Comparison of ultrasonography with computed tomography in the diagnosis of nasal bone fractures.

OBJECTIVES: The aim of this study is to compare ultrasonography with CT in the diagnosis of nasal bone fractures. METHODS: 40 patients (9 female and 31 male) with mid-facial fractures, which were suspected nasal bone fractures, were included. All of the patients had mid-facial CT images. Ultrasonography with a 7.5 MHz transducer (Aloka 3500, Tokyo, Japan) was used to evaluate the nasal bone fractures. All of the sonograms were compared with CT findings for sensitivity, specificity and predictive values. A χ(2) test was applied to the data to assess statistical significance. RESULTS: CT diagnosed nasal bone fractures in 24 of the 40 patients (9 unilateral fractures and 15 bilateral fractures) while ultrasonography diagnosed the fractured bones in 23 patients (9 unilateral fractures and 14 bilateral fractures). Ultrasonography missed one fractured bone in a bilateral fractured case and a unilateral fracture was also missed (two false-negative results). The sensitivity and specificity of ultrasonography in assessing nasal bone fracture in comparison with CT were 94.9% and 100%, respectively. The positive predictive value (PPV) and the negative predictive value (NPV) of ultrasonographic evaluation of the nasal bone fractures were 100% and 95.3%, respectively. The χ(2) test did not show any significant difference between CT and ultrasonography in diagnosis of nasal bone fractures (P = 0.819). CONCLUSION: Ultrasonography can be used as a first line of diagnostic imaging for evaluating nasal bone fractures, especially in children and pregnant women.

Relationship Among Panoramic Radiography Findings, Biochemical Markers of Bone Turnover and Hip BMD in the Diagnosis of Postmenopausal Osteoporosis.

BACKGROUND/OBJECTIVE: Recent investigations have shown that panoramic radiography might be a useful tool in the early diagnosis of osteoporosis. In addition, bone turnover biochemical markers might be valuable in predicting osteoporosis and fracture risks in the elderly, especially in post-menopausal women. The aim of the present study was to evaluate the relationship among the radiomorphometric indices of the mandible, biochemical markers of the bone turnover and hip BMD in a group of post-menopausal women. PATIENTS AND METHODS: Evaluations of mandibular cortical width (MCW), mandibular cortical index (CI), panoramic index (PMI) and alveolar crest resorption ratio (M/M ratio) were carried out on panoramic radiographs of 140 post-menopausal women with an age range of 44-82 years. Hip BMD was measured by DEXA method. BMD values were divided into three groups of normal (T score>-1.0), osteopenic (T score, -2.5 to -1.0) and osteoporotic (T score<-2.5). Serum alkaline phosphatase and 25(OH) D(3) were measured. RESULTS: A decrease in MCW by 1 mm increases the likelihood of osteopenia or osteoporosis up to 40%, having taken into consideration the effect of menopause duration. A 1 mm decrease in MCW increased the likelihood of moderate or severe erosion of the lower cortex of the mandible up to 28% by taking age into consideration. The results did not demonstrate a statistically significant relationship between bone turnover markers and mandibular radiomorphometric indices. CONCLUSION: Panoramic radiography gives sufficient information to make an early diagnosis regarding osteoporosis in post-menopausal women. Panoramic radiographs may be valuable in the prevention of osteoporotic fractures in elderly women.