A standard canulated screw may not fit up to 1/3 of the patients treated percutaneously for anterior column acetabular fractures-A pilot study.

A proper evaluation of the narrowings and length of the anterior acetabular column would offer better predictability and precision for implant insertion in the case of an acetabular fracture. OBJECTIVE: To determine the diameter and length of the safety corridor of the anterior column of the acetabulum in patients with available pelvic computed tomography (CT), analyze the obtained measurements against those of a standard 6.5-mm implant, and verify possible sex differences regarding these measurements. A secondary aim was to develop a method for measurement of the anterior column of the acetabulum based on CT images. MATERIALS AND METHODS: In 200 CT scans of hemipelvises we measured the diameter of two areas of narrowing and the length of the safety corridor of the anterior column. The images were submitted to multiplanar reformatting adjusted to a plane orthogonal to the bone corridor, drawn at the level of the superior pubic ramus. RESULTS: Measurement #1 had a mean value of 8.12 (2.27) mm in the overall sample and median values of 9.03 (7.76-10.48) mm in men and 6.77 (5.44-7.19) mm in women. Measurement #2 had a mean value of 7.29 (2.19) mm and median values of 8.23 (7.18-9.82) mm in men and 5.9 (4.65-7.19) mm in women. Measurement #3 had a mean value of 109.53 (13.66) mm in the overall sample and median values of 117.17 (112.9-122.9) mm in men and 100.91 (90.95-111.17) mm in women (p<0.001 all three measurements). Measurement #1 was smaller than 6.5 mm in 22.5% of the patients (of whom 90% were women). Measurement #2 was smaller than 6.5 mm in 35% of the patients (of whom 80% were women). CONCLUSIONS: This study proposed an anatomic evaluation of the anterior column of the acetabulum using conventional CT images The areas of narrowing in the anterior column had an average of 8.12 mm at the level of the pubic tubercle and 7.29 mm at the level of the acetabular fossa. The mean length of the safety corridor was 109.53 mm. In 35% of the cases, a 6.5 mm percutaneous screw would have violated the cortical bone of the safety corridor.

Pertinencia de la gammagrafia de tiroides en un servicio de medicina nuclear de referencia del oriente colombiano / Relevância da cintilografia da tireoide em um centro de referência de medicina nuclear no leste colombiano / Pertinence of Thyroid Scan in a Nuclear Medicine Department in Eastern Colombia

Introducciَn: La gammagrafia de tiroides es un examen frecuentemente empleado en el estudio de la enfermedad tiroidea. Se recomienda su realizaciَn en el paciente con tirotoxicosis, nَdulo tiroideo con citologيa indeterminada y en la bْsqueda de tiroides ectَpica. Objetivo: Determinar la pertinencia de la solicitud de la gammagrafia tiroidea en un servicio de medicina nuclear de referencia del oriente colombiano. Metodologia: Estudio observacional, corte transversal retrospectivo tipo descriptivo. Se evaluaron las gammagrafias de tiroides realizadas en la unidad de medicina nuclear de la clيnica Carlos Ardila Lulle durante 3 meses consecutivos que en la hoja de solicitud incluyeran todas las variables de interés. Se registrَ la indicaciَn del estudio, formaciَn académica del médico que solicitaba el examen, sexo del paciente, presencia concomitante de TSH con su valor respectivo y el consumo de levotiroxina previo al examen. Adicionalmente se registrَ el resultado gammagrلfico. Resultados: 277 gammagrafيas fueron analizadas, 244 (88%) eran mujeres. EL 67% no estaban correctamente indicadas y de estas el 32% de los pacientes estaban recibiendo suplencia hormonal, la cual fue suspendida 25 dيas antes de la realizaciَn del examen. Los médicos generales y médicos especialistas no endocrinَlogos tienen la probabilidad de 9.08 veces y 9.37 veces respectivamente de no indicar adecuadamente la gammagrafيa tiroidea respecto a los médicos endocrinَlogos. Conclusiones: Dos de cada 3 gammagrafيas tiroideas que se realizaron en un servicio de medicina nuclear de referencia del oriente colombiano no estلn adecuadamente indicadas, teniendo esto un impacto en la salud pْblica.

Introduction: Thyroid scan is a test frequently used in the study of thyroid diseases. It is recommended to perform it in patients presenting thyrotoxicosis, thyroid nodules with indeterminate cytology and when diagnosing ectopic thyroid. Our objective was to determine the pertinence of ordering thyroid scan in a nuclear medicine department in eastern Colombia. Methodology: Observational, retrospective, and cross-sectional descriptive study. Thyroid scans including relevant variables performed in the nuclear medicine department at Carlos Ardila Lulle hospital were evaluated during 3 consecutive months. The indication of the study, academic background of physician requesting the test, patient’s gender, concomitant presence of TSH with its respective value, and intake of Levothyroxine before test. Test results were also taken into account. Results: Out of the 277 performed scans, 244 (88%) were women. 67% of them were not correctly indicated, and 32% of these patients were taking hormonal supplements, which was suspended 25 days before performing the test. General practitioners and consultants without specialization in endocrinology have a 9.08 and 9.37 probability respectively, of not indicating correctly the thyroid scan compared to endocrinologists. Conclusions: Two out of 3 thyroid scans performed in a nuclear medicine department in Eastern Colombia are not correctly indicated, producing a big impact in public health.(au)

Introduçمo: A cintilografia da tireَide é um teste muito usado no estudo de doenças da glândula tireَide. O monitoramento é recomendado em doentes com tireotoxicose, nَdulos de tireَide com citologia indeterminada e suspeita de tireَide ectَpica. Objetivo: Nosso objetivo foi determinar a pertinência do pedido de cintilografia da tireَide em um centro de referência de medicina nuclear no leste da Colômbia. Metodologia: Estudo de observaçمo, com corte transversal retrospectivo e descritivo. As cintilografias realizadas na unidade de medicina nuclear da clيnica Carlos Ardila Lulle foram avaliados por 3 meses consecutivos, incluindo no formulلrio todas as variلveis de interesse. Registrou-se a indicaçمo do estudo, a formaçمo acadêmica do médico que pediu o exame, o sexo do paciente, a presença concomitante de TSH com seu respectivo valor e o uso de levotiroxina antes de fazer o teste. Além disso foi registrado o resultado da cintilografia. Resultados: 277 cintilografias foram analisadas, 244 (88%) eram de mulheres. 67% nمo foram devidamente identificados e, destes, 32% dos pacientes estavam recebendo substituiçمo hormonal, que foi suspensa 25 dias antes do exame. Os clيnicos gerais e os especialistas nمo endocrinologistas têm a probabilidade de 9,08 vezes e 9,37 vezes, respectivamente, de nمo indicar corretamente o exame da tireَide, em relaçمo aos médicos endocrinologistas. Conclusُes: Dois de cada três exames de tireَide que sمo feitos num centro de referência de medicina nuclear no leste colombiano nمo estمo corretamente solicitados, o que gera grande impacto na saْde pْblica.