CT scans were shown to be better at detecting fractures over plain radiographs, according to a recent study by the American Orthopedic Foot and Ankle Society (AOFAS). The study set out to determine the effects of computed tomography (CT) on both the detection of fractures as well as its effects in changing a surgeon’s overall operative plan.
Ankle fractures rank among the most common of injuries, with 150 out of 100,000 people experiencing a fracture every year. Of those injuries, up to half of them involve the posterior malleolus, a bone near the lower back of the tibia. Due to its position as well as its tendency to break irregularly, fractures in the posterior malleolus are particularly difficult for orthopedists to diagnose. The AOFAS study noted that multiple past studies show that plain radiographs are unreliable for determining and diagnosing fractures. It remains imperative to have powerful imaging like CT in order to determine with complete confidence the presence ankle fractures of this kind as well as others.
The AOFAS study’s methods focused on finding patients with record of ankle fractures treated both operatively and nonoperatively. Patients were drawn entirely from the registry of the study’s home institution. Using this pool of more than three thousand patients, the study surveyed three orthopedic surgeons, asking them to determine if the radiograph of the fracture presented was complex or simple. Then, based on these scans, they asked these surgeons for their operative plan moving forward. In the study’s second part, the same surgeons were presented with a randomized set of CT scans from the same patients, and they were asked the same set of questions. Those in charge of the study then compared changes in operative approach, operative indications, and positioning after the CT scan was reviewed.
The results showed that complex fractures were less likely to be identified using a radiograph as compared to a CT scan. The writers of the study made suggestions based on these results to use CT scans more regularly in the diagnosis of ankle fractures. These results and this conclusion are consistent with prior studies, which generally agree that CT scans are more accurate, and are therefore more useful for orthopedic surgeons.
When it comes to complex fractures and fractures in the problematic posterior malleolus, this study affirms that CT scans are more reliable for developing operative plans. If the annual occurrence of ankle fractures continues to be so common, it’s important for orthopedic surgeons to take note of these results and adapt their methods.
To learn more about CT scanners that are ideal for orthopedic clients, click here.
CurveBeam recently had the pleasure of attending and participating in the 103rd Annual Meeting of the Radiological Society of North America (RSNA), held in Chicago from November 26 to December 1. The RSNA Annual Meeting is a unique opportunity for attendees from around the world to gather and meet with thought leaders and innovators to learn about the latest advances in imaging. Post-event, we wanted to share our experiences including some key takeaways.
Rising Injuries in Youth Sports
Diego Jaramillo, MD, MPH, from Miami Children’s Hospital in Miami, delivered a presentation titled “The Perfect Storm for Athletic Injuries: Youth, Growth, and Hormones”. Dr. Jaramillo shared how childhood sports have become increasingly intense and competitive. As young athletes dedicate more time and energy to one specific sport and even specialize in specific functions within that sport, the type of injuries, particularly repetitive injuries, are intensifying. Increased bone porosity of a young skeleton coupled with an increase in muscle strength can stress a skeleton and predispose it to damage. Puberty, including the hormonal influences on the growth plate, also increases the vulnerability of the skeleton to injury. Following x-rays, most young athletes are diagnosed using CT, especially for injuries that involve the head or that are primarily osseous such as the triplane fracture.
Effect of Weight Loss on Knee Cartilage Degeneration
Alexandra S. Gersing, MD, from the University of California, San Francisco, shared the results of a study on “How Weight is Lost Can Slow Knee Cartilage Degeneration”. The study examined which types of weight loss are most beneficial for patients who need to lose a significant amount of weight to slow the progression of knee cartilage degeneration. The study looked at 760 male and female patients with a body mass index greater than 25 who were enrolled in the Osteoarthritis Initiative (OAI), a U.S.-based study focused on the prevention and treatment of knee osteoarthritis. Patients were categorized into groups according to the amount of weight they were asked to lose over a 48-month period, as well as the weight loss method. Changes in the right knee were assessed at baseline, 48-, and 96-months using 3T MRI. Patients who lost weight showed significantly less T2-value increase in the bone layer of all compartments compared to those with stable weight, suggesting less cartilage degeneration over 96 months.
Patients Prefer Immediate Test Results
Radiology resident David Mihal, MD, of the University of Cincinnati College of Medicine and the Cincinnati Children’s Hospital (CCH), shared a “Survey that Showed Patients Prefer to Get Immediate Test Results”. Dr. Mihal began the four-phase study after learning that 20 percent of patients were uncertain about how they were going to get their results and had expressed anxiety to the technologist doing the exam. In phase one, techs screened outpatients to identify those who were nervous about their results. In phase two, the front desk staff checked for patients who didn’t have a follow-up appointment and offered them the option of immediate results. In phase three, all radiography outpatients were offered results as part of a questionnaire at check-in after a 10 to 20 minute wait. In phase four, the wait-time notification was eliminated from the questionnaire. Each successive phase tripled the rate at which patients used the service. Perhaps more important, 97 percent of patients understood that immediate results were available, and 92 percent of patient comments on the availability of the service were positive.
CurveBeam designs and manufactures Cone Beam CT imaging equipment specifically designed for the orthopedic and podiatric specialties, including the pedCAT, a compact, ultra-low dose CT imaging system. This technology allows doctors to make a better diagnosis the first time, eliminating the need for additional scans and, therefore, reducing low-level radiology exposure to patients. Best of all, the practice has access to the results right away. CurveBeam is proud to have participated in the 2017 RSNA Annual Meeting and is looking forward to RSNA 2018!
To learn more, visit CurveBeam.com today.
CurveBeam, the designer and manufacturer of Cone Beam CT imaging equipment for orthopedic and podiatric specialties, is pleased to announce a new partnership with Stratum Med, a collaborative alliance of physician-owned and health system-employed physician groups. Stratum leverages the collective “Groups” consolidated purchasing power to achieve higher discounts and reduce costs. CurveBeam systems are now offered through an exclusive contract with Stratum Med. Stratum saves its shareholders and clients money on their medical/surgical supply, equipment, laboratory, pharmacy and office supply purchases.
Stratum Med, Inc. is a physician owned and governed company, founded in 1996 headquartered in Urbana, Illinois with relationships with 60+ physician groups and integrated health systems across the country consisting of over 10,000 physicians. Stratum strives
to advance the quality of care, improve financial performance and optimize operational efficiency by using a collaborative alliance model to leverage the collective groups’ consolidated purchasing power and yet preserve independent purchasing practices. At the same time, its dedicated support teams ensure consistent, first-class service. This model also provides a “watch dog” to ensure pricing integrity and consistency based on contract terms, as well as networking opportunities where materials managers, lab directors, pharmacy directors and imaging directors can challenge and learn from one another.
Stratum has achieved savings ranging from 8-20% and has developed a non-acute, integrated purchasing program providing Stratum Shareholders and Clients access to pricing, services, and features typically available only to large hospitals and healthcare systems.
CurveBeam is proud to be a part of such a useful purchasing model and looks forward to the opportunities this new partnership will provide. To learn more about the benefits of purchasing CurveBeam imaging machines for your practice, visit curvebeam.com/products/pedcat/ today.