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Weight Bearing CT Finds Important Displacement in Patients with Hallux Valgus

It’s difficult to understand how much a bunion can affect your life until you experience it. Known by the medical term hallux valgus, this deformity is painful and can be extremely disruptive. While the traditional solution has been to perform a fusion of two key bones in what is known as the Lapidus Procedure, a team of researchers believes this overlooks a secondary displacement that can cause lasting postoperative problems.

In their study, Comparison of Intercuneiform I-2 Joint Mobility Between Hallux Valgus and Normal Feet Using Weightbearing Computed Tomography and 3-Dimensional Analysis, Dr. Tadashi Kimura and fellow researchers looked at an understudied joint to find out if there is more that can be done in the treatment of hallux valgus. They looked at the feet of 11 women with the condition, as well as the feet of 11 healthy women, and found a significant difference in the displacement of the I-2 joint between the two groups.

To conduct their study, the team used CT scanning with simulated weightbearing effects on the foot to see the mobility of the joint. The images portrayed enough difference in the two groups to suggest that hallux valgus does affect the I-2 joint. Previously, a Lapidus Procedure had been used to fuse the first metatarsal with the medial cuneiform, but an additional operation may be needed to fuse the I-2 joint, a process known also as arthrodesis, in order to relieve the patient’s symptoms.

While this might not be the case for all patients with hallux valgus, it can be significant for those who experience hypermobility of this joint. To determine that this is the case, utilizing true weightbearing CT scanning technology may be critical. This study used CT scans that simulated a weightbearing environment with the intention of replicating the effects, but the authors state that the displacement may be even more severe once true weightbearing interaction is observed.

An industry leader in weight bearing, 3D scanning technology, CurveBeam’s innovations give doctors the ability to develop comprehensive treatment plans that address this entire issue. The authors of the study write that simple radiography would be unable to capture the displacement of the I-2 joint and traditional CT scanning is unable to account for the shifts caused once the full weight of a patient’s body is placed on the foot. Hallux valgus treatment can greatly improve the quality of life for a patient, and it is important to ensure that the treatment provided eliminates the problem. The PedCAT can give doctors the ability to do exactly that. To learn more about CurveBeam and the pedCAT, click here.

CurveBeam Throws A Curve at Conventional CT Scans for Orthopedic Practices

Often used for orthopedic and podiatric use when plain x-rays do not provide the visualization needed, a CBCT (Cone Beam Computed Tomography) scan is a quick, pain-free, noninvasive radiology diagnostic imaging test used to accurately generate comprehensive images of bones. These images can then be reformatted into three-dimensional images which can be easily shared through PACS. Quicker than the spiral motion of a typical CT scan, CBCT imaging exposes patients to less radiation than traditional CT scanners.

Watch the below video to learn Dr. Josef Zoldos, MD, DDS, one of the founders of the Arizona Center for Hand Surgery, explain how CurveBeam CBCT aids their doctors in detecting inflammatory conditions, tumors, and evaluating other abnormalities of the hand, wrist, and elbow, improving overall diagnoses, treatment plans, and patient engagement in their facility.

Health Canada Approves CurveBeam’s InReach Cone Beam CT

March 26, 2018 – Warrington, Penn. – CurveBeam announced the InReach cone beam CT system for orthopedics has been approved by Health Canada regulatory authority for sale in Canada.

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The InReach is primarily designed for the hand, wrist &elbow; & lower extremities in non-weight bearing position. The InReach is an ultra-compact CT scanner that provides high-contrast 3D datasets of bony anatomy, which could potentially replace radiographs as a first line of diagnosis.

The InReach is ideal for the point-of-care, imaging centers, and hospital orthopedic departments because of its small footprint, its self-shielded design, and standard power requirements.

“The InReach will revolutionize the speed and accuracy of assessment of upper extremity conditions that specialists have traditionally found challenging to diagnose with plain X-Ray, such as scaphoid fractures,” said CurveBeam President & CEO, Arun Singh. “The InReach continues the company’s mission to elevate advanced diagnostic imaging capabilities to enhance orthopedic care.”

