Purpose To compare the wireless flat-panel detector with gadolinium oxide coating in X-ray photography in the small joints of the limbs compared with conventional flat panel detector with cesium iodide coating. Materials and Methods Comparison was randomly performed between gadolinium oxide coated sulfur wireless flat-panel detector and cesium iodide coated conventional flat-panel detector for 80 patients who received routine X-ray photography, and scoring data were applied with statistical analysis. Results There was no significant difference between the scoring data from two film-reading people (P>0.05). The resolution of anatomical structure of small joint of limbs and tube current showed no significant difference for two types of imaging systems (P>0.05). Conclusion Wireless flat panel detector sulfur with gadolinium oxide coatings can obtain satisfactory image quality at a reasonable inspection doses in the X-ray photography of small joint of limbs. The imaging quality and inspection doses are similar to conventional flat panel detector device with cesium iodide coating, but the posture is more convenient.

Objective To investigate the imaging features of intra-osseous ganglia surrounding the ankle joints and their diagnostic value.Methods Imaging features of 40 cases of intra-osseous ganglia proved by the pathology from 1 982 to 2012 were analyzed ret-rospectively.33 cases underwent radiography,26 cases underwent computed tomography (CT)and 13 cases underwent magnetic resonance imaging (MRI).Results Intra-osseous ganglia were detected at talus in 23 cases,distal tibia in 1 5 cases (8 cases in pos-terior melleolus,6 cases in medial melloulus and 1 case in anterior part of distal tibia),and lateral malleolus in 1 case.Multiple in-tra-osseous ganglia was detected in 1 case,which located in both talus and posterior malleolus.29 cases were oval,monolocular os-teolytic lesions.1 1 cases were multilocular lesions with separation.All cases were observed with slightly sclerous edge.Articular surface disruptions were observed in 1 5 cases,and lesions were connected with the joint space.① Oval cystic translucent areas with sharp and sclerous edge adjacent to the ankle joint were observed in 34 lesions of 33 cases on radiograph.Cracks were noted on the articular surface of 12 lesions.② Round translucent areas with sharp and sclerous edge were observed in 26 isolated lesions on CT images.Cracks were noted on the articular surface of 14 lesions.③ 14 lesions of 13 cases showed low to moderate signal on T1 WI and high signal on T2 WI.Cracks were observed in 4 lesions adjacent to the ankle joint,and soft tissue swelling was noted in 6 le-sions.Conclusion Intra-osseous ganglia can be diagnosed accurately based on the typical imaging features and special locations.

Objective To investigate the imaging features of the juxta-artieular bone cyst (intraosseous ganglia). Methods The imaging findings of 54 cases histopathologically confirmed were studied retrospectively. X-ray, CT, and MRI were performed in 46 eases,30 cases, and 14 cases, respectively.Results Of the 54 cases, 27 arised from the ankle (including multiple lesions), 16 from the knee joint,7 from the hip joint, 1 from the proximate end of the humerus, ulna, trapezium bone, the first phalange in each, and 1 from the talus and the distal end of the tibia. There were 43 eases (44 lesions) in the ankle and knee joints, with 29 (65.9%) lesions located in the medial articular surface. Fifty-four eases had thinning sclerotic rim, showing a unilocular round osteolytic appearance in 44 cases and a muhiloculated-cystic appearance with septa in 10 cases. Discontinuous articular surface were seen in 15 cases, articular surface collapse in 1, gas density in 3 and fluid-fluid plane in 1. (1) On x-ray films, 46 cases (47 lesions) with well-defined sclerotic rim revealed round, arch or irregular lyric areas at the adjacent articular surface. The fissures were found at the adjacent articular surface in 6 lesions. No joint spaces were abnormal. (2)On CT,30 cases with sclerotic rim showed round in 19 lesions, arch in 3, and irregular in 8. The fissures were seen at the adjacent articular surface in 14 lesions. The density showed homogeneous in 27 lesions, and gas existed in 3. (3) Fourteen cases (15 lesions)showed hypointense to isointense signal on MR T1 Wl and hyperintense signal on T2WI. Fluid- fluid plane was found in 1 ease. The fissures were observed at the adjacent articular surface in 8 lesions. 7 cases showed swelling soft tissue. Conclusion The characteristic locations combined with the typical imaging features may suggest the diagnosis of jaxta-articular bone cyst.

