PubMed · 4062393
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D Resnick. 1985. Frozen shoulder.. https://doi.org/10.1136/ard.44.11.805-b
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STUDY DESIGN: Lumbosacral fusion masses were assessed by angled radiography. OBJECTIVES: To introduce the use of the angled anteroposterior radiograph in the evaluation of the fusion mass at the lumbosacral region. SUMMARY OF BACKGROUND DATA: Determination of the presence and progress of the fusion mass at the lumbosacral junction may be difficult clinically and radiologically. Few studies regarding the use of the angled anteroposterior view of plain radiographs in evaluating L5-S1 fusion are available. METHODS: The patient was placed in the supine position, and an angled view of the lumbosacral junction was obtained. Radiography of the angled anteroposterior view was performed with the x-ray beam oriented toward the cranial portion at 50 degrees to 55 degrees relative to the x-ray table. RESULTS: The use of the angled view of the lumbosacral junction eliminates the superimposition of the L5 transverse process on the posterior part of the superior ala of the sacrum, widens the L5-S1 intertransverse space, and enhances direct visualization. CONCLUSIONS: The use of the angled anteroposterior view on plain radiographs is recommended in the evaluation of the fusion status at L5-S1.
STUDY DESIGN: A comparison between computer-assisted measurement using digitized radiographs, which has the potential to reduce error, and manual measurement using standard radiographs. OBJECTIVE: To assess measurement variability for the Cobb method on digital radiographs and compare it with that of manual measurements on standard radiographs. BACKGROUND DATA: Studies of the Cobb method have demonstrated multiple sources of error leading to significant intraobserver measurement variability. Estimates for the 95% confidence interval for intraobserver variability range from 2.8 degrees to 10 degrees. METHODS: Twenty-four scoliosis radiographs were measured by six examiners. Two measurement sets were done manually ("manual set"), and two measurement sets were done on digitized images using a computer mouse ("computer set"). RESULTS: For the manual set, the 95% confidence interval for intraobserver variability was 3.3 degrees (range, 2.5-4.5 degrees). For the computer set, the value was 2.6 degrees (range, 2.3-3.3 degrees). This difference in 95% confidence intervals between the manual and computer sets was statistically significant (P < 0.001). CONCLUSIONS: The results of this study demonstrate that intraobserver variability for manual and computer Cobb angle measurements yield a 95% confidence interval of approximately 3 degrees, with the computer having a slightly lower variability. The computer technique removes sources of intrinsic error, e.g., the variability introduced by using different manual protractors, the inaccuracy of standard protractors, and the use of wide-diameter radiographic markers. Identical digital images can be shared electronically between centers, without having to duplicate and mail films. Multicenter studies in which different examiners will be measuring Cobb angles may consider using the computer as a measuring device to reduce intrinsic measurement errors.
This report describes a new mathematical model for defining the joint reaction forces of the lower extremity using Kane's method of dynamics. Our model utilized average lower extremity joint motion and force/plate data from one healthy female patient during gait. From a cadaver specimen, the anatomical mass centers of the pelvis, femur, tibia, and foot were determined. Joint angular motion during the normal gait cycle was computed using Cardan angles for each distal segment relative to the proximal segment. Fluoroscopy of four normal knees determined average femorotibial and patellofemoral contact positions throughout flexion. A three-dimensional model of the lower extremity was defined in weight-bearing motion by 30 differential equations. During normal walking, the joint reaction forces for the subject tested ranged from 1.9 to 2.6 times body weight at the hip joint and 1.7-2.3 times body weight at the knee joint, depending primarily on gait speed. The method correlates well with known in vivo telemetrically measured forces at the hip joint.