allograft, Gung Memorial Hospital at Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan.
- Healthy Aging Research Center, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan.
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Schwarze M, Schiltenwolf M. Osteoporosis in the Context of Medial Expert Evidence. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2019; 158:517-523. [PMID: 31634955 DOI: 10.1055/a-0969-8743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Due to its high prevalence und sometimes serious medical consequences, osteoporosis is of highest socio-economic importance. Medical experts are confronted with it in a wide variety of fields of law. In order to be able to correctly classify the disease in the respective legal framework, current knowledge about it is required. Important classifications as well as scientifically determined findings on fractures and fracture healing are in the foreground. This knowledge can be used to answer questions concerning prevention, reduced earning capacity, incapacity for work, context assessments or restrictions according to the social compensation law or the severely disabled law.
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Affiliation(s)
- Martin Schwarze
- Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinikum Heidelberg
| | - Marcus Schiltenwolf
- Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinikum Heidelberg
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Clinical and genetic characterisation of dystrophin-deficient muscular dystrophy in a family of Miniature Poodle dogs. PLoS One 2018; 13:e0193372. [PMID: 29474464 PMCID: PMC5825102 DOI: 10.1371/journal.pone.0193372] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/08/2018] [Indexed: 11/19/2022] Open
Abstract
Four full-sibling intact male Miniature Poodles were evaluated at 4–19 months of age. One was clinically normal and three were affected. All affected dogs were reluctant to exercise and had generalised muscle atrophy, a stiff gait and a markedly elevated serum creatine kinase activity. Two affected dogs also showed poor development, learning difficulties and episodes of abnormal behaviour. In these two dogs, investigations into forebrain structural and metabolic diseases were unremarkable; electromyography demonstrated fibrillation potentials and complex repetitive discharges in the infraspinatus, supraspinatus and epaxial muscles. Histopathological, immunohistochemical and immunoblotting analyses of muscle biopsies were consistent with dystrophin-deficient muscular dystrophy. DNA samples were obtained from all four full-sibling male Poodles, a healthy female littermate and the dam, which was clinically normal. Whole genome sequencing of one affected dog revealed a >5 Mb deletion on the X chromosome, encompassing the entire DMD gene. The exact deletion breakpoints could not be experimentally ascertained, but we confirmed that this region was deleted in all affected males, but not in the unaffected dogs. Quantitative polymerase chain reaction confirmed all three affected males were hemizygous for the mutant X chromosome, while the wildtype chromosome was observed in the unaffected male littermate. The female littermate and the dam were both heterozygous for the mutant chromosome. Forty-four Miniature Poodles from the general population were screened for the mutation and were homozygous for the wildtype chromosome. The finding represents a naturally-occurring mutation causing dystrophin-deficient muscular dystrophy in the dog.
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Guerri S, Mercatelli D, Aparisi Gómez MP, Napoli A, Battista G, Guglielmi G, Bazzocchi A. Quantitative imaging techniques for the assessment of osteoporosis and sarcopenia. Quant Imaging Med Surg 2018. [PMID: 29541624 DOI: 10.21037/qims.2018.01.05] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bone and muscle are two deeply interconnected organs and a strong relationship between them exists in their development and maintenance. The peak of both bone and muscle mass is achieved in early adulthood, followed by a progressive decline after the age of 40. The increase in life expectancy in developed countries resulted in an increase of degenerative diseases affecting the musculoskeletal system. Osteoporosis and sarcopenia represent a major cause of morbidity and mortality in the elderly population and are associated with a significant increase in healthcare costs. Several imaging techniques are currently available for the non-invasive investigation of bone and muscle mass and quality. Conventional radiology, dual energy X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound often play a complementary role in the study of osteoporosis and sarcopenia, depicting different aspects of the same pathology. This paper presents the different imaging modalities currently used for the investigation of bone and muscle mass and quality in osteoporosis and sarcopenia with special emphasis on the clinical applications and limitations of each technique and with the intent to provide interesting insights into recent advances in the field of conventional imaging, novel high-resolution techniques and fracture risk.
