Also remember that if all you ever do is blindly apply a bunch of 95 % rules, you can be replaced by a file room clerk with a rubber stamp. Remember that 95 % diagnostic accuracy is easier to accept if you and your family are not in the other 5 %. This may not be a bad strategy for the larval radiologist, but as you move up the radiologic food chain, you should strive to do better than this. In fact, if you just dropped the term osteopenia and used the term osteoporosis instead, you would be right about 95 % of the time, which is not a bad batting average. Osteoporosis is, by far, the most likely cause of osteopenia. The approach to osteopenia can be simplified greatly, if one forgets all causes except osteoporosis. Resnick has made the statement that “You can take a normal patient and an abnormal X-ray technician, and give the patient osteoporosis at will.” Approach Finally, differences in radiographic technique can widely alter the radiologist’s perception of whether or not osteopenia is present. Another problem with plain films is the lack of some standard by which to compare the area of interest. One must lose 30 – 50 % of the bone mass before it can be detected on a plain film. First of all, plain films are hideously insensitive to changes in bone mineral. It can be fairly difficult to diagnose osteopenia accurately on plain radiographs. For example, the table below shows several disorders that can produce osteopenia, as well as more specific radiographic clues to their diagnosis. Rather, it prompts a search for other more specific clues to the exact underlying disorder. However, there are many disease entities that can cause osteopenia, so the mere finding of radiolucent bone does not make this an automatic diagnosis. The most common cause by far of osteopenia is osteoporosis. This term is much preferred over terms such as “demineralization” or “undermineralization”, since we really can’t tell the exact mineral status of the patient’s bone from the radiograph alone. Gonad shielding in paediatric pelvic radiography: disadvantages prevail over benefit (2012) Frantzen MJ, Robben S, Postma AA, Zoetelief J, Wildeberger JE, Kemerink GJ.One of the most common findings in skeletal radiology is increased radiolucency of bone, most properly termed osteopenia. Painful paediatric hip: frog-leg lateral view only!.In some atypical situations an abdominal ultrasound may therefore be of value.ĭiagnostic imaging: pediatrics. In 524 children analyzed for hip pain we found three cases of mesenteric adenitis. How to Differentiate Carotid ObstructionsĬorner- or bucket handle fractures should raise the suspicion of non-accidental injury (NAI).Ankle fractures - Weber and Lauge-Hansen Classification.Ankle Fracture Mechanism and Radiography.TI-RADS - Thyroid Imaging Reporting and Data System.Head Neck tumors - When to think of malignancy.Anatomy and Pathology of the Infrahyoid Neck.Esophagus II: Strictures, Acute syndromes, Neoplasms and Vascular impressions.Pulmonary nodule - Benign versus Malignant.Mediastinal Masses - differential diagnosis.Esophagus I: anatomy, rings, inflammation.Vascular Anomalies of Aorta, Pulmonary and Systemic vessels.Contrast-enhanced MRA of peripheral vessels.Ischemic and non-ischemic cardiomyopathy. Coronary Artery Disease-Reporting and Data System 2.0.Bi-RADS for Mammography and Ultrasound 2013.Transvaginal Ultrasound for Non-Gynaecological Conditions.Acute Abdomen in Gynaecology - Ultrasound.Appendicitis - Pitfalls in US and CT diagnosis.
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