Abstract Background While animal study and cadaveric study have demonstrated an association between knee joint loading rate and joint degeneration, the relationship between knee joint loading rate ...during walking and osteoarthritis has not yet been sufficiently studied in humans. Methods Twenty-eight participants (14 transfemoral amputees and 14 age and body mass matched controls) underwent knee MRI with subsequent assessment using the semiquantitative Whole-Organ Magnetic Resonance Image Score. Each subject also underwent gait analysis in order to determine knee adduction moment loading rate, peak, and impulse and an exploratory measure, knee adduction moment rate ∗ magnitude. Findings Significant correlations were found between medial tibiofemoral joint degeneration and knee adduction moment peak (slope = 0.42 SE 0.20; P = .037), loading rate (slope = 12.3 SE 3.2; P = .0004), and rate ∗ magnitude (slope = 437 SE 100; P < .0001). These relationships continued to be significant after adjusting for body mass or subject type. The relationship between medial knee semiquantitative MRI score and knee adduction moment loading rate and rate ∗ magnitude continued to be significant even after adjusting for peak moment ( P < .0001), however, the relationship between medial knee semiquantitative MRI score and peak moment was no longer significant after adjusting for either loading rate or rate ∗ magnitude ( P > .2 in both cases). Interpretation This study suggests an independent relationship between knee adduction moment loading rate and medial tibiofemoral joint degeneration. Our results support the hypothesis that rate of loading, represented by the knee adduction moment loading rate, is strongly associated with medial tibiofemoral joint degeneration independent of knee adduction moment peak and impulse.
To learn the impact of health care reform, it is important for radiologists to first understand basic administrative aspects of medicine. This article describes the processes of radiology billing, ...reimbursement, and the revenue cycle, which includes the importance of proper coding, the resource-based relative value scale, and accounts receivable.
An understanding of the basics of medical practice management can help radiologists effectively provide optimal patient care. This article provides an overview of one component of this topic--the current radiology reimbursement system.
The purpose of this review is to understand the role of imaging in the diagnosis and management of non-traumatic subarachnoid hemorrhage (SAH). SAH is a life-threatening emergency and a relatively ...common entity, the most common etiology being ruptured aneurysms. Multiple conundrums exist in literature at various steps of its imaging workup: diagnosis, management, and follow-up. We target our review to highlight the most effective practice and suggest efficient workup plans based on literature search, and describe in detail the clinical diagnostic and prognostic scales, role of CT scan, lumbar puncture, and MR, including angiography in the diagnosis and workup of SAH and its complications, and try to simplify the conundrums. Practical knowledge of imaging workup of SAH can help guide correct management of these patients, so as to reduce morbidity and mortality without resource overutilization.
A 46-year-old schizophrenic male presented to the emergency department (ED) after deliberate ingestion of an undetermined number of open razor blades. Abdominal radiograph revealed one razor blade ...but raised suspicion of a second blade which was subsequently confirmed by digital tomosynthesis (DTS), seen as two razor blades superimposed upon each other placed at slightly different angles. A careful search was made during endoscopy and the two razor blades were retrieved from the stomach and duodenum, respectively. This case illustrates the use of digital tomosynthesis as a smart, timely, cost-effective, and low-dose alternative to conventional computed tomography (CT) that can be conveniently employed in the ED for foreign body localization.
The purposes of this article are to provide a primer on financial statements and to review several financial concepts that are at the foundation of the business of medicine.
For radiologists to ...effectively contribute to the leadership and management of their practices, it is imperative that they understand the business aspects of radiology. Radiologists' understanding and participation in practice management may also facilitate job satisfaction and assist the provision of optimal patient care.
In this study, we sought to quantify the sedentary worklife of the radiologist, a potential health risk. Radiologists of all training levels at our academic institution were surveyed to estimate the ...levels of at-work and out-of-work sitting. Fitbit One activity monitors were used to measure the at-work activity levels of radiology, pediatric, and internal medicine (IM) residents. Correlation between awareness and utilization of dynamic (sitting or standing, walking, or biking) picture archiving and communication system (PACS) workstations among radiology residents was assessed. Among surveyed radiologists ( n = 89), 78% estimated sitting for at least 6 hours per workday. Estimated workplace sitting accounted for most of the total sitting for 81% of respondents. As measured by activity monitors, radiology residents ( n = 27) took fewer steps per day (2683 vs 4602 vs 4967) and per hour (294 vs 419 vs 444) and experienced more sedentary time per hour (40.3 vs 36.2 vs 34.9 min/h) than IM ( n = 15) and pediatric ( n = 9) residents. Activity experienced during reading room–based work and interventional work was compared by studying 4 additional radiology residents during both types of rotations. Reading-room activity was low, whereas activity on interventional rotations surpassed average levels for the pediatric and IM residents in our study. Radiology residents’ ( n = 28) awareness and utilization of dynamic PACS workstations varied among reading rooms, but were generally low—75% reported never or rarely using them. Resident utilization correlated with awareness of dynamic workstations available at our institution ( R 2 = 0.64; P = 0.013). In conclusion, radiology residents in our study led more sedentary worklives compared with residents from other specialties and took minimal advantage of available tools to mitigate this. Potential health risks of inactivity justify individual and departmental efforts to limit workplace inactivity among radiologists.
We describe a technique of radiocarpal arthrography using the lateral approach. This technique may be used as an alternative to conventional dorsal techniques.
Radiocarpal injection using the lateral ...approach can be considered as an alternative to conventional dorsal approaches in the evaluation of wrist pain and instability.
Many scrotal conditions manifest similarly as pain, swelling, a palpable abnormality, or a combination of these symptoms. Most common scrotal pathologies have characteristic accompanying sonographic ...findings. Less common pathologies can have similar clinical presentations, and imaging with scrotal ultrasound is required to aid in proper diagnosis. This article focuses on several of these less commonly encountered scrotal pathologies--including testicular segmental infarction, scrotal filariasis, scrotal mesothelioma, seminiferous tubule fibrosis, and scrotal leiomyosarcoma--and compares and contrasts them to more routine diagnoses. Familiarity with both typical and atypical scrotal conditions is necessary to make accurate diagnoses at ultrasound to guide appropriate treatment and avoid unnecessary surgery.
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