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Affiliation(s)
- Sara Guerri
- The Unit of Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine, Division of Radiology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Daniele Mercatelli
- The Unit of Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Grafton, Auckland, New Zealand.,Department of Radiology, Hospital Nueve de Octubre, Valencia, Spain
| | - Alessandro Napoli
- Radiology Section, Department of Radiological, Oncological and Anatomopathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Giuseppe Battista
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Radiology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy.,Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Alberto Bazzocchi
- The Unit of Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
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Mattera M, Reginelli A, Bartollino S, Russo C, Barile A, Albano D, Mauri G, Messina C, Cappabianca S, Guglielmi G. Imaging of metabolic bone disease. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:197-207. [PMID: 29350648 PMCID: PMC6179066 DOI: 10.23750/abm.v89i1-s.7023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 01/12/2018] [Indexed: 12/25/2022]
Abstract
Osteoporosis is the most important metabolic bone disease, with a wide distribution among the elderly. It is characterized by low bone mass and micro architectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. Identify bone weakening with an appropriate and accurate use of diagnostic imaging is of critical importance in the diagnosis and follow-up of osteoporotic patients. The aim of this review is to evaluate the detection rates of the different imaging modalities in the evaluation of bone strength, in the assessment of fracture risk and in the management of fragility fractures. (www.actabiomedica.it)
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Esmaeli F, Payahoo S, Mobasseri M, Johari M, Yazdani J. Efficacy of radiographic density values of the first and second cervical vertebrae recorded by CBCT technique to identify patients with osteoporosis and osteopenia. J Dent Res Dent Clin Dent Prospects 2017; 11:189-194. [PMID: 29184636 PMCID: PMC5666220 DOI: 10.15171/joddd.2017.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/02/2017] [Indexed: 11/09/2022] Open
Abstract
Background. Osteoporosis is a systemic skeletal disease characterized by a decrease in bone strength with an increase in the risk of fractures. This study aimed at evaluating the ability to predict osteoporosis and osteopenia based on radiographic density values obtained from CBCT imaging technique. Methods. CBCT images of 108 patients were prepared by using NewTom VGI (QR, Verona, Italy). Then the patients were assigned to osteoporosis, osteopenia and healthy group, using the T-score derived from the DEXA technique. Finally, RD of the lateral mass of C1 on the left and right sides and body and dens of the C2 were measured. RD values were compared between the three groups by one-way ANOVA, followed by an appropriate post hoc test. Results. The results of the comparisons of RD values at the first and second cervical vertebrae in the three groups showed that all the values had statistically significant differences (P<0.05). The most precise diagnosis of osteoporosis was related to the RD values of the body of C2 and left lateral mass of C1 that was equal to 99% and their cut-off points were 375 and 386, respectively. Conclusion. Based on the findings of this study, it is possible to predict the osteoporosis status of the patient through the RD related to the body of C2 and the left lateral mass of C1 more accurately than the other areas.
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Affiliation(s)
- Farzad Esmaeli
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Salar Payahoo
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Majid Mobasseri
- Endocrinology and Metabolism Section, Department of Medicine, Imam Reza Hospital, Tabriz, Iran
| | - Masoome Johari
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Yazdani
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Pisani P, Renna MD, Conversano F, Casciaro E, Di Paola M, Quarta E, Muratore M, Casciaro S. Major osteoporotic fragility fractures: Risk factor updates and societal impact. World J Orthop 2016; 7:171-81. [PMID: 27004165 PMCID: PMC4794536 DOI: 10.5312/wjo.v7.i3.171] [Citation(s) in RCA: 276] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/14/2015] [Accepted: 12/07/2015] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis is a silent disease without any evidence of disease until a fracture occurs. Approximately 200 million people in the world are affected by osteoporosis and 8.9 million fractures occur each year worldwide. Fractures of the hip are a major public health burden, by means of both social cost and health condition of the elderly because these fractures are one of the main causes of morbidity, impairment, decreased quality of life and mortality in women and men. The aim of this review is to analyze the most important factors related to the enormous impact of osteoporotic fractures on population. Among the most common risk factors, low body mass index; history of fragility fracture, environmental risk, early menopause, smoking, lack of vitamin D, endocrine disorders (for example insulin-dependent diabetes mellitus), use of glucocorticoids, excessive alcohol intake, immobility and others represented the main clinical risk factors associated with augmented risk of fragility fracture. The increasing trend of osteoporosis is accompanied by an underutilization of the available preventive strategies and only a small number of patients at high fracture risk are recognized and successively referred for therapy. This report provides analytic evidences to assess the best practices in osteoporosis management and indications for the adoption of a correct healthcare strategy to significantly reduce the osteoporosis burden. Early diagnosis is the key to resize the impact of osteoporosis on healthcare system. In this context, attention must be focused on the identification of high fracture risk among osteoporotic patients. It is necessary to increase national awareness campaigns across countries in order to reduce the osteoporotic fractures incidence.