Objective To explore the optimal dose ratio set in the hip digital tomosynthesis (DTS),and to reduce patient's examination dose as low as possible.Methods Ninety patients who received hip DTS examination were randomly divided into 3 groups,with the dose ratio as 6,7 and 8,respectively.One-way ANOVA test was used to compare.the image quality and radiation dose among 3 groups.Results The values of entrance surface dose (ESD),dose-area product (DAP) and image quality score of 3 groups were [(3.76 ± 1.89) mGy,(18.41 ± 11.71) dGy·cm2,3.03 ± 0.24],[(5.24±2.76)mGy,(26.99±13.34)dGy·cm2),3.60±0.11],and [(6.39±1.75)mGy,(36.96± 22.49) dGy· cm2,3.64 ± 0.09],respectively.The difference among three groups was statistically significant (F =10.94,9.45,139.26,P ＜ 0.05).The S-N-K test showed that both ESD values and DAP values in 6,7,and 8 time-dose ratio group was from small to large.The image quality score of 6 time-dose ratio group was lower than that of the other groups with no significant difference.Conclusions Dose ratio is one of the important parameters to result in the radiation dose of DTS.Dose ration 7 is optimal in hip DTS,which could match the image quality and radiation dose best and finally protect patients from unnecessary radiation damage.

Objective To evaluate the clinical and radiological features of Gorham disease. Methods Clinical and radiological features of Gorham disease were retrospectively analyzed by reviewing the eleven cases from our hospital and the cases reported in the domestic literature in the past fifty years. The diagnoses of all these 11 patients were in accordance with the diagnostic criteria established by Wells and Gray et al. All patients had X?ray plain film, four had CT scan and five had MR examination, with one had additional contrast?enhanced MR examination. Results There were 7 males and 4 females, age ranged from 16 to 66 years with a median age of 32 years. There were six cases involving hand, one involving ulnar and radial bones, one involving acetabulum and three involving jaw bones. The main clinical manifestations were pain, swelling, limited activity, and focal muscular atrophy occurred in 7 cases. On X?ray plain films, the affected bone became thin and the cortexes were not smooth and became coarse in 6 cases. Local lucent area was seen in 5 cases and massive bone absorption was seen in 6 cases. The residual bones showed a tapering appearance in 1 case. Pathological fracture occurred in 1 case. On CT scans, the affected bone became thin and the cortexes became coarse in 4 cases. Local lucent area was seen in 1 case. Massive bone absorption was seen in 3 cases. The adjacent muscular atrophy and widened intermuscular fat space occurred in 2 cases (atrophic bone absorption). On MRI, normal signal intensity of bone marrow disappeared and demonstrated low signal on T1WI and high signal on T2WI. The signal could be homogeneous or heterogeneous. There were widespread strip and patchy high signal areas in the soft tissue around the absorption areas in 4 cases, which resembled the edema?like signal. In 1 case, there was irregular widespread soft tissue mass around the absorption areas with heterogeneous high signal on T2WI. The adjacent muscle showed atrophy, and the intermuscular fat space became wide. There were a total of 92 cases reported cases in the literature including our 11 cases. There were 63 males and 29 females. The onset age ranged from 10 to 40 years in 66/92(72%)cases. The lesion affected one bone in 24 cases, affected two or more bones in 68 cases, out of which 9 cases had single center distribution, 59 cases had multiple centers distribution. Pectoral girdle, pelvis, maxillofacial bones, and hand were the most common sites of involvement in decreasing order. Forty three cases had muscle atrophy and 8 cases had soft tissue mass. Conclusion Gorham disease should be considered when atrophic bone absorption in one bone or continuous bones occurs that does not match clinical symptoms, with soft tissue atrophy but no bone sclerosis or periosteal reaction in the osteolytic areas.

