Efficacy analysis of tomosynthesis in the diagnosis of the femoral head osteochondropathy (Legg-Calvé-Perthes disease)
Background: Despite the fact that the prevalence of the femoral head osteochondropathy is 2.9% of all bone and muscle disorders and 25% of the disorders of the hip joint, this problem demands special attention, while late diagnosis could lead to disability of the patient.Aim: To compare and clarify...
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| Format: | Article |
| Language: | Russian |
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MONIKI
2017-02-01
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| Series: | Alʹmanah Kliničeskoj Mediciny |
| Subjects: | |
| Online Access: | https://www.almclinmed.ru/jour/article/view/470 |
| _version_ | 1818606437676351488 |
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| author | A. Yu. Vasil'ev S. S. Karpov |
| author_facet | A. Yu. Vasil'ev S. S. Karpov |
| author_sort | A. Yu. Vasil'ev |
| collection | DOAJ |
| description | Background: Despite the fact that the prevalence of the femoral head osteochondropathy is 2.9% of all bone and muscle disorders and 25% of the disorders of the hip joint, this problem demands special attention, while late diagnosis could lead to disability of the patient.Aim: To compare and clarify X-ray symptomatology of Legg-Calvé-Perthes disease found by standard digital radiography and by tomosynthesis.Materials and methods: Eighty six patients aged from 5 to 12 years with the femoral head osteochondropathy were allocated into two groups: 43 patients from the group 1 were assessed by standard two-plane digital radiography (frontal and Lauenstein projections), whereas 43 patients from the group 2 were assessed by direct plane tomosynthesis only. The investigations were performed with the X-ray machine FDR AcSelerate 200 (Fujifilm, Japan) with the function of tomosynthesis. Radiographic symptoms of the disease were assessed in the subgroups that were identified depending on the disease stage: 24 patients had stage I, 20 – stage II, 20 – stage III, and 22 – stages IV and V.Results: Standard radiography could not detect any bone abnormalities in any patient with stage I of Legg-Calvé-Perthes disease (n1 = 12, 100%); however, by means of tomosynthesis, all patients from this subgroup (n2 = 12, 100%) had minimally increased density on the affected side. In 9 (75%) patients, tomosynthesis showed cystiform remodeling of trabecular structure in subchondral parts of the femoral head of the affected hip, and in 2 (17%) patients, flattening of the inner epiphysis pole was visualized. At stage II of the disease standard radiography showed femoral head compression with widening of the joint space in 8 (80%) patients, absence of subchondral lucency in 6 (60%), and increased density of the femoral head in 4 (40%). In all these patients (n2 = 10, 100%) tomosynthesis showed signs of intra-articular effusion, in 6 (60%) cases there were areas of osteonecrosis, and in 8 (80%) cases, non-congruent edge of the femoral head and acetabulum. At stage III of the disease, all patients in whom standard radiography was performed (n1 = 10, 100%) had homogeneous blurring of the femoral head with loss of its bony structure, and with the femoral neck shortening in 6 (60%) of them. With the use of tomosynthesis, all these patients (n2 = 10, 100%) displayed synovial effusion, in 9 (90%) of cases, head fragmentation, and 7 (70%) patients had shortening and thickening of the femoral neck. Patients with stages IV and V had similar number of symptoms, excluding lateral subluxation of the femoral head (in 63.6% by standard radiography and in 81.8% by tomosynthesis). Accuracy, sensitivity and specificity of standard radiography were 73.3, 70.3, and 71.2%, whereas those of tomosynthesis 91.8, 92.4, and 93.1%.Conclusion: Tomosynthesis is more accurate, sensitive, and specific and has better positive and negative prognostic values, compared to standard digital radiography. Tomosynthesis can be recommended as a method of choice for diagnosis of the femoral head osteochondropathy. |
| first_indexed | 2024-12-16T14:10:51Z |
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| institution | Directory Open Access Journal |
| issn | 2072-0505 2587-9294 |
| language | Russian |
| last_indexed | 2024-12-16T14:10:51Z |
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| series | Alʹmanah Kliničeskoj Mediciny |
