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Znaczenie badania rentgenowskiego stawu biodrowego u dzieci z bólem biodra i obraz radiologiczny w wybranych patologiach nienowotworowych

Stopa Joanna, Klęba Joanna, Truszkiewicz Adrian, Guz Wiesław

Inżynier i Fizyk Medyczny

2022

Vol. 11, nr 2

99--107

U dzieci z podejrzeniem patologii stawów biodrowych w algorytmie postępowania nadal są uwzględniane badania rentgenowskie. Badania rentgenowskie są pomocne w obrazowaniu, gdyż w zakresie diagnostyki układu kostnego charakteryzują się wysokimi wskaźnikami skuteczności rozpoznawczej. Mimo że badania rentgenowskie związane są z niewielką lub umiarkowaną dawką promieniowania jonizującego, wykonując je u dzieci, należy szczególnie uwzględniać metody ograniczania narażenia na promieniowanie rentgenowskie. Wśród nieprawidłowości stawów biodrowych u najmłodszych dzieci istotną patologią jest dysplazja stawu biodrowego. Do częstszych chorób, które mogą przebiegać z obrazem zajęcia stawów biodrowych w badaniu rentgenowskim, należą także przemijające zapalenie błony maziowej, choroba Perthesa (młodsze dzieci) i młodzieńcze złuszczenie głowy kości udowej (starsze dzieci).

In children with suspected hip joint pathology, X-ray examinations are still included in the management algorithm. X-ray examinations are helpful in imaging, as they are characterized by high rates of recognition efficiency in the diagnosis of the skeletal system. Although X-ray examinations are associated with a low or moderate dose of ionizing radiation, when performing them in children, special consideration should be given to the methods of limiting exposure to x-rays. Among the abnormalities of the hip joints in the youngest children, hip dysplasia is a significant pathology. Transient synovitis, Perthes’ disease (younger children), and juvenile slipped capital femoral epiphysis (older children) are also among the more common diseases that may be associated with an X-ray changes of the hip joints.

Assessment of coxarthritis risk with dimensionless biomechanical parameters

Uršič Bojana, Kocjančič Boštjan, Romolo Anna, Iglič Aleš, Kralj-Iglič Veronika, Zupanc Oskar

Acta of Bioengineering and Biomechanics

2021

Vol. 23, no. 1

25--34

Purpose: Unfavourable distribution of contact stress over the load bearing area is considered a risk factor for early coxarthritis and it is of interest to outline respective biomechanical parameters for its prediction. The purpose of the work was to develop a transparent mathematical model which can be used to assess contact stress in the hip from imaged structures of pelvis and proximal femora, in large population studies and in clinical practice. Methods: We upgraded a previously validated three-dimensional mathematical model of the human hip in the one-legged stance HIPSTRESS by introducing parameters independent from the size of the structures in the images. We validated a new parameter – dimensionless peak stress normalized by the body weight and by the radius of the femoral head ( pmaxr2/WB) on the population of 172 hips that were in the childhood subjected to the Perthes disease and exhibited increased proportion of dysplastic hips. Results: The dimensionless parameter pmaxr2/WB exhibited smaller number of indecisive cases of hip dysplasia predicted by the model than the previously used parameter pmax/WB (6% vs. 81%, respectively). A threshold for an increased risk of early coxarthritis development by the HIPSTRESS parameter H = pmaxr2/WB was found to be 2. Conclusions: We proposed a dimensionless peak stress on the load bearing area with the border value of 2 as a decisive parameter over which hips are at risk for early development of degenerative processes and presented a method for determination of biomechanical parameters with the use of nomogram.

Evaluation of contact characteristics of a patient-specific artificial dysplastic hip joint

Mutlu I., Ugur L., Celik T., Buluc L., Muezzinoglu U. S., Kisioglu Y.

Acta of Bioengineering and Biomechanics

2014

Vol. 16, no. 2

111--120

This study addresses the results of the experimental measurements for the contact surface areas and contact pressure distributions of a dysplastic hip joint. The hip joint consists of pelvis, proximal femur and artificial cartilages for both acetabulum and femoral head. The dysplastic hip joint is modeled in three dimensional (3D) form using the computerized tomography (CT) images obtained in vivo of an adult female patient. The modeled hip joint components are manufactured as a non-natural dysplastic hip joint using different materials and manufacturing processes. The dysplastic hip joint produced is subjected to compression forces experimentally to measure the contact surface area and contact pressure distributions between the femoral head and acetabulum using the pressure sensitive Fuji film. Different types of specific fixtures and molds are designed and manufactured to produce the dysplastic hip joint components and perform the experimental studies. The measured results using a non-natural dysplastic hip joint are compared with relevant results reported in current literature considering the peak and mean contact pressure values. Therefore, the obtained results showed that the non-natural dysplastic hip models can be generated and replaced to determine the contact characteristics for an elusive cadaveric model. In conclusion, the artificial models might be useful to understand the contact pressure distributions and potential changes in surface pressure contours and their effects on the stress distributions.