Objective To analysis the imaging features of the chondroblastoma in the tarsal bone. Methods The locations of 134 cases of pathologically confirmed chondroblastoma were retrospectively analyzed. Eleven of them were in tarsal bones and their X-ray and CT findings were analyzed. Results Of the 11 cases of tarsal chondroblastoma, 6 were in talus, 3 were in calcaneus and 2 cases were in navicular bones. They were examined by the X-ray and 5 cases had additional CT scans. The common locations were the posterior portion of the talus and calcaneus. The X-ray findings included expansive destruction (10/11), mild osteosclerosis (11/11), bone ridge (9/11), articular facet destruction (7/11) and spot or patching calcification(6/11). The imaging findings of CT included articular facets destruction (5/5), bone ridge (5/5) and spot or patching calcification (2/5). Conclusion The talus and the calcaneus are the frequently involved location of tarsal chondroblastoma. Its X-ray and CT findings are characteristic but not exclusive.

Objective To investigate the status of musculoskeletal articles and musculoskeletal injury articles published in the major journals of radiology in China and compare with abroad during the last decade.Methods Statistic analysis and comparison were done with musculoskeletal injury articles published in the major journals of radiology in China and abroad.The number,category,exam methods,study region and study contents were analyzed respectively.The journals in China included Chinese Journal of Radiology,Journal of Clinical Radiology and Journal of Practical Radiology.The journals at abroad included Radiology,the American Journal of Roentgenology(AJR),the British Journal of Radiology(BJR)and Skeletal Radiology.Results The rate of musculoskeletal articles among the treatise articles was 13.O%(827/6352)in China and 10.4%(900/8659)in three kinds of compressive jonrnals at abroad.The rate of musculoskeletal injury articles in musculoskeletal articles was 21.5%(178/827)in China and 10.8%(97/900)abroad.Among the review articles,the rate was 9.9%(73/741)and 13.7%(10/73)in China.respectively,while that was 4.3%(34/783)and 23.5%(8/34),respectively abroad.Among the case reports,the rate was 17.0%(675/3971)and 3.4%(23/675)in China respectively,while that was 8.8%(177/2019)and 14.7%(26/177),respectively abroad.The rate of exam methods which onlv used X-ray plain film in injury articles was 11.7%(26/222),mainly CT was 42.8%(95/222)and mainly MR was27%(60/222)in China,while that was10.9%(32/295),9.8%(29/295)and 32.5%(96/295),respectively in four kinds of journals at abroad.The combination examination was 16.2%(36/222)in China and 42.0%(124/295)at abroad respectively,The other was 2.3%(5/222)in China and 4.8%(14/295)at abroad.As for the study region,the rate of vertebrate column was 22.5%(50/222).knee joint was 21.1%(47/222),cranial and facial bones was 15.3%(34/222),hip joint was 7.2%(16/222).thoracic region was 6.8%(15/222),foot and ankle was 4.5%(10/222),hand and wrist was 4.1%(9/222),respectively,while that was 14.6%(43/295),14.6%(43/295),1.7%(5/295).6.4%(19/295),3.7%(11/295),12.9%(38/295)and 7.5%(22/295)at abroad,respectively.As for the study contents,the rate of bone was 64.9%(144/222),articular capsule and ligament was 8.6%(19/222),cartilage and osteoepiphysis was 7.7%(17/222),dislocation with or without fracture was 5.8%(13/222),menisci was 5.4%(12/222),combination study was 4.0%(9/222)and the other was 3.6%(8/222),respectively,while that was 62.4%(184/295),24.1%(71/295),4.7%(14/295),0.3%(1/295),2.7%(8/295),2.4%(7/295)and 3.4%(10/295)at abroad,respectively,The number of experimental articles in Chinese Journal of Radiology was 7,while that of Radiology was 29.Conclusion The rate of article on bone and bone injury was lower in all articles.Emphasize should be laid on experimental research and non-bone musculoskeletal injury in china.