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Amador Gil A, Rico Gala S. Radiología de las fracturas: algo más que un trazo. RADIOLOGIA 2013; 55:215-24. [DOI: 10.1016/j.rx.2012.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 09/07/2012] [Accepted: 10/29/2012] [Indexed: 11/30/2022]
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Abstract
The diagnosis and management of osteoporosis have been improved by the development of new quantitative methods of skeletal assessment and by the availability of an increasing number of therapeutic options, respectively. A number of imaging methods exist and all have advantages and disadvantages. Dual-energy X-ray absorptiometry (DXA) is the most widely available and commonly utilized method for clinical diagnosis of osteoporosis and will remain so for the foreseeable future. The WHO 10-year fracture risk assessment tool (FRAX(®)) will improve clinical use of DXA and the cost-effectiveness of therapeutic intervention. Improved reporting of radiographic features that suggest osteoporosis and the presence of vertebral fracture, which are powerful predictors of future fractures, could increase the frequency of appropriate DXA referrals. Quantitative CT remains predominantly a research tool, but has advantages over DXA--allowing measurement of volumetric density, separate measures of cortical and trabecular bone density, and evaluation of bone shape and size. High resolution imaging, using both CT and MRI, has been introduced to measure trabecular and cortical bone microstructure. Although these methods provide detailed insights into the effects of disease and therapies on bone, they are technically challenging and not widely available, so they are unlikely to be used in clinical practice.
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Affiliation(s)
- Judith E Adams
- Manchester Academic Health Science Centre, The Royal Infirmary and University of Manchester, Department of Radiology, The Royal Infirmary, Manchester M13 9WL, UK.
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Fritz J, Fishman EK, Carrino JA, Horger MS. Advanced imaging of skeletal manifestations of systemic mastocytosis. Skeletal Radiol 2012; 41:887-97. [PMID: 22366736 DOI: 10.1007/s00256-012-1374-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 01/26/2012] [Accepted: 01/27/2012] [Indexed: 02/02/2023]
Abstract
Systemic mastocytosis comprises a group of clonal disorders of the mast cell that most commonly involves the skeletal system. Imaging can be helpful in the detection and characterization of the osseous manifestations of this disease. While radiography and bone scans are frequently used for this assessment, low-dose multidetector computed tomography and magnetic resonance imaging can be more sensitive for the detection of marrow involvement and for the demonstration of the various disease patterns. In this article, we review the pathophysiological and clinical features of systemic mastocytosis, discuss the role of imaging for staging and management, and illustrate the various cross-sectional imaging appearances. Awareness and knowledge of the imaging features of this disorder will increase the accuracy of image interpretation and can contribute important information for management decisions.
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Affiliation(s)
- J Fritz
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD 21287, USA.
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Guglielmi G, Muscarella S, Bazzocchi A. Integrated imaging approach to osteoporosis: state-of-the-art review and update. Radiographics 2012; 31:1343-64. [PMID: 21918048 DOI: 10.1148/rg.315105712] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Osteoporosis is the most common of all metabolic bone disorders. It is characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fractures. Because of the increasing aging of the world population, the number of persons affected by osteoporosis is also increasing. Complications related to osteoporosis can create social and economic burdens. For these reasons, the early diagnosis of osteoporosis is crucial. Conventional radiography allows qualitative and semiquantitative evaluation of osteoporosis, whereas other imaging techniques allow quantification of bone loss (eg, dual-energy x-ray absorptiometry and quantitative computed tomography [CT]), assessment for the presence of fractures (morphometry), and the study of bone properties (ultrasonography). In recent years, new imaging modalities such as micro-CT and high-resolution magnetic resonance imaging have been developed in an attempt to help diagnose osteoporosis in its early stages, thereby reducing social and economic costs and preventing patient suffering. The correct diagnosis of osteoporosis results in better management in terms of prevention and adequate pharmacologic or surgical treatment.
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