The InReach is designed with patient comfort in mind. Patients’ hand, wrist or elbow is positioned in a height-adjustable bore while in standing or sitting position. The unit can also accommodate non-weight bearing, lower limb imaging. Scan times are less than 30 seconds.

The InReach device is supplemented by CubeVue, CurveBeam’s custom visualization software.  CubeVue gives orthopedic specialists to multi-planar slice navigation tools and vivid 3D renderings of the anatomy previously not easily accessible to specialists. CubeVue’s Insta-X feature provides Digitally Reconstructed Radiographs, potentially eliminating the need for radiographic exams altogether.

The InReach is the second extremity CT imaging system CurveBeam has introduced to Canada. CurveBeam’s pedCAT system permits weight bearing CT imaging of the feet and ankles.

The InReach system was cleared by the US FDA for sale in the United States in 2017.

CurveBeam is the leader in Weight-Bearing extremity CT imaging, starting with the introduction of its pioneer product, the pedCAT, in 2012. The pedCAT is the only CT system that allows for bilateral, true weight-bearing imaging of the lower extremities. Since 2012, the pedCAT has been integrated into leading foot & ankle orthopedic and podiatric practices around the world.

CurveBeam is currently developing its next generation multi-extremity device, the LineUP, which will provide bilateral Weight-Bearing images of the knees in addition to feet, as well as hand, wrist & elbow.

Weight-Bearing CT Can Help Doctors Zoom in on the Problem

Sometimes the simplest solution to a difficult challenge is a change of perspective. That’s exactly what Dr. Selene Parekh and his colleagues at the North Carolina Orthopaedic Clinic have learned after using the CurveBeam pedCAT. In his talk titled “Standing CT: Zooming in on the Problem,” Dr. Parekh outlines how his experiences at the clinic and as a professor of orthopaedic surgery at Duke University have demonstrated the importance of weight-bearing computed tomography (WBCT) scans.

All too often, clinics rely solely on x-rays for initial diagnosis. If CT scans are used, the patient is usually lying horizontally, with weight and pressure completely removed from the area in question. As a result, the treatment plans or pre-operation strategies are developed from incomplete information. With WBCT scanners, doctors can accurately view the interaction of elements in the patient’s lower extremities, allowing them to better diagnose the issue.

To illustrate this point, Dr. Parekh outlines several of his own real-world cases, one of which occurred within the last week. A 35-year-old woman visited the clinic complaining of medial ankle pain. While an initial x-ray revealed a minor increased talar tilt, a review of the patient’s history prompted her doctors to look again with the weight-bearing pedCAT. The test revealed the presence of osteochondral lesions. This refined diagnosis resulted in more appropriate treatment options, such as a resurfacing procedure to repair the issue at the heart of the problem.

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Another case involved a 61-year-old man who liked to stay active by biking and running. He presented with pain in his right foot. An x-ray revealed a malunion of the fibula and some arthritis. A total ankle replacement was subsequently performed, and the man resumed his active lifestyle. After five years, however, he returned complaining of increasing pain in the same foot. This time, a WBCT was taken, and the clinic saw the full extent of the problem. They discovered an impingement of the bone as well as a settling of the talar component into the talus, which was causing a talar fracture. Without this scan, it is likely that minor (and insufficient) treatments would have been considered. The patient chose to undergo an entire talus replacement, so he could keep cycling, a healthy activity that he enjoyed.

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These cases, as well as others outlined by Dr. Parekh, illustrate the significant difference that WBCT scanners such as the CurveBeam pedCAT can make in a physician’s ability to treat patients. Even beyond these new perspectives offered, there are other benefits to the patient, most significantly, reduced radiation exposure. While traditional CT scans have radiation levels around 2000 sieverts, the pedCAT only emits about 2 sieverts of radiation. Curve Beam is also releasing the LineUP, which will facilitate total lower body scans, from floor to knees.

By giving physicians a complete view of a patient’s extremities and the interactions of the bones, ligaments, and joints within, CurveBeam aids in providing the best treatment possible to patients. You can learn more about CurveBeam here!