Oesophageal dilatation on high-resolution computed tomography scan of the lungs as a sign of scleroderma.

BACKGROUND: Systemic sclerosis (SSc) is a generalised autoimmune disease that causes morbidity and reduced life expectancy. Recently, evidence has been accumulating that immunosuppressive treatment in an early stage of the disease could improve survival, enhancing the need for early diagnosis and regular evaluation of organ involvement. Among others, a high-resolution computer tomography (HRCT) scan of the chest is performed for the assessment of pulmonary involvement in SSc. The objective of this study is to evaluate the predictive value of oesophageal dilatation on the HRCT scan for the diagnosis of SSc. METHODS: In total, 105 consecutive patients with scleroderma and 107 consecutive controls were included in this study. The first available scan for each patient and control was evaluated in random order and blinded for the diagnosis, by two independent radiologists, for oesophageal dilatation and interstitial lung disease. RESULTS: The positive predictive value of oesophageal dilatation for the diagnosis of SSc was 83%. No significant correlation of oesophageal dilatation and interstitial lung disease was found in the patients with scleroderma or controls. CONCLUSION: Oesophageal dilatation as visible on an HRCT scan of the chest may alert doctors to look for other signs or symptoms of SSc in these patients, enabling early diagnosis and specific treatment.

Safety of computer-assisted surgery for cannulated hip screws.

Computer-assisted orthopaedic surgery has developed considerably during the past few years. Several manufacturers produce hardware and software for use in trauma surgery. Validation of these systems before clinical application is mandatory to be sure they work accurately and safely. The accuracy of surgical performance is highly correlated with the cut-out percentages of hip screws. In a standardized operative setting, three cannulated hip screws were inserted in each of 20 sawbones. The screws were positioned either by fluoroscopic navigation technique or by conventional operative technique depending on randomization. Our primary aim was to assess whether computer-navigated screw fixation is equally safe compared with conventional screw fixation using fluoroscopy. To determine safety, we investigated number of drilling attempts, screw position, and radiation time. Secondary to these safety parameters, we also compared the operating time between the two procedures to assess the efficiency of computer navigation. Statistical analysis showed no differences regarding accuracy of screw position. Computer-assisted surgery resulted in fewer drilling attempts and less radiation time, with a similar operation time. We believe the currently used navigation system is safe and accurate.