| spelling | doaj.art-945586adb6aa4fc481caa40329bcee4f2022-12-21T22:28:47ZrusMONIKIAlʹmanah Kliničeskoj Mediciny2072-05052587-92942017-02-01451142210.18786/2072-0505-2017-45-1-14-22418Efficacy analysis of tomosynthesis in the diagnosis of the femoral head osteochondropathy (Legg-Calvé-Perthes disease)A. Yu. Vasil'ev0S. S. Karpov1Central Radiology InstituteMoscow State University of Medicine and Dentistry named after A.I. EvdokimovBackground: Despite the fact that the prevalence of the femoral head osteochondropathy is 2.9% of all bone and muscle disorders and 25% of the disorders of the hip joint, this problem demands special attention, while late diagnosis could lead to disability of the patient.Aim: To compare and clarify X-ray symptomatology of Legg-Calvé-Perthes disease found by standard digital radiography and by tomosynthesis.Materials and methods: Eighty six patients aged from 5 to 12 years with the femoral head osteochondropathy were allocated into two groups: 43 patients from the group 1 were assessed by standard two-plane digital radiography (frontal and Lauenstein projections), whereas 43 patients from the group 2 were assessed by direct plane tomosynthesis only. The investigations were performed with the X-ray machine FDR AcSelerate 200 (Fujifilm, Japan) with the function of tomosynthesis. Radiographic symptoms of the disease were assessed in the subgroups that were identified depending on the disease stage: 24 patients had stage I, 20 – stage II, 20 – stage III, and 22 – stages IV and V.Results: Standard radiography could not detect any bone abnormalities in any patient with stage I of Legg-Calvé-Perthes disease (n1 = 12, 100%); however, by means of tomosynthesis, all patients from this subgroup (n2 = 12, 100%) had minimally increased density on the affected side. In 9 (75%) patients, tomosynthesis showed cystiform remodeling of trabecular structure in subchondral parts of the femoral head of the affected hip, and in 2 (17%) patients, flattening of the inner epiphysis pole was visualized. At stage II of the disease standard radiography showed femoral head compression with widening of the joint space in 8 (80%) patients, absence of subchondral lucency in 6 (60%), and increased density of the femoral head in 4 (40%). In all these patients (n2 = 10, 100%) tomosynthesis showed signs of intra-articular effusion, in 6 (60%) cases there were areas of osteonecrosis, and in 8 (80%) cases, non-congruent edge of the femoral head and acetabulum. At stage III of the disease, all patients in whom standard radiography was performed (n1 = 10, 100%) had homogeneous blurring of the femoral head with loss of its bony structure, and with the femoral neck shortening in 6 (60%) of them. With the use of tomosynthesis, all these patients (n2 = 10, 100%) displayed synovial effusion, in 9 (90%) of cases, head fragmentation, and 7 (70%) patients had shortening and thickening of the femoral neck. Patients with stages IV and V had similar number of symptoms, excluding lateral subluxation of the femoral head (in 63.6% by standard radiography and in 81.8% by tomosynthesis). Accuracy, sensitivity and specificity of standard radiography were 73.3, 70.3, and 71.2%, whereas those of tomosynthesis 91.8, 92.4, and 93.1%.Conclusion: Tomosynthesis is more accurate, sensitive, and specific and has better positive and negative prognostic values, compared to standard digital radiography. Tomosynthesis can be recommended as a method of choice for diagnosis of the femoral head osteochondropathy.https://www.almclinmed.ru/jour/article/view/470tomosynthesisradiographychildren and adolescentsosteochondropathylegg-calvé- perthes disease |
| spellingShingle | A. Yu. Vasil'ev S. S. Karpov Efficacy analysis of tomosynthesis in the diagnosis of the femoral head osteochondropathy (Legg-Calvé-Perthes disease) Alʹmanah Kliničeskoj Mediciny tomosynthesis radiography children and adolescents osteochondropathy legg-calvé- perthes disease |
| title | Efficacy analysis of tomosynthesis in the diagnosis of the femoral head osteochondropathy (Legg-Calvé-Perthes disease) |
| title_full | Efficacy analysis of tomosynthesis in the diagnosis of the femoral head osteochondropathy (Legg-Calvé-Perthes disease) |
| title_fullStr | Efficacy analysis of tomosynthesis in the diagnosis of the femoral head osteochondropathy (Legg-Calvé-Perthes disease) |
| title_full_unstemmed | Efficacy analysis of tomosynthesis in the diagnosis of the femoral head osteochondropathy (Legg-Calvé-Perthes disease) |
| title_short | Efficacy analysis of tomosynthesis in the diagnosis of the femoral head osteochondropathy (Legg-Calvé-Perthes disease) |
| title_sort | efficacy analysis of tomosynthesis in the diagnosis of the femoral head osteochondropathy legg calve perthes disease |
| topic | tomosynthesis radiography children and adolescents osteochondropathy legg-calvé- perthes disease |
| url | https://www.almclinmed.ru/jour/article/view/470 |
| work_keys_str_mv | AT ayuvasilev efficacyanalysisoftomosynthesisinthediagnosisofthefemoralheadosteochondropathyleggcalveperthesdisease AT sskarpov efficacyanalysisoftomosynthesisinthediagnosisofthefemoralheadosteochondropathyleggcalveperthesdisease |