Dual energy X-ray absorptiometry (DXA) has become the most common method for measuring bone mineral density (BMD) of small animals in metabolic bone disease research, and errors should be minimized in all procedures involved in research studies in order to increase the accuracy of the study results. DXA is simpler and rapid compared to Micro-computed tomography for quantitative analysis of change in trabecular bone of test subject. In human research, measuring BMD is widely used; post-operative evaluation on orthopedic surgery, evaluation of osteoporosis medication in menopause and many other areas of study. For the study, the inspector should be trained by the equipment manufacturer regarding the utilization and analysis of the equipment and regular phantom testing should be conducted to ensure the stability of the equipment, and precision tests should be conducted to analyze the positioning and data analysis. They should also be familiar with the clinical trials and conduct studies based on the approval of the Institutional Review Board. In the absolute BMD measurement of the human body, it is necessary to apply and compare the position and condition, rotation degree, region of interest, and area of the scan in the follow-up test. In the case of small animals, animal selection, measurement and equipment should be modeled to match the research. Therefore, we would like to provide information for researchers to minimize the errors, effective data management and accurate data presentation. This article reviews the process of DXA measurement for research purpose including plan for DXA examination, BMD measurement in a human body study and small animal studies.
Absorptiometry, Photon ; Animals ; Bone Density ; Bone Diseases, Metabolic ; Ethics Committees, Research ; Female ; Follow-Up Studies ; Human Body ; Humans ; Menopause ; Methods ; Orthopedics ; Osteoporosis ; Statistics as Topic

The image quality management of bone mineral density (BMD) is the responsibility and duty of radio-technologists who carry out examinations. However, inaccurate conclusions due to the lack of understanding and ignorance regarding the methodology of image quality management can be a fatal error to patients. The accuracy and precision of BMD measurement must be maintained at the highest level so that actual biological changes can be detected with even slight changes in BMD. Accuracy and precision should be continuously preserved for image quality of machines. Those factors will contribute to ensure the reliability of BMD examination. The enforcement of proper quality control of radiologists performing BMD inspections which brings about the durability extensions of equipment and accurate results of calculations will help the assurance of reliable inspections.
Absorptiometry, Photon ; Bone Density ; Densitometry ; Humans ; Quality Control*

MRI (magnetic resonance imaging) is widely applied to diagnose sport-related injuries including bone and soft-tissue injuries. Because the MR characteristics of hydrogen nuclei depend upon on their local tissue environment, soft tissue structures of similar density may exhibit difference in signal intensity (brightness on image). This enables MRI to get high soft-tissue contrast resolution superior to other imaging modalities such as computed tomography (CT). Advantages of MRI are its capacity to depict occult bone trauma or bone bruise and ligamentous or tendinous injuries that are not visible on conventional radiographs. MRI does not expose the patient to radiation dose, so it can be used safely for pediatric patients. In this review, we will discuss on the osseousand soft-tissue injuries of the extremities which could be helpful from MRI in various clinical situations.
Athletic Injuries ; Contusions ; Extremities ; Humans ; Hydrogen ; Ligaments ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Sports

Osteoporotic vertebral fractures suspected at clinical evaluation require radiological confirmation. Most radiologists make the diagnosis of vertebral fracture on the basis of a qualitative impression. However, unlike other fractures, vertebral fractures are commonly found on radiographs obtained for other reasons in patients who do not show signs or symptoms suggestive of fractures. Radiologists qualitatively analyze radiographs of the thoracolumbar spine to identify vertebral fractures in patients whose clinical indications suggest trauma, osteoporosis, malignancy, or acute back pain. The accuracy of decision-making process can be enhanced by additional radiographic projections or by complementary examinations including DXA (Dual Energy X-ray Absorptiometry) morphometry, bone scan, CT, or MRI. The importance of imaging is highlighted by the fact that only about one in four vertebral fractures is recognized on the basis of clinical evaluations without radiographs. Radiographs may include lateral and AP (anterior/posterior) X-rays of the affected spinal segments. The physician may request bone scan and/or CT to help identify the location of the fracture, its status (stable versus unstable). Furthermore, an MRI scan may be performed if neurologic deficit, soft tissue trauma or hematoma are suspected.
Back Pain ; Hematoma ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Osteoporosis ; Osteoporotic Fractures ; Spine

OBJECTIVES: The aim of this study was to evaluate the appropriate position of the forearm for measuring the BMD (Bone Mineral Density). MATERIAL & METHODS: CT scanning was performed in 21 men to determine the appropriate position for the forearm. Twenty one healthy volunteers who were without any history of operations, anomalies or trauma were enrolled. CT scanning was used to evaluate the cross sectional structures and the rotation angle on the horizontal plane of the distal radius. The rotation angle was measured by the m-view program on the PACS monitor. The DXA was used for measuring 20 dried radii of cadaveric specimens in pronation and supination with 3degrees, 5degrees, 7degrees and 10degrees of rotation respectively, including a neutral position (0degrees) to evaluate the changes of BMD according to the rotation. RESULTS: The mean rotation angle of the distal radius on the CT scan was 7degrees of supination (76%, n=16), 3.3degrees of pronation (15%, n=3), and 0degrees at the neutral position (9%, n=2), respectively. The total average rotation angle in the 21 people was 5.2degrees of supination. In the cadaveric study, the BMD of the distal radius was different according to the rotational angles. The lowest BMD was obtained in 1.4degrees of pronation. CONCLUSION: In the case of the measuring of the BMD in the forearm in a neutral position, the rotational angle of the distal radius is close to supination. Therefore, pronation is needed for the constant measurement of BMD in the forearm. We recommend measuring the lowest BMD of the distal radius at about five degrees of pronation.
Cadaver ; Forearm ; Humans ; Male ; Organothiophosphorus Compounds ; Pronation ; Radius ; Supination