Objective To study radiographic classification of tarsometatarsal joint dislocation and postoperative imaging evaluation.Methods 74 patients with tarsometatarsal joint dislocation were included in this study.Tarsometatarsal joint dislocations were classified by the Myerson fracture displacements classification.All patients were evaluated according to the American Orthopedics Foot & Ankle Society (AOFAS)clinical rating systems.Results There were 19 patients with Myerson A,46 patients with Myerson B and 9 patients with Myerson C tarsometatarsal joint dislocation.39 distal tarsal bone fractures and 156 metatarsal fractures,with simultaneous scaphoid fractures in 10 patients were showed.All patients who were followed up and no infection.The AOFAS scale was categorized as excellent,good,fair or poor,and 22 patients were considered as excellent,29 patients as good,17 patients as fair and 6 patients as poor.Postoperative imaging evaluation required anatomical reduction of tarsometatarsal joint.On the anteroanterior radiogragh,the base medial edge of the second metatarsal bone and the medial edge of intermediate cuneiform were combined to form a straight line.The shortest distance between the base of the first metatarsal bone and the second metatarsal bone should be less than 2 mm.On the medial oblique radiogragh,a smooth line connecting the medial edge of the fourth metatarsal bone with the medial edge of cuboid bone always appeared.On the lateral radiogragh,the dorsal edge of the second metatarsal bone and intermediate cuneiform formed a smooth line.The height of metatarsus should not exceed the dorsal edge of corresponding cuneiform.The longitudinal arch angle was restored within normal limits.Conclusion The type-B tarsometatarsal joint dislocation is the most common type and frequently accompanies by multiple fractures.Intraoperative and postoperative multidirectional observation of anatomical reduction of tarsometatarsal joint dislocation can reduce incidence of posttraumatic arthritis.

Objective To investigate the imaging manifestations of inflammatory bowel disease-associated spondyloarthritis(IBD-SpA).Methods A retrospective analysis was conducted on 85 patients with inflammatory bowel disease(IBD)who underwent abdominal CT and MRI examinations.Patients with pregnancy,lactation,psoriasis,tumors,and other conditions were excluded through medical record screening,all patients met the diagnostic criteria for IBD.The presence of spondyloarthritis(SpA)was confirmed through ima-ging findings,and the imaging characteristics of the location and bone changes of SpA were observed.Twenty patients who under-went abdominal CT examination during the same period were selected as the control group.Results A total of 85 patients with IBD under-went CT and MRI examinations,the detection rate of MRI(37.6％)was significantly higher than that of CT(30.6％)(P＜0.05).Based on comprehensive imaging features,5 cases of grade 1,13 cases of grade 11,11 cases of grade Ⅲ,and 3 cases of grade Ⅳ,IBD-SpA were diagnosed.In the control group,1 case of sacroiliitis was detected,of which 1 case of grade Ⅱ.The detection rate of CT in the IBD group(30.6％)was significantly higher than that in the control group(5％)(P＜0.05).Conclusion The incidence of SpA is relatively high in patients with IBD.Both CT and MRI have certain diagnostic value for IBD-SpA.CT has diagnostic advantages in bone sclerosis and joint space narrowing,while MRI can better reflect minor lesions and early bone marrow edema changes.The com-bination of CT and MRI examinations can provide diagnostic evidence for clinicians and effectively improve patient symptoms.

Objective:To summarize the evidence of pelvic floor muscle training for the prevention and treatment of postpartum urinary incontinence, providing guidance and reference for clinical practice.Methods:According to the "6S" pyramid model, clinical decision-making, guidelines, and systematic reviews on pelvic floor muscle training for the prevention and treatment of postpartum urinary incontinence were searched in UpToDate, British Medical Journal (BMJ) Best Practice, National Institute for Health and Care Excellence, Scottish Intercollegiate Guideline Network, New Zealand Guideline Group, Guidelines International Network, Medlive, Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, Cochrane Library, professional association website, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, China Biology Medicine disc, WanFang Data, and VIP. The search period was from March 2013 to March 2023. Two trained researchers evaluated the quality of literature and integrated and extracted evidence.Results:A total of 22 articles were included, including 8 clinical decision-making, 6 guidelines, 7 systematic reviews, and 1 expert consensus. Twenty-one best pieces of evidence were summarized from 5 aspects, consisting of risk factors, prevention, evaluation, treatment and health guidance for postpartum urinary incontinence.Conclusions:The best evidence for the prevention and treatment of postpartum urinary incontinence through pelvic floor muscle training summarized is convenient for medical and nursing staff to conduct scientific urinary incontinence assessment, pelvic floor muscle training education and guidance for pregnant and postpartum women.