ABSTRACT
AIM: To determine a valid and reliable neck-shaft angle (NSA) measurement method while rotating the pelvises in increments of 5° in order to simulate patient malpositioning. MATERIALS AND METHODS: CT images of 17 patients were used to produce digitally reconstructed radiographs in frontal and lateral views and three-dimensional (3D)-reconstructions of the femurs, considered to be the reference standard. Malpositioning was simulated by axially rotating the frontal radiographs from 0° to 20°. Three operators measured in two-dimensions the NSA using four different methods, three times each, at each axial rotation (AR) position. Method 1 (femoral neck axis drawn by joining the centre of the femoral head (CFH) to the median of the femoral neck base; femoral diaphysis axis drawn by joining the median of two lines passing through the medial and lateral edges of the femoral axis below the lesser trochanter) and method 2 (femoral axis taken as the median of a triangle passing through base of femoral neck and medial and lateral head-neck junction; femoral diaphysis as previous) were described for the first time; method 3 was based on a previous study; method 4 was a free-hand technique. Reliability, validity, and global uncertainty were assessed. RESULTS: Method 1 showed the best reliability and validity. The global uncertainty also showed minimal values for method 1, ranging from 7.4° to 14.3° across AR positions. CONCLUSION: Method 1, based on locating the CFH, was the most reliable and valid method and should be considered as a standardised two-dimensional NSA measurement method for clinical application.
Subject(s)
Femur Neck/diagnostic imaging , Femur/diagnostic imaging , Adult , Aged , Aged, 80 and over , Diaphyses/diagnostic imaging , Female , Femur Head/diagnostic imaging , Humans , Imaging, Three-Dimensional/methods , Male , Middle Aged , Patient Positioning , Reference Standards , Reproducibility of Results , Tomography, X-Ray Computed/methods , Young AdultABSTRACT
Congenital segmental dilatation (CSD) is a rare pathology of unknown etiology, usually with early-onset presentation in the neonatal age. We present a case of CSD of the jejunum of a 9-year-old boy with severe malnutrition. Its clinical, radiological and histological features are similar to those described in the literature but the remarkable aspect of this case lies in its late presentation.
