Usefulness of Bone SPECT/CT for Predicting Avascular Necrosis of the Femoral Head in Children with Slipped Capital Femoral Epiphysis or Femoral Neck Fracture

Objective@#This study aimed to investigate the usefulness of bone single-positron emission tomography/computed tomography (SPECT/CT) of the hip in predicting the later occurrence of avascular necrosis (AVN) after slipped capital femoral epiphysis (SCFE) or femoral neck fracture in pediatric patients. The quantitative parameters of SPECT/CT useful in predicting AVN were identified. @*Materials and Methods@#Twenty-one (male:female, 10:11) consecutive patients aged 1 year after the surgery. The SPECT/CT parameters were compared between patients who developed AVN and those who did not. The accuracy of SPECT/CT parameters for predicting AVN was assessed. @*Results@#Six patients developed AVN. There was a significant difference in the ratio of the mean SUV among patients who developed AVN (mean ± SD, 0.8 ± 0.3) and those who did not (1.1 ± 0.2, p = 0.018). However, there were no significant differences in the ratios of the maximum and minimum SUV between the groups (all p = 0.205). For the maximum, mean, and minimum SUVs, no significant differences were observed between the groups (p = 0.519, 0.733, and 0.470, respectively). The cutoff mean SUV ratio of 0.87 yielded a 66.7% sensitivity and 93.2% specificity for predicting AVN. @*Conclusion@#Quantitative bone SPECT/CT is useful for evaluating femoral head viability in pediatric patients with SCFE or femoral neck fractures. Clinicians should consider the high possibility of later AVN development in patients with a decreased mean SUV ratio.

National Trends in Pediatric CT Scans in South Korea: A Nationwide Cohort Study

Purpose@#This study evaluated the rates and annual trends of pediatric CT scans in South Korea using a nationwide population-based database. @*Materials and Methods@#Data regarding pediatric CT scan usage between 2012 and 2017 were retrieved from the health insurance review and assessment service. Data on the age, sex, diagnosis, and the anatomical area of involved patients were also extracted. @*Results@#A total of 576376 CT examinations were performed among 58527528 children aged below 18 years (9.8 scans/1000 children), and the number of CT examinations per 1000 children was noted to have increased by 23.2% from 9.0 in 2012 to 11.0 in 2017. Specifically, the number of CT examinations increased by 32.9% for the 6–12 years of age group (7.4/1000 to 9.8/1000) and by 34.0% for the 13–18 years of age group (11.4/1000 to 15.3/1000). Moreover, majority of the CT scans were limited to the head (39.1%), followed by the extremities (32.5%) and the abdomen (13.7%). Notably, the number of extremity CT scans increased by 83.6% (2.3/1000 to 4.2/1000), and its proportion as compared to other scans increased from 25.3% to 37.7%. @*Conclusion@#CT scans in the pediatric population increased continuously from 2012 to 2017 at an annual rate of 4.4%. Therefore, physicians should balance the benefits of CT with its potential harms from associated radiation exposure in pediatric patients.

Prevalence of Gait Features in Healthy Adolescents and Adults / 대한법의학회지

Forensic gait analysis is the identification of individuals by their gait style and walking characteristics. This study aimed to examine the prevalence of gait patterns in healthy adolescents and adults. Five hundred healthy participants (mean age, 36.9 years) were enrolled and divided into four age groups: 13-20, 21-35, 36-50, and ≥51 years. The gait of the participants was recorded in a gait analysis laboratory. Five specialists experienced in gait analysis selected several gait features. The prevalence of out-toe, in-toe, planovalgus, and turtleneck was 25.0%, 1.6%, 6.8%, and 4.2%, respectively. The prevalence of genu varum (10.4%) was higher than that of genu valgum (5.6%). Genu valgum and hindfoot valgus were more common in younger than in older subjects (P=0.018 and P=0.029, respectively). Genu varum was more prevalent in older subjects (P<0.001). The prevalence of out-toe was higher in males (P<0.001), whereas the in-toe and genu valgum were more common in females than in males (P=0.027 and P=0.038, respectively). We have documented the prevalence of several gait features in healthy adolescents and adults. These gait features can be used to enhance evidentiary competence in forensic gait analysis and thereby help improve the arrest rate of offenders.