Henoch-Schonlein purpura (HSP) is a small-vessel vasculitis that are predominantly observed in children, affecting their skin, joints, gut and kidneys. The renal prognosis of HS nephritis is known to be worse in adults than in children. It is defined by tissue deposition of IgA. In most HSP patients, serum complement levels are usually normal. However, some authors reported abnormalities of serum complement levels in children-onset HSP. The authors report here a rare adult-onset case of HSP combined with post-infectious glomerulonephritis, especially hypocomplementemia and subepithelial 'hump'- like electron dense deposits.
Adult ; Child ; Complement System Proteins ; Electrons ; Glomerulonephritis ; Humans ; Immunoglobulin A ; Joints ; Kidney ; Nephritis ; Prognosis ; Purpura ; Purpura, Schoenlein-Henoch ; Skin ; Vasculitis

To investigate potential health risks associated with exposure to metals from an abandoned metal mine, the authors studied people living near an abandoned mine (n=102) and control groups (n=149). Levels of cadmium, copper, arsenic, lead, and zinc were measured in the air, soil, drinking water, and agricultural products. To assess individual exposure, biomarkers of each metal in blood and urine were measured. beta2-microglobulin, alpha1-microglobulin, and N-acetyl-beta-glucosaminidase and bone mineral density were measured. Surface soil in the study area showed 2-10 times higher levels of metals compared to that of the control area. Metal concentrations in the groundwater and air did not show any notable differences between groups. Mean concentrations of cadmium and copper in rice and barley from the study area were significantly higher than those of the control area (p<0.05). Geometric means of blood and urine cadmium in the study area were 2.9 microgram/L and 1.5 microgram/g Cr, respectively, significantly higher than those in the control area (p<0.05). There were no differences in the levels of urinary markers of early kidney dysfunction and bone mineral density. The authors conclude that the residents near the abandoned mine were exposed to higher levels of metals through various routes.
Aged ; Cadmium/*blood/*urine ; Copper/blood/urine ; Environmental Exposure ; *Environmental Monitoring ; Female ; *Food Contamination ; Hordeum ; Humans ; Korea ; Lead/blood/urine ; Male ; Middle Aged ; *Mining ; Oryza sativa ; Risk Factors ; Soil Pollutants/analysis ; Water Pollutants, Chemical/analysis ; Zinc/blood/urine

Positron emission tomography/computed tomography (PET/CT) is valuable for the diagnosis of malignancies. However, PET/CT is unable to discriminate exactly between inflammation and a neoplasm. We report a case of a 50-year-old man with pulmonary paragonimiasis that was suspicious for lung cancer, as detected by PET/CT. The use of PET/CT revealed multilobulated consolidation on the right lung and patchy consolidation on the left lung, with increased fluorodeoxyglucose (FDG) uptake. In addition, the left paraaortic lymph node (LN) and peripancreatic LN showed enlargement with increased FDG uptake. Lung cancer with multiple lymph node metastases was suspected from the increased standardized uptake values (SUV >4.5) determined by PET/CT. We performed wedge resection via video-assisted thoracic surgery (VATS) and found Paragonimus westermani eggs in the involved tissues.
Diagnosis ; Eggs ; Electrons ; Humans ; Inflammation ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Ovum ; Paragonimiasis* ; Paragonimus westermani ; Positron-Emission Tomography and Computed Tomography* ; Thoracic Surgery, Video-Assisted

Positron emission tomography/computed tomography (PET/CT) is valuable for the diagnosis of malignancies. However, PET/CT is unable to discriminate exactly between inflammation and a neoplasm. We report a case of a 50-year-old man with pulmonary paragonimiasis that was suspicious for lung cancer, as detected by PET/CT. The use of PET/CT revealed multilobulated consolidation on the right lung and patchy consolidation on the left lung, with increased fluorodeoxyglucose (FDG) uptake. In addition, the left paraaortic lymph node (LN) and peripancreatic LN showed enlargement with increased FDG uptake. Lung cancer with multiple lymph node metastases was suspected from the increased standardized uptake values (SUV >4.5) determined by PET/CT. We performed wedge resection via video-assisted thoracic surgery (VATS) and found Paragonimus westermani eggs in the involved tissues.
Diagnosis ; Eggs ; Electrons ; Humans ; Inflammation ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Ovum ; Paragonimiasis* ; Paragonimus westermani ; Positron-Emission Tomography and Computed Tomography* ; Thoracic Surgery, Video-Assisted

Epithelioid sarcoma is a rare tumor which is usually presented with a nontender nodule on a distal extremity. It is sometimes confused with granulomatous process or chronic inflammation. We report of a case of epithelioid sarcoma on a foot of an adult male, which progressed rapidly.
Adult ; Extremities ; Foot* ; Humans ; Inflammation ; Male ; Sarcoma*