Diagnostic Reliability of Plain Radiography in Osteonecrosis of the Femoral Head: General Radiological Features Revised

BACKGROUND AND OBJECTIVES

Osteonecrosis of the femoral head (ONFH) is an incapacitating disease that frequently results in the collapse of the femoral head and secondary osteoarthritis. The diagnosis and staging of this pathology, which usually rely on imaging studies, are challenging. Currently, conventional radiography is the basis of the initial diagnostic assessment. In recent decades, however, radiographs have been considered insensitive to early changes in ONFH and thus, a suboptimal diagnostic tool. Paradoxically, the imaging features of radiographs are often profuse, substantial, and characteristic. This study aimed to elucidate the real limitations of this radiologic tool by assessing the diagnostic reliability of the key radiologic features and staging.

METHODS

This was a retrospective study in which radiographs from 28 idiopathic ONFH confirmed cases who underwent hip arthroplasty were analyzed by eight observers who were asked to identify the presence or absence of ONFH universally reported imaging features in AP hip radiographs.

RESULTS

Concordance analysis revealed a poor agreement between observers for most of the assessed imaging features. Only the identification of femoral head flattening and osteoarthritis signs exhibited moderate agreement with statistical significance. In contrast, the detection of radiological osteoporosis and the loss of trabeculation showed the lowest reliability, with negative kappa coefficients.

CONCLUSION

There is a lack of agreement between qualified observers, even for the identification of the most characteristic ONFH radiographic feature. The reliability of plain radiography for the detection of basic radiological elements is even weaker in the early stages of the disease.

Instagram's Influence on Radiology Today: Reviewing the Evolving Educational Journey from a Hospital to National Societies

We define social media as an interactive online platform that allows users to communicate and exchange knowledge. Educational and medical profiles have slowly emerged on different social media platforms, helping to teach about and publicize diverse aspects of medicine. Radiology is one of the specialties that could potentially benefit the most from social media, as the radiologist tends to have little outside-the-hospital representation. Progressively, audiovisual content has been gaining ground on social networks: Facebook, Twitter, Instagram, Youtube, TikTok, etc. Instagram appears to be ideally suited for radiology given its image-based nature. In addition, Instagram can also be used as a tool to help radiologists share and discuss radiological images, improve communication with clinicians and patients, advertise themselves and their specialty, and humanize their profession. Nevertheless, legal matters and privacy issues should always be taken into account when using these tools. In this overview, we describe the development of social networks and communication tools in our own radiology department, focusing especially on our Instagram account, as it has had a wide impact on our hospital and radiology residents around the country. We will also provide a summary of the various social media platforms used for radiology education along with their pros and cons, including useful tips for safe and